How many times have you gone into the physician's office with an injury or pain wanting to know exactly what the problem is? As a PT I often hear, “Why couldn’t I just have an MRI?” or “I’d feel better if I knew exactly what was going on in there.” There are usually two common reasons. The first being insurance. There are times when an MRI is warranted right from the beginning but insurance will not reimburse for it until you’ve had alternative treatments. This reason, feeds into the next reason. There are numerous high level studies (double blinded, randomized control trials) that show both the trial group and the placebo group have something pathological on their MRI. Or in other words, the first group of people HAD pain, the second group DID NOT HAVE pain and yet both had something “abnormal” show up. This tells us that what you find on an MRI is not always indicative of your source of pain. Pain can come from many things other than what is shown on an MRI including abnormal biomechanics, poor posture, lack of mobility, even social/emotional causes like stress and mental health. Which is why patients are often referred to physical therapy in the first place. A physical therapist is an expert on evaluating and treating movement dysfunction. Finding the cause of the problem can be far more helpful that naming exactly what structure is the problem. As a result, there are many times that there is no longer a need for an MRI after going through a course of therapy.
Of course, there are times when physical therapy does not help. In many cases, going through a course of therapy is not time wasted as patients will have had education on their injury, home exercises to work on, possibly more strength/range of motion/balance, etc than they started with. In a case where physical therapy is not helping, there is always the option to refer you back to the physician to reassess the plan of care-possibly an MRI, or possibly other methods as well (injections, pain management, etc).
For more information or to schedule an appointment please call the office at 301-694-8311 or visit our website at www.mmidocs.com. We look forward to helping you live your best life.