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Dr. Arnan Sisson, PT/ August 18, 2022
This is Dr. Sisson here to tell you that you don’t need an MRI to know exactly what’s going on or why you are in pain.
It might seem like the easy way to find that one thing that is to blame for your pain.
I mean, if you have a tumor or a fracture, those are important things to know, and that an MRI can tell you. But, if you’re concerned that you have disc degeneration, arthritis, a labral tear, it is not as simple as getting an MRI because pain is very complex. I’ve learned this over the course of years, but also research shows that pain is more complex than we give it credit for.
It’s not as simple as taking a pill, especially if you’ve been struggling for weeks, months, or years.
Maybe it is time to think differently about what’s going on with your body. Because there is no magic pill, or magic surgery, or magic picture of your body that is going to tell you exactly what’s going on and is going to fix this forever.
Yes, sometimes surgery is absolutely appropriate. It is not ALWAYS appropriate. Sometimes, your brain gives your body the pain signal when it feels unsafe, or when it is guarding to prevent you from tearing something. You might not have any tissue damage, but the pain signal is still being sent.
So how do you know if you have torn something? By seeing a movement expert. My hands and clinical reasoning skills can tell if you’ve torn something or not. I do this by watching you sit, stand, walk, and by listening to you when you tell me what’s going on. I’ll know exactly what’s going on. Because I have experience and I have time to listen and investigate.
What most providers don’t have right now is time. Many medical providers do not have enough time. They are lucky if they get 15 minutes to spend with you. It may not even be their fault, and because they do not have time to figure it out, they may say, “Go get an image. And the image will tell us.”
Once that happens, we’ve got this image, picture, MRI. Now we’ve got something to blame. So most providers think, “let’s throw modalities at it”. Injections, medications, or even try to fix it with surgery.
I can tell you this: surgery isn’t going to fix why you hurt.
It might fix something on the inside that seems abnormal, but it doesn’t always fix the pain. That’s why people are coming to us six months, six years, or even a decade after their surgery. And they still have pain.
That’s why the research keeps showing that surgery for back pain is no better than a sugar pill. You don’t need that. The problem is when you get an MRI, you’re more likely to get surgery or injections, and you’ll spend $5,000 or more. That’s a research statistic. When you see a PT first, your cost of getting this problem resolved is a lot lower, with less risk, and in less time.
And your potential side effects of physical therapy are almost none. You might feel sore. You might be a little irritated. Your body might hurt a little bit more temporarily, or it might feel a whole lot better. But, with medications, you can have a bleeding ulcer, even with Tylenol or Advil. You can get a hospital borne infection.
You could also lose feeling, or even die from surgery. I mean, those are all negative side effects that we hear people report all of the time. So, we’re not going to focus on that. I want to talk about all the positive things. Things like how your body is strong and capable. Your spine is resilient. It’s supposed to move. Your knees are supposed to move. Arthritis is not the end of the world. You might’ve been told, “you’re bone on bone”, or, “you’ve got the worst arthritis I’ve ever seen”, or, “you should never do ______ again, lift 35 pounds again, because it might damage something”, or, “ you’ve got a pinched nerve”.
When someone says “a pinched nerve”, there isn’t anything actually pinching it.
On the image, the nerve just looks like it’s being compressed, and you might have pain because of it, or because of something else that is unrelated. And we’ve seen hundreds of patients who are being diagnosed with one of these pinched nerves, but the pain isn’t congruent with where that would be if I looked at the image.
So, let me get back to the MRI. The MRI is supposed to show you everything. When you get the results, the radiologist who doesn’t have to have seen you in person, and who probably has not talked to you or heard your story, is just going through this picture and going through hundreds of pictures a day and just listing all the things that are off normal from the textbook. But, what’s really happening is that the majority of these findings on the MRI are normal, age-related changes.
The worst problem is right now, the way medicine is set up, is as a patient, you’re getting the results of your tests, and not just MRIs, but of your blood level tests, and other tests. And then you’re getting those tests delivered to you via MyChart, or the internet before your provider even has a chance to sit down with you to help you interpret it.
And you see all these really scary terms, and go Google them and get freaked out. Then you go and ask friends and they say, “Oh yeah, the herniated disc runs in the family. The pain was so bad. I could never exercise again.” Now we’re not exercising, and we’re not strong.
As a society, we’re gaining weight and obese. And now, we’re more susceptible to other diseases, infections, and viruses. I mean, how can we be healthy if we can’t work out, and walk, and go to the gym, and it hurts to get off the couch? It’s like this downward spiral, and the results on the MRI do not tell the whole picture. People have gone through studies to get MRIs without any pain or symptoms. And they’ll still have a full list of findings or “things wrong” on the MRI.
So I want you to understand that you are not your MRI results. If you really want to know what’s going on, you need to speak with someone who is an expert in pain, injuries, and recovery, as well as can look at your whole body. It’s called a Discovery Visit.
A Discovery Visit is where we take a look at your whole body and how it moves.
Because, where your body hurts may not be where the problem is. You can have shoulder pain, but it’s because your mid back doesn’t move well. Or, you might have hip pain, but just because your ankle’s not moving well. One story we hear too much is people go in and you say, “Hey, doctor, my hip hurts.” And they say, “Oh, that’s bursitis. Let’s do an injection.” And then it doesn’t work, so let’s do an MRI.
Then, they see that you’ve got a torn labrum. They tell you to do some surgery to fix your labrum. This whole time, you’ve never been to PT or you’ve never been to multiple PTs. You’re going down the wrong path, but it’s not your fault. Because that’s the path that is the path of least resistance for the way the medical system is being incentivized right now.
What you need to do is stop and think, ”Am I scared about my test results? Okay. I need to speak to someone who has time to sit down with me, hear my story and explain what’s happening, and even possibly offer me an alternate understanding of what’s going on.” Because if you’ve been struggling for years because of a herniated disc, herniated discs heal. They heal just like a cut or a scab.
So, if it has been weeks and you’re healed, and if you’re still thinking, I’ve got a herniated disc, I can’t do X, Y, and Z, then you need to be seeing someone else. Someone who can tell you WHY you still hurt, and empower you to move.
The way we do it here, is by taking all of our patients through a Discovery Visit. It’s 20 minutes of your time where we sit and chat with you about what’s going on. We discuss your goals, where the problem is, how long it’s been there.
We look through your whole body. We find out where you hurt. We replicate or improve your symptoms.
Now I know we can help you. Then we know exactly where the problem is, and you’ll know exactly what you can do to fix it. You’ll know all of this without going and spending weeks waiting for an MRI, getting the results and getting freaked out, and without going into the hospital right now where other people are, and risking getting sick with COVID, the flu, or other hospital borne infections.
Why risk that unnecessarily, when we know what’s going on and we can start helping you resolve the problem right away, instead of waiting two weeks to get your result? And then, add another two weeks to see if a treatment works, and then maybe see if it goes away on its own. If the pain does go away, it doesn’t mean the problem’s gone. That just means your pain has changed.
If you want to know what is the cause of your pain without wasting time waiting on imaging, click here to apply for one of our Discovery visits, so we can help you resolve your problem and reach your goals!