LOW BACK:
-It is estimated that 40% of asymptomatic people have a “bulging disc” on MRI (38, 39).
-Disc “bulges” reabsorb in a matter weeks and months (40-44).
-In 40-year old asymptomatic males and females, between 25-50% will demonstrate disc degeneration and signs of injury, endplate changes, foraminal stenosis and facet joint degeneration on spinal imaging (45).
-Lumbar spine degeneration starts in a person’s early 20s and there is little correlation between arthritis and LBP in later life (45-48).
-In asymptomatic elite tennis players 33% had a spondylolisthesis when scanned, with several showcasing pars fractures, stress fractures, etc., yet no pain (39).
-Despite presenting with the same LBP, patients receive completely different MRI results when visiting different imaging centers and have different radiologists interpret the findings (49).
NECK:
-Among people with significant degeneration visible in their imaging, only 10% experience pain (50).
-90% of asymptomatic people undergoing cervical MRI scan have a “bulging” disc (including people in their early 20’s) (51).
-Demolition derby drivers crash over 1500 times during their career; averaging over 24 miles per hour, and yet almost all report no chronic whiplash-associated neck pain.
SHOULDER:
-One in three people over the age of 30 and two out of tree people over the age of 70 have abnormal MRI findings related to their shoulder including complete rotator cuff tears (53-55).
-After successful rotator cuff surgery and postoperative rehabilitation to regain full range of motion, strength and function, 90% of patients’ MRI reports reveal “abnormal findings” and 20% still have a complete rotator cuff tear (56).
KNEE:
-In asymptomatic individuals 25-50% of MRIs reveal significant “degenerative” changes, highlighting the poor correlation between knee osteoarthritis, pain and disability (57, 58).
-In active collegiate basketball players with no knee pain, 35% of the MRI scans show significant abnormalities (59).
-It is currently estimated that one in three knee replacements are unnecessary (60).
HIP:
-MRI of asymptomatic people show abnormalities in 73% of hips and labral tears in 69% of the asymptomatic group (61).
-Hip MRI studies show that femoroacetabular impingement and labral injuries are common in asymptomatic individuals (62).
-In hockey players with no hip pain, two out of three have scans that show significant degenerative changes (63).
Adapted from Louw's Pain Neuroscience Education 2nd Ed.