Do you have abnormal findings on MRI scans of the lumbar spine?
Please don’t panic.
On MRI examination of the lumbar spine, many people without back pain have disk bulges or protrusions … the discovery by MRI of bulges or protrusions in people with low back pain may frequently be coincidental.The New England Journal Medicine
- At M.E. Holistic Care, we believe in viewing the human body as a whole, and also connecting this person to his/her natural and social environment.
- Low back pain can be due to disk bulges or protrusions, but also can be coincidental.
- The lumbar muscle strength, flexibility and muscular tension can cause low back pain.
- Poor circulation and chronic inflammation can also contribute to low back pain.
- Long term chronic low back ache/weakness in an elderly person may due to Kidney Deficiency according to Chinese Medicine theory.
- In some cases, people who have severe low back pain accompanied with radiating nerve pain may end up needing to have surgery to solve the problem. We will review the situation in time and refer people to appropriate health practitioners without any delay.
METHODS: We performed MRI examinations on 98 asymptomatic people. The scans were read independently by two neuroradiologists who did not know the clinical status of the subjects. To reduce the possibility of bias in interpreting the studies, abnormal MRI scans from 27 people with back pain were mixed randomly with the scans from the asymptomatic people. We used the following standardized terms to classify the five intervertebral disks in the lumbosacral spine: normal, bulge (circumferential symmetric extension of the disk beyond the interspace), protrusion (focal or asymmetric extension of the disk beyond the interspace), and extrusion (more extreme extension of the disk beyond the interspace). Nonintervertebral disk abnormalities, such as facet arthropathy, were also documented.
RESULTS: Thirty-six percent of the 98 asymptomatic subjects had normal disks at all levels. With the results of the two readings averaged, 52 percent of the subjects had a bulge at at least one level, 27 percent had a protrusion, and 1 percent had an extrusion. Thirty-eight percent had an abnormality of more than one intervertebral disk. The prevalence of bulges, but not of protrusions, increased with age. The most common nonintervertebral disk abnormalities were Schmorl’s nodes (herniation of the disk into the vertebral-body end plate), found in 19 percent of the subjects; annular defects (disruption of the outer fibrous ring of the disk), in 14 percent; and facet arthropathy (degenerative disease of the posterior articular processes of the vertebrae), in 8 percent. The findings were similar in men and women.
CONCLUSIONS: On MRI examination of the lumbar spine, many people without back pain have disk bulges or protrusions but not extrusions. Given the high prevalence of these findings and of back pain, the discovery by MRI of bulges or protrusions in people with low back pain may frequently be coincidental.
—— N Engl J Med. 1994 Jul 14;331(2):69-73. Magnetic resonance imaging of the lumbar spine in people without back pain. Jensen MC, etc.