Can You Tell Me Where Your Low Back Pain is Coming From?

Where is your low back pain (LBP) coming from?  This is an MRI of a 56 year old male with LBP.   Many patients come to me with spine pain and the first this that they tell me is ..... "well I have degenerative disc disease", " I have a herniated disc", "I have a bulging disc", etc.  Usually I come back and say " Well, I have a bulging disc at L5-S1 too and I don't have low back pain."  Their facial expression is usually disturbed and surprised!  This is what my lumbar spine looks like and what a normal spine should look like (as compared to the first picture).

For those that do not know what we are looking at this is an MRI image of a lumbar spine.  The last disc before the sacrum starts is L5-S1 and this is the most common area of LBP.  To the left is the front of the body and the right is the back.  You can see that my L5-S1 does not look the same as the other discs above it and it is not as bright.  So some degeneration is going on there, but it doesn't mean that you have to experience pain.  This may be normal degenertion that occurs from stress to the spine, weightllifting, and from playing sports.  I usually tell my patients that you can take 10 people with LBP, put them in an MRI machine, and their MRI will have positive findings, such as a herniated disc, degenerative disc disease, modic signs, osteoarthritis, etc.  You can then take 10 people WITHOUT LBP, put them in an MRI machine, and their MRI will have the same positive findings!  Research has shown ( from a highly respectable journal and from a high quality study) that these abnormalities seen in MRIs do not strongly correlate the underlying pathology and cause of your LBP.  This means that there are false positives with MRI and with most LBP, you may not need an MRI right away.  This is when you can get started with physical therapy and treatment right away!  Why do you need to see a physician with complaints of LBP and get diagnosed with LBP, and then get referred to a specialist?  Research has shown the cost effectiveness, improved outcomes, and more efficient treatment with the early treatment of LBP with physical therapy services.

In Florida, you have direct access to physical therapy so you can begin you treatment early and there is no need to wait for weeks to begin treatment.  If you do not respond to physical therapy or if you present with red flags, then you can be referred to a spine specialist for more diagnostic testing and possibly warranting an MRI.  Contact Pursuit Physical Therapy today for your LBP and start treatment now!  407-494-8835 or www.pursuittherapy.com.  We also have a Patient Perspective page for information for patients regarding LBP and physical therapy.  Feel free to consult with us regarding your LBP and what is the best treatment for you!  Remember just because you have a herniated disc or a positive MRI finding doesn't mean you have to have LBP.  Even this person was asymptomatic and did not have LBP!  Look how far the spine has slipped forward in the picture below!