Communication with patient regarding Lumbar spine MRI

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The role of MRI in spine pain is controversial. However, it is certainly appropriate in case of red flags. We should only request MRI, if it is likely to shape the management strategies. We also have to be realistic. Sometimes MRI will be used appropriately or inappropriately by clinicians. 

I recognise that different clinicians have different approach.Certainly it’s not one size fits all in terms of communication approach. I feel this is an opportunity to promote a health literacy and engage patients positively as part of a shared journey.

What should you say when u look MRI of different labe

NORMAL SCAN

 There is no specific evidence of damage or injury On MRI. You do not have a bad back. MRI  is not a pain scan. Your pain comes from either a facial,  muscles or ligaments structure. We cannot see a muscles pain on an MRI. They are just irritated due to a structural problem.

A normal scan demonstrates that your pain over the years has not represented cumulative humps or damage.

• Normal age related changes on MRI 

 In most of the case (40-50% )of people, have a disc bulging on MRI? But It is common and nothing to concern about It. Your back is stable With support we help you to move towards a better life.

• Disc herniation & Bulge

The MRI confirms a bulge at different level. However, bulge likely happens over period of time. The disk is not weak and vulnerable to slip. It is just a irritate next to nerve.

• Lumbar spine stenosis

Over the period of time these have caused some narrowing of the foramen. Due to narrowing you get a pinch type of pain in the leg While walking and in certain position. You may also get  lean back position. It is safe to do exercise, however we need to be clever during the functional activity as well as the exercise program.

Patient says. Does the bulge go away?? Does surgery required??

Sometimes big bulges. Shrivel up, but that is not necessary for your pain to go away. In most case, it will settle without removing the disk. The nerve is rarely damaged. However, we will keep a close eye on your pain. Repeated skin does not gives you to relieve pain and improved function.

Patient ask will injection help to relieve my pain?

Injection do not work to relieve pain in lumbar stenosis. However, certain exercise and strengthening can improve your pain and endurance. Our aim is to tailor made exercise and monitor your pain and function.

In summary, Every patients is a different book. Give a realistic perspective when patient ask about MRI report.