Thursday, August 24, 2017
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Lumbar Resonance: Is It Necessary?

Lumbar Resonance: Is It Necessary?

Lumbar MRI is a test where we will get detailed images of the lower back. We will be able to see the anatomical structures of the lumbar region of the back as well as some specific characteristics like the liquid content or the inflammation present in the different regions studied.

In the photo on the left we can see a model drawn from the column seen from the side. The image on the right shows how this column would look in real images of an MRI. If we look at the last discs we can see that they have left their site, that is, there has been a herniated disc.

Lumbar Resonance: Is It Necessary?MRI could then be said to be a kind of picture of our interior. And like in all the photos, some days we looked more handsome and some uglier. Sometimes we get ugly in a photo and that does not mean that we are ugly. Well with this test the same thing happens. Resonance is a very useful tool but is used too much for the social demand it has. The person suffering from a back pain that lasts longer than he or she considers reasonable begins to feel the uncertainty of whether he will have a more serious injury than he thought. Popular culture and information on the internet lead to the concept that resonance is fundamental to know what we have.

Well, I’m going to turn the tortilla around. The resonance will show us the anatomical alterations but in a majority of the cases it will not determine the cause of the pain. The resonance is very useful for detecting some serious lesions such as a tumor but these lesions are fortunately present in a very very low percentage of the scans performed. However, most of the resonances practiced show images of a lumbar zone with more or less wear (in the form of osteoarthritis or hernias) and that only suggest possible causes of pain and contribute little to healing.

For all this, magnetic resonance imaging often causes more harm than good. How can this be? When the patient reads the description of the injuries in the report, a concern is generated. Most of what the report describes are going to be simple traces of time on our backs, but the use of technical words will make us think worse. We read the word “hernia” and the ailment automatically becomes more serious in our brain and the reality is that it does not have by far the importance we give it because of popular wisdom. On many occasions I have seen in the consultation how this concern generates more disability than the injury itself. On these occasions the most healing are the reassuring words of a sensible doctor,

In short, MRI is a fantastic tool and is getting better every day, but should be used when complications are suspected and not done to everyone, because in my experience, a resonance performed without good reason generates more harm than good.

Having said that and explaining this, most patients will want to have a resonance when they are worried about their low back pain. In fact we must be the doctors who explain well each ailment and know how to reassure when the symptoms show no probability of complication or serious illness.

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