Disc degeneration in low back pain: a 17-year follow-up study using magnetic resonance imaging.

Spine (Phila Pa 1976). 2007 Mar 15;32(6):681-4.

Disc degeneration in low back pain: a 17-year follow-up study using magnetic resonance imaging.

Waris E¹, Eskelin M, Hermunen H, Kiviluoto O, Paajanen H.

This study, which began in 1987 is yet another indicator of the difficulty of using MRI (unarguably the most sophisticated imaging process available) to predict future pain or LBP disability. As has been noted in at least a dozen “follow-up” studies over the last 25 years very few findings are associated with actual patient outcome i.e. disability, future medical costs, future pain or severity of future pain. What is interesting is that early findings of degenerative disc  “disease” is generally indicative of progression of degeneration (in this case over the next 17 years) however those changes were not able to predict future pain and in fact were not directly associated with pain, severity of pain or disability. It is immensely tempting to want to MRI everyone and, as patients tend to believe; “find out what’s really going on”. The trouble is knowing what’s going on hardly ever tells us what’s actually going on…and that’s doubly frustrating due to the fact 80% of the population with the same findings are not in pain.