Do I need a scan?

A question we often get asked by our patients in physiotherapy is whether they need a scan to tell us what’s wrong. Perhaps surprisingly, in the vast majority of cases the answer is no!

Unfortunately, over the past 20 years, the medical profession has become accustomed to relying on various imaging techniques such as ultrasound, X-ray, CT and MRI to diagnose common causes of musculoskeletal pain. However, the more we have studied the results of these scans, the more we have come to realise that many of the “abnormal” findings identified on scans are in fact commonly present in the pain-free general population too.

Let’s look at lower backs for example. A study conducted in 2014 looking at MRI results for people without any back pain found that once we’re in our 30s, 52% of us will have signs of disc degeneration. On reaching our 40s, 50% of us have a disc bulge and in our 60s, 50% of us have wear & tear of the joints.

If we look at shoulders, there’s a similar story. Findings on ultrasound such as tendon scan 2 tears and bursitis are often held up as diagnosis and cause of someone’s pain. In one study however, 96% of people without any shoulder symptoms were found to have these “abnormalities”, as well as many others, on imaging.

How can this be the case? We know that the human body is very adaptable and it seems in a proportion of the population, the body learns to cope with tissue changes. We also know that pain is a lot more complex than simply being linked to a specific defective structure. Factors such as how well we sleep, our levels of stress and anxiety, how well hydrated we are, our home and work situation as well as many more, can all have a significant effect. A study looking at tennis elbow for example found that people’s satisfaction at work was a far more important predictor of prognosis than the condition of their tendons on ultrasound.

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A visit to our skilled team here at Ellenbrook Physiotherapy will help you to identify what factors may be contributing to your personal pain experience and what strategies would be most beneficial in order to address these and reach your goals and desired outcomes as soon as possible, whilst giving you expert guidance on whether or not a scan is required.



Andrew Leggett


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