Don’t Panic Over Your Spine MRI: What the Findings Really Mean

Getting an MRI report that mentions a bulging disc, degenerative disc disease, or spinal arthritis can be alarming. But according to Ben Burch, MD, spine surgeon at Atlanta Spine Institute, the words on an MRI report don’t necessarily mean you need surgery—or that the findings are even responsible for your pain.

“A finding is not a diagnosis, and a scan is not a sentence,” Dr. Burch explains.

Abnormal MRI Findings Can Be Part of Normal Aging

Many changes seen on spine MRIs are surprisingly common, even among people who have no back pain. Dr. Burch points out that researchers have performed MRIs on thousands of pain-free people and found signs of disc degeneration in more than a third of people as young as 21. By age 80, these changes are present in almost everyone.

In many cases, degenerative changes in the spine can be thought of much like gray hair—they are signs of aging, but they do not automatically mean something is seriously wrong.

That is why Dr. Burch emphasizes the importance of treating the patient rather than simply treating an MRI.

“If your scan doesn’t match your symptoms and your physical exam, it’s just a picture,” he says.

Most Back Pain Does Not Require Surgery

Even though Dr. Burch is a spine surgeon, he stresses that most back pain never requires an operation. The decision to recommend treatment should be based on how a patient feels, the physical examination, symptoms, and whether those findings actually correspond with what appears on the MRI.

An MRI can provide valuable information, but it is only one part of determining the cause of back or leg symptoms.

Know the Warning Signs

There are situations in which symptoms require prompt medical evaluation. Dr. Burch advises patients to pay particular attention to new leg weakness or a foot that begins slapping the ground when walking.

More urgent warning signs include numbness in the area where you would sit on a saddle or loss of bladder or bowel control. These symptoms should not be treated as a “wait and see” situation and warrant same-day evaluation.

For most other MRI findings, the next step is much less frightening: have a conversation with a spine specialist who can determine whether what appears on the scan actually explains your symptoms.

At Atlanta Spine Institute, Ben Burch, MD, evaluates the whole patient—not simply the words appearing on an MRI report.