As individuals grow older, it is common for their bodies to began to show signs of “wear & tear”. One of the most common signs of aging is wrinkles. Just as our bodies show signs of aging on the surface, they also show signs of aging under the surface (IE: arthritis, muscle atrophy, decreased bone density, etc.). One of my favorite professors in graduate school described this process in a way that really resonated with me: “wrinkles on the inside, wrinkles on the outside”.
Why is this relevant? Medical imaging (IE: x-rays, MRI’s, CTs, etc.) often picks up on these “wrinkles on the inside”, which can be very beneficial. However, sometimes these imaging devices act in just the opposite way, identifying “problem areas” that are really just normal signs of aging.
For example, a recent study showed spinal disc degeneration was present - on CT & MRI findings- in 37% of asymptomatic 20-year-olds; this number increased to 96% of asymptomatic 80-year-olds (Brinjikji et al., 2015). This study is a great example of the effects of our bodies’ natural aging process; however, these same individuals may be labeled as having problems with their back, even if they have no pain at all. Furthermore, not only is medical imaging not always consistent with symptoms, but it can also result in higher cost of care and overall utilization of health care services if completed early on in an individual’s plan of care (Fritz et al., 2015).
Physical therapists are trained to identify which “wrinkles” are normal process of aging, and which “wrinkles” need to be addressed further. Therefore, before you run to get that MRI (especially the cash-pay imaging entities), head to your local Advanced Physical Therapy and Sports Medicine provider so we can check out your wrinkles.
1. Brinjikji, W., Luetmer, P. H., Comstock, B., Bresnahan, B. W., Chen, L. E., Deyo, R. A., … Jarvik, J. G. (2015). Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations. American Journal of Neuroradiology, 36(4), 811–816.
2. Fritz, J. M., Brennan, G. P., Hunter, S. J. (2015). Physical Therapy or Advanced Imaging as First Management Strategy Following a New Consultation for Low Back Pain in Primary Care: Associations with Future Health Care Utilization and Charges. Health Services Research, 50(6), 1927–1940.