PT TALK: Degeneration on My MRI?

While it is true that every person who comes into our clinic has a unique story, there is one commonality that we see month after month, year after year. 

Signs of degeneration in MRI results. 

For most who receive this diagnosis from their primary care provider, degeneration can feel like an impending doom looming over them. “When will I have surgery?” or “How long before I have trouble getting out of bed?” are concerns we hear all too often from patients in fear of their MRI findings. 

But what is degeneration exactly? What does it actually mean?

​Here we seek to shed more light on this subject, uncover the realities of this common diagnosis, and reset years of misleading language.

The medical definition of degeneration is at its most basic ‘the state and process of decline’. And contrary to popular belief, it is the natural changes that our tissues experience as we age. “A colleague of mine calls degenerative tissue 'the wrinkles on the inside”, says physical therapist Leah Versteegen. “That paints such a clear picture for many of my patients.”

There is research that indicates that certain muscle fibers begin their decline in our 30s, and other tissue decline begins in our 40s and 50s. In regards to surgery, degenerative changes that show up on your MRI certainly don't always require surgery. Just like wrinkles and saggy skin on the outside don't require surgery. 

“Research has shown us over and over again that there is very little relationship between degenerative changes on imaging and the pain you are experiencing”, says physical therapist Angela Listug-Vap. “Imaging is mostly used to rule out significant problems but it's very sensitive so it shows us all the changes of normal aging as well.”

​“...there is very little relationship between degenerative changes on imaging and the pain you are experiencing” 

So what is to be done? How can our healthcare system be better about educating our patients?

​“Good clinical reasoning has to be used by a skilled healthcare practitioner to match the clinical presentation with the results of your image”, says Listug-Vap. “Degeneration on an image may mean nothing at all”.

“We need to advocate for treating patients and their symptoms, not their MRIs.”

In short, We need to advocate for treating patients and their symptoms, not their MRIs. There is a certain level of human decency in not allowing patients to spiral into uncertainty after a diagnosis such as common degeneration, and we need to hold that to a higher standard. Healthcare professionals are not only responsible for the identification of conditions, but education about the condition as well. ​