Chronic Pain Management

Medical Investigations for Chronic Pain

Often during periods of long term chronic pain, patients will naturally ask for a referral for medical scans as a way of explaining and understanding their pain (i.e. “something must be wrong!”). While medical investigations certainly have an important place in injury diagnosis, they may potentially also be misleading. Altaira’s physiotherapists will always thoroughly run through scan findings in detail to explain what is clinically relevant compared to incidental findings which might look scary.

You are not your scans! Pain does not necessarily equate to tissue damage.

Technological advances have resulted in highly sensitive and detailed medical imagery now being available in the form of X-Rays, MRI, and CT scans, just to name a few. While these have brought about many positive changes in terms of obtaining an accurate diagnosis for acute injuries, they have also led to some other unintended consequences, specifically with regard to chronic injuries such as lower back, shoulder, and knee pain.

Throughout a person’s lifetime they will undergo normal age-related changes. These may be visible (e.g. wrinkled skin) or invisible (e.g. chronic body structure changes). What we often see on scans can be thought of as “wrinkles on the inside”, in that these findings are normal age-related changes, but should not necessarily result in pain. Examples of this include “disc degeneration”, “rotator cuff tears”, or “meniscus tears”. While these are often seen on scans, they are not necessarily considered to be significant. Multiple studies have illustrated that people with and without pain often have similar results on scans. This tells us pain cannot be wholly explained by scans.