Modern medical advancement such as MRIs and other scans have really changed the landscape of medicine. We can more than ever get to 'see' inside the body. As costs come down and the numbers of scanning machines multiply, scans are done more than ever. This helps with diagnosis, but can also add to 'knowing too much.' Could we be over-scanning?
As we understand more and more about pain and the brain, health professionals are now realising that damage to the tissues does not directly correlate to the amount of pain we feel. Pain is a central process, meaning that it comes from the higher centers in the brain. Sure, inflammation is one part of the pain response, but not the whole. Our values about pain or exercise, our previous pain experiences, our mood, our brain chemistry, our immune system and our general fitness or conditioning all play a huge role in our pain responses.
So, when scans can see inside and show us issues with joint and tissue structure, such as 'wear and tear', bulging discs, muscle and tendon thickening or scarring, what does this really mean for that individual? Are these findings on scan actually the sole or part contributors to their pain? Are we getting a false representation of the individual and their tissues? Does a scan result make you jump to conclusions too quickly, such as the need for surgery which may not be really warranted? Do we panic at the findings and provoke fear and anxiety and even avoidance of activity in someone unnecessarily? Do we even contribute to their pain response by drawing too much attention to scan findings? Scary.
Studies are increasingly looking at this dilemma we have created through medical advancement. Above is a clear reflection of these recent studies, where populations were scanned and even those without symptoms of pain had scans showing significant findings. Take the lower back disc injury as a great example, where 37% of 20 year olds without lower back pain have 'bulges' in their discs, or where 20% of those over 40 are living pain free with knee cartilage or meniscal tears.
Scanning certainly has it's place, but the rush to the scanners that appears to becoming the new norm really needs to be thought about more cautiously.