Do MRIs correlate with symptomatic low back pain?

Introduction

Low back pain (LBP) is a prevalent condition that affects a significant portion of the population. Magnetic Resonance Imaging (MRI) is commonly used to diagnose the underlying causes of LBP. However, the correlation between MRI findings and symptomatic low back pain remains a topic of debate in the medical community.

Key Insights

Higher Prevalence of Certain MRI Findings in Symptomatic Individuals:
- Disc bulge, disc degeneration, disc extrusion, disc protrusion, Modic 1 changes, and spondylolysis are more prevalent in symptomatic individuals compared to asymptomatic controls .
Limited Clinical Importance of Some MRI Findings:
- Disc height narrowing and annular tears are associated with low back pain, but their sensitivities are poor, making them of limited clinical importance .
No Strong Predictive Value of MRI for Future LBP:
- MRI findings do not predict the development or duration of low back pain in asymptomatic individuals over a long-term follow-up .
Lack of Correlation with Pain Intensity and Quality of Life:
- Combined MRI changes do not correlate with pain intensity, depressive and anxiety symptoms, or quality of life in patients with low back pain .
Discography and MRI Correlation:
- Disc degeneration grades on MRI are associated with discographic grades, and the presence of high-intensity zones (HIZ) and endplate abnormalities might indicate discogenic pain.

Conclusion

The correlation between MRI findings and symptomatic low back pain is complex. While certain MRI findings such as disc bulge, degeneration, and extrusion are more prevalent in symptomatic individuals, their predictive value for future low back pain is limited. Additionally, MRI findings do not strongly correlate with pain intensity or quality of life. Therefore, while MRI can provide valuable insights, it should be used in conjunction with clinical evaluation for a comprehensive assessment of low back pain.

Do MRIs correlate with symptomatic low back pain?

Summary

Consensus Meter

Introduction

Key Insights

Conclusion

Sources and full results

MRI Findings of Disc Degeneration are More Prevalent in Adults with Low Back Pain than in Asymptomatic Controls: A Systematic Review and Meta-Analysis

MRI findings of disc degeneration are more prevalent in adults with low back pain than in asymptomatic controls.

Associations Between Back Pain History and Lumbar MRI Findings

Disc height narrowing and anular tears are significant MRI findings associated with lifetime low back pain, but their sensitivities are poor and their clinical importance is limited.

Longitudinal associations between incident lumbar spine MRI findings and chronic low back pain or radicular symptoms: retrospective analysis of data from the longitudinal assessment of imaging and disability of the back (LAIDBACK)

Incident lumbar MRI findings are associated with incident chronic low back pain, but the 3-year incidence of these findings is extremely low and does not explain most incident symptom cases.

No association between MRI changes in the lumbar spine and intensity of pain, quality of life, depressive and anxiety symptoms in patients with low back pain.

Combined MRI changes in the lumbar spine do not correlate with pain intensity, depressive and anxiety symptoms, or quality of life in patients with low back pain.

Correlation Between MR Imaging and Discography With Provocative Concordant Pain in Patients With Low Back Pain

MR imaging and discography are significantly correlated with concordant pain in patients with chronic low back pain.

Magnetic Resonance Study of Disc Degeneration in Young Low-Back Pain Patients

MRI is a safe and sensitive method for detecting disc degeneration in young low-back pain patients, with increased weight, positive straight leg raising tests, and reduced lumbar mobility increasing the frequency of the condition.

The Value of Magnetic Resonance Imaging of the Lumbar Spine to Predict Low-Back Pain in Asymptomatic Subjects: A Seven-Year Follow-up Study

Magnetic resonance imaging of the lumbar spine is not predictive of the development or duration of low-back pain in asymptomatic individuals.

The symptomatic lumbar disc in patients with low-back pain. Magnetic resonance imaging appearances in both a symptomatic and control population.

Magnetic resonance imaging accurately determines nuclear anatomy, but discography remains the only method for symptomatic assessment in low-back pain.

The added prognostic value of MRI findings for recovery in patients with low back pain in primary care: a 1-year follow-up cohort study

MRI findings do not add significant prognostic value to factors like age, attitude, and neurological symptoms in patients with low back pain in primary care.

Correlation of Pain With Objective Quantification of Magnetic Resonance Images in Older Adults With Chronic Low Back Pain

The objective parameter, MRI index, can potentially identify pain generators in patients with chronic low back pain.

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