Degeneration – Pathology or normal part of being human?

30 Apr Degeneration – Pathology or normal part of being human?

Have you ever had an X-Ray, CT Scan, or MRI and tried to read the report that accompanies it? It’s not a fun read – full of technical jargon and overwhelming language – they tend to feel like a science textbook. But if you did persevere, you may have seen words like “degeneration” and wondered what exactly that means.  

In fact, we often have people come into the clinic who are quite concerned that they have seen something “not so good” on a clinical report.  They want to know what is going on, and how it will impact them in the future.

Believe it or not, most people will have something show up on a radiological report – and it’s not necessarily a “bad” thing!

Our wonderful Leona, is here to help set the record straight:

They say a picture is worth a thousand words, but in this case I think it’s a table that’s doing all the talking!  

The below table has been adapted from an important systematic review of MRI findings in an asymptomatic population of 3,110 people (asymptomatic means that these people had NO pain or symptoms of any kind).  

As you can see, there is a significant percentage of the population who showed up as having “degeneration” or other anatomical changes.  But these people had NO symptoms!

What does this mean?

Firstly, radiological evidence of anatomical change does not correlate to symptoms.  Secondly, age-related changes are normal, and not necessarily indicative of pain and suffering to come.   

While the above table is related to changes in lower back anatomy only, similar findings have also been recorded for the shoulder (Needell et al., 1996), hip (Frank et al., 2015; Register et al., 2012), knee (Guermazi et al., 2012), and neck (Siivola et al., 2002).

What do we recommend?

If you are experiencing symptoms of any kind, come and see us.  We can gain a clinical understanding of what is happening for you – based on not only your radiological reports, but also your presentation, history, and in-depth testing specific to your unique symptoms.  Better yet, we can help you to reduce your symptoms and prevent future issues.

References

Brinjikji, W., Luetmer, P. H., Comstock, B., Bresnahan, B. W., Chen, L. E., Deyo, R. A., … & Wald, J. T. (2015). Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. American Journal of Neuroradiology, 36(4), 811-816.

Frank, J. M., Harris, J. D., Erickson, B. J., Slikker III, W., Bush-Joseph, C. A., Salata, M. J., & Nho, S. J. (2015). Prevalence of femoroacetabular impingement imaging findings in asymptomatic volunteers: a systematic review. Arthroscopy: The Journal of Arthroscopic & Related Surgery, 31(6), 1199-1204.

Guermazi, A., Niu, J., Hayashi, D., Roemer, F. W., Englund, M., Neogi, T., … & Felson, D. T. (2012). Prevalence of abnormalities in knees detected by MRI in adults without knee osteoarthritis: population based observational study (Framingham Osteoarthritis Study). Bmj, 345, e5339.

Needell, S. D., Zlatkin, M. B., Sher, J. S., Murphy, B. J., & Uribe, J. W. (1996). MR imaging of the rotator cuff: peritendinous and bone abnormalities in an asymptomatic population. AJR. American journal of roentgenology, 166(4), 863-867.

Register, B., Pennock, A. T., Ho, C. P., Strickland, C. D., Lawand, A., & Philippon, M. J. (2012). Prevalence of abnormal hip findings in asymptomatic participants: a prospective, blinded study. The American journal of sports medicine, 40(12), 2720-2724.

Siivola, S. M., Levoska, S., Tervonen, O., Ilkko, E., Vanharanta, H., & Keinänen-Kiukaanniemi, S. (2002). MRI changes of cervical spine in asymptomatic and symptomatic young adults. European Spine Journal, 11(4), 358-363.