At our Compass Physio clinics in Enfield, Kilcock and Castlecomer and Trim we get asked a lot about MRI scans and imaging

This blog outlines the role we play as a chartered physiotherapist and when we refer for MRI scans

In answer to the question can a chartered physiotherapist refer for an mri scan (magnetic resonance imaging) the answer is yes

Please read on to find out why we often dont refer people for an mri scan

We will use lower back pain as an example.

This is one of the most common conditions we see for physiotherapy treatment.

Lower back pain is very common in the general population with approximately 80% of people having experienced an episode of back pain at some point in their lives.

MRI Scans are rarely recommended for back pain and here’s why:

Quick facts about MRI Scans

• The average MRI scan costs around €300-350
• MRI stands for Magnetic Resonance Imaging
• MRI Scans show detailed images of muscle (i.e. hamstring), ligaments (i.e. ankle ligaments) and joints (i.e. with shoulder pain)
• MRI are used when appropriate as an alternative to x ray or ct scans

The majority of back pain patients experience ‘mechanical’ back pain which do not require an mri scan.

This is normally an issue with the joints and muscles.

Exercise, physiotherapy, strengthening exercises along with on occasion medication, are sufficient to manage symptoms.

As Physiotherapists we would often only refer for an MRI in cases where we identified there was something more complicated going on.

We find the best course of action is to link in with your GP, who we send a letter to or have a chat with and they can organise the formal referral letter.

Your GP letter will ensure that your private medical cover is activated and that may cover some of the cost of the MRI

If you wish to pay privately for an MRI Physio can refer you direct

What Could an MRI Scan Findings be?

MRI findings often come back reporting “wear and tear”, “disc degeneration” and “disc bulges”, amongst other things.

These kinds of reports can easily worry a person about the structure and health of their spine.

It is important to note that these are normal and common findings. As we age our body does so too. Degenerative changes are just part of life and have little to do with the pain we experience.

Studies frequently show the prevalence of degenerative changes in pain free individuals. Here are a few examples of.

91% of a pain-free population had signs of disc degeneration (‘wear and tear’)

56% of a pain-free population had signs of disc height loss

64% of a pain-free population had signs of at least one-disc bulge

32% of a pain-free population had signs of at least one-disc protrusion (‘slipped disc’)

38% of a pain-free population had signs of at least one annular tear (tear in outer part of a disc)

Keep in mind that these are participants who are experiencing NO PAIN symptoms!

What to Do with Your MRI Results?

Too often in clinic I see people come in with an MRI scan disc or a link on their app and literally zero idea of what to do with the results

You should be speaking to one or more of the following people

• A Chartered Physiotherapist
• GP
• Consultant

The results must be matched up with what your symptoms are

If you have low back pain and have had an intensive course of physiotherapy treatment and are still having symptoms then you may seek imaging of the spine

If you have the results of your MRI and have had limited success with physio we then refer to a Consultant or back to your GP

How physiotherapy can help you with your back pain?

At Compass Physio a detailed examination will be completed to determine the extent of your back pain.

This thorough assessment will include strength, movement and neurological testing.

The first goal of physiotherapy rehab is to decrease pain and tenderness.

Physiotherapy interventions will include manual (hands on) and exercise-based therapies.

Physiotherapy will aim to restore full range of movement and strength within the early stages of healing. Next physiotherapy will work to restore strength in your movements.

This could relate to being confident that you can lift/carry items or indeed children without having to worry about your back. Late stage rehab will include dynamic exercises for a return to normal activities or sports.

These might be gym based or indeed a home exercise programme that you complete 2-3 times a week yourself in the long term.

Where appropriate symptoms are found on examination of the low back pain we can refer for an MRI scan

To find out how Compass Physio can help, call 046 954 9456 (this number covers all clinics), click here to book online.

You can also email any questions to info@compassphysio.ie

Paddy Mulligan – MISCP Chartered Physiotherapist Compass Physio