Normal vs pathological disc changes

Normal vs pathological intervertebral disc changes

In this section we will try to remove some myths about spinal degeneration and what is considered normal and abnormal in regards to the spine. MRI scans and CT scans are the best way to image and visualise the spine for degeneration. When you see the word normal on MRI and CT scan reports, this means the disc does not have any changes related to a disease, trauma or even normal ageing. No changes, period. The disc looks like a million bucks. In anyone over 25 years of age, this is not typical. We will all age, we will all get wrinkles on the skin, and we will all get some signs on ageing in the spine and the intervertebral discs.

When a chiropractor, physiotherapist or medical practitioner says your spine is normal, this means you are asymptomatic, not perfect on image (MRI, CT scan, X-Ray). However, even though you are pain-free and have great function of your spine it is likely that on images of your spine (MRI, CT scan) you may have a variety of harmless “abnormal” findings such as congenital or developmental variations in the shape of your discs, disc bulging, age related dryness, bone spurs and disc herniations. We will all likely get some or all of these changes as we age. Because we all have these, they are considered ‘normal’ in every respect (except on a scan report). The line must be drawn to limit confusion however. So for consistency a truly “normal” spine on image would have no changes what so ever. But who cares? Your chiropractor or physiotherapist at Sydney Spine & Sports Centre (S3C) will assess and treat your spine in regards to your specific situation, age and spinal function. We will look at all image findings but we will not make assumptions based only on image findings as they may have no significance at all, besides the fact that you have been on this planet for a period of time (you’re getting old). If our chiropractors or physiotherapist find issues with your spine we will treat them and fix them. If they find nothing and your spine is functioning perfectly then we will not treat “abnormalities” on an image that everyone has anyway.

A radiologist (medical doctor who reads x-rays) will report on every possible thing when it comes to reading an image (CT, MRI). Therefore degenerative disc terms will be used for any changes regardless of whether they are from normal ageing or pathological processes (diseases). It is then up to the chiropractor, physiotherapist or medical doctor to explain that some wear and tear (degeneration) is likely in all of us. This is extremely important, too often are patients scared by their healthcare providers because an X-ray, CT scan or MRI has shown something that 90% of people have anyway.

Read some of the other articles written by our Sydney chiropractors