MRI Findings of Cervical or Lumbar Disc Herniation Do Not Always Mean Symptoms 

by Son PMR(Physical medicine & Rehabilitation ) & Chiropractic Clinic in Seoul

It's a common misconception that MRI findings of disc herniation or degeneration in the cervical or lumbar spine always indicate a painful or symptomatic condition. However, extensive research over the past decades has shown that many people without any back or neck pain also exhibit such findings on MRI.

1. Disc bulges and degeneration are common in people without pain

One of the most cited studies on this topic is the 2015 systematic review by Brinjikji et al., which analyzed MRI data from asymptomatic individuals. The study found that:

  • In people in their 20s, about 30% had lumbar disc bulges despite having no symptoms.

  • In those in their 80s, the prevalence increased to 84%.

Brinjikji W, Luetmer PH, Comstock B, et al. "Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations." AJNR Am J Neuroradiol. 2015;36(4):811–816.

This highlights that degenerative changes on MRI can be part of normal aging, and do not necessarily correlate with pain or functional impairment.

2. Clinical symptoms are not always explained by imaging

In practice, we often see patients with MRI-proven disc herniation who have no pain or neurological symptoms. Conversely, some patients suffer from intense pain, numbness, or weakness even when their MRI shows minimal or no abnormalities.

This disparity underscores that symptoms are more closely related to functional nerve irritation and biomechanical imbalance, rather than simply the presence of structural changes.

3. Diagnosis should be based on a comprehensive clinical evaluation

At Son’s Rehab Clinic, we never base diagnosis or treatment solely on MRI findings. Instead, we combine:

  • Detailed symptom history

  • Physical and orthopedic examination (e.g., Spurling's test, straight leg raise test)

  • Neurological signs (e.g., muscle strength, reflexes, sensory changes)

Only through this integrated approach can we identify the true cause of a patient’s symptoms and design an effective, personalized treatment plan.

In many cases, non-surgical management including chiropractic care, functional rehabilitation, and posture correction can lead to significant improvement — even in patients with MRI-confirmed disc herniations.

[References]

  • Brinjikji W, et al. AJNR Am J Neuroradiol. 2015;36(4):811–816.

  • Jensen MC, et al. “MRI of the lumbar spine in people without back pain.” N Engl J Med. 1994;331(2):69–73.

  • Boden SD, et al. “Abnormal MRI of the lumbar spine in asymptomatic subjects.” J Bone Joint Surg Am. 1990;72(3):403–408.

👍Consultation and Appointment Information

Son PMR & Chiropractic Clinic( 2nd floor, 229-1 Gucheonmyun-Ro, Gangdongu, Seoul, South Korea) 

by  Dr Son MD & DC 
Contact: 02-482-8875 in Seoul( +82-2-482-8875)

댓글

댓글 쓰기

이 블로그의 인기 게시물

 What is Central Sensitization? by Son PMR(Physical medicine & Rehabilitation ) & Chiropractic Clinic in Seoul Central sensitization refers to a condition where the brain and spinal cord become abnormally sensitive to pain signals following an injury or inflammation. In simpler terms, the pathways that perceive pain become overly reactive, causing individuals to experience excessive pain from minor stimuli or persistent pain even after healing . Key Features of Central Sensitization Amplified pain responses (Allodynia) Pain is felt even with non-painful stimuli, such as light touch or gentle movement. Increased pain sensitivity (Hyperalgesia) Painful stimuli feel much more intense than usual. Persistent pain Pain can continue even after the original injury or inflammation has resolved. How Central Sensitization Develops Peripheral nerve injury or inflammation → Continuous transmission of pain signals to the spinal cord and brain → Hyperexcitab...
자세한 내용 보기
Why Is My Knee Swollen, and Why Does It Take So Long to Heal? by Son PMR(Physical medicine & Rehabilitation ) & Chiropractic Clinic in Seoul – Understanding Knee Swelling and Recovery Strategies Many people have experienced knee swelling and discomfort at some point. At first glance, it may seem like a minor issue, but in reality, it often takes longer than expected to heal. In this article, we’ll explore the common causes of knee swelling , why recovery tends to take time , and what treatment options may help . 1. What Causes Knee Swelling? Knee swelling is not a diagnosis itself—it’s a symptom with a variety of possible causes. Here are some of the most common: ✅ ① Trauma or Overuse Injuries from sports or prolonged walking can lead to inflammation in the knee joint, resulting in swelling. ✅ ② Meniscus or Ligament Injury Damage to structures like the meniscus or cruciate ligaments may cause internal bleeding or increased joint fluid, leading to visible swelling. ✅ ③...
자세한 내용 보기
A Case of Hand Numbness Improved through Upper Cervical and Integrative Treatment by Son PMR(Physical medicine & Rehabilitation ) & Chiropractic Clinic in Seoul  A patient recently visited our clinic complaining of persistent numbness in both hands. This individual had worked in a physically demanding job for many years, frequently using their hands and arms in repetitive tasks. Despite receiving various treatments at multiple clinics, the symptoms either temporarily improved or continued to recur. Referred by an acquaintance, the patient underwent a comprehensive evaluation at our clinic, including a detailed consultation, postural assessment, and upper cervical spine (C1 and C2) functional testing. It was found that subtle misalignments in the upper cervical spine were likely contributing to ongoing nerve irritation, muscular tension, and postural imbalance — all of which could aggravate hand numbness. Our treatment approach combined gentle upper cervical chiropractic ...
자세한 내용 보기