NO KNEE PAIN BUT AN MRI SHOWS OTHERWISE

WHAT HAPPENS WHEN MY MRI IS INCONCLUSIVE

Did you ever notice a kid who falls but then only starts to cry AFTER they see blood? Or there is a long delay between the fall and the perception that there might be something wrong because bleeding doesn’t usually mean anything good.

As a PT, I’ve had patients that come in with moderate pain but when they show me their MRI reports I scratch my head wondering how they walked in and are moving around and not in need of a wheelchair.

THE PERCEPTION OF PAIN

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The perception of pain is an interesting concept and there is an entire medical specialty dedicated to it: PAIN MANAGEMENT. It often includes prescribing heavy-duty drugs which have contributed to the huge opioid crisis in this country, leaving so many people far worse off, addicted, needing rehab, and with so many more physical problems than their initial need for pain control.

This brings me to this recent (February 2020) research paper by Skeletal Radiology. Before we are 50, pathologies settle into our bones and joints, and ligaments due to the aging process. Add in traumas like falls, accidents, surgeries, scars, and the process of degeneration of tissue speeds up. If you are in your 40’s or 50’s you know that healing isn’t the same as when you were younger. In fact, I was shocked to learn that the spine begins to degenerate around the age of 25 years old but that’s for another conversation.

MRI OF THE KNEES

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So, what about this knee research? Taking sedentary male and female individuals through an MRI to assess their knees showed a whopping 97% of them all had some type of pathological change! Don’t be like that kid now who sees blood and begins to cry because you all of a sudden know the truth!

The patients in the study had NO PAIN yet their scans showed:

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meniscal tears, in fact, 48% of them had some type of meniscal degeneration
46% had tendon abnormalities of which some were even high-grade tendonitis
38% had ligament damage and some even had partial ruptures of their ACL!

WHAT TO DO WITH YOUR MRI RESULTS

What is the conclusion then? The researchers pose this: “The study questions clinical decision-making regarding arthros-

copy and its efficacy in reducing symptoms and treatment. The high rate of asymptomatic adults with knee joint abnormalities on MRI may indicate why arthroscopy and other surgical interventions for these do not result in better outcomes than sham surgery.” 😯

Have you had knee surgery and your pain didn’t go away? Comment below. Would love to hear your answers!