How many of you get an MRI report and read it and think….” Oh my, this is bad. Am I bound for surgery”? I bet a lot of you have heard or read a report and thought just this. A randomized controlled study done in 2021 revealed some pretty interesting findings. The study took 44 patients with low back pain and performed MRIs on each of those subjects. One group was told their MRI was normal and there were no significant findings. The other group had their MRI’s explained in detail with consistent typical terminologies used (ie, degenerative disc disease, lumbar stenosis, severe, mild disc degeneration, etc). The group that had their MRIs explained in detail had significantly less functional status reporting, more pain perceived, and less improvement in low back pain, whereas the group with perceived normal MRI had improved functional status, less pain, and less aggressive interventions like surgery. The study concluded that Routine MRI reports produce a negative perception and poor functional outcomes in low back pain.

You heard that right. The group with a positive perception and less detail from MRI had better outcomes and had surgery significantly less! The truth of the matter is, positive perception and outlook go a long way in patient outcomes. That is precisely why treating patients with positivity and encouragement is important, not just to their active outcomes to get better, but also to improve mental well-being.

Something that really chaps my butt is when a patient comes into my office with low back pain, and they are crying actual tears….” I was told I have degenerative disc disease”. It is frustrating to me because the patient hears two words there…degenerative and disease. And I don’t blame the patient for being upset and worried. The fact is, degenerative disc disease is a fancy way of saying your discs and the spacing between your vertebrae are aging. Like everyone else in this world, our spines are aging. Some more than others due to a number of factors, but all of us, from the time we are 25 onward, are experiencing degenerative changes of the spine where discs wear and spacing narrows. In fact, studies show that over 70% of the population walks around with disc bulges and protrusions. They just don’t know it until the nerve tissue coming out of the spine is impacted by stress or compression. And yes, we can slow down the progression of degeneration through exercise, improved flexibility, and conservative treatment like physical therapy, chiropractic care, and massage therapy.

Who says discs can’t heal??? Studies since 2015 have shown that in 96% of disc herniations, there is spontaneous regression. This means that the disc herniation becomes smaller and regresses back to a more optimal position. This doesn’t happen overnight, but discs have the ability to recover and heal on their own in most cases, and conservative treatment can speed up the process of healing if done properly.  Rehab should consist of controlling pain first, improving ROM, and then building strength and stability around the spine to prevent re-injury. It is estimated that 60-90% of disc herniations can be treated successfully with conservative treatment that does not include surgical interventions. This means that you should start with conservative measures of treatment. Surgery is not always the best option, and it definitely shouldn’t be your first option.

At the end of the day, we must all recognize that positive outlooks on our health are vital to recovery from injury and pathology. It is hard sometimes to look positively at a “bad MRI” or to view something positively when it produces negative results, like pain, stiffness, and decreased functional status. But understand that there are things you can do to improve your condition, and it doesn’t always have to include significant, aggressive, life-changing interventions to improve. Think positively that you will make it through and that the body is an amazing temple that has the ability to recover naturally, even as we age.

I pray that our community learns more about our bodies and overall health. God has blessed us with one physical body; we must care for it, nurture it, and protect it with a positive mindset and outlook.

To your health

-Dr. Emilio Galis