Imaging and Physical Therapy

Example of xrays of a persons neck.

Oftentimes we have patients asking if they should get imaging such as an X-ray, MRI or other scan to determine why they have pain or to diagnose what’s causing their particular problem. Believe it or not, it is more common for us to educate patients as to why they might not need an expensive imaging test performed. It’s not that imaging isn’t helpful, but it’s not always necessary to guide our treatment. In this article we will explain the commonly used types of imaging and how we use it in Physical Therapy.

 

  • X-ray
    • Usually the go-to test initially, as it is the most inexpensive and quickest test to perform
    • Used to rule out pathology of the bone such as a fracture or subluxation
    • Will show degeneration or arthritis of a joint

 

  • CT or CAT scan
    • Much like an X-ray but produces a 3D image
    • Excellent for examining bone for fractures, degenerative changes or loose bodies
    • Also good for identifying aneurysms, infections, cysts and tumors
    • Contrast dye can be used to enhance the image
    • Disadvantage: higher levels of radiation than an X-ray

 

  • MRI
    • Primarily used for soft tissues such as tendons, ligaments, meniscus, intervertebral discs 
    • Also commonly used for the nervous system including the brain and spinal cord
    • Disadvantages: higher cost, can’t be used if a pacemaker or certain types of metal are present in your body, problematic for patients with claustrophobia
      • Example of an MRI of a person’s lower back.

What can Resolve Physical Therapy do?

Physical Therapists are highly skilled and trained in diagnosing musculoskeletal disorders. While conducting our examination, we are asking certain questions and looking for specific patterns that help us reach a conclusion as to why there is pain or other limitations. In most cases, we can determine what’s happening without always needing an image.

However, if we identify “red flags” that would indicate something more serious is happening, then we will immediately recommend additional testing to further clarify our examination findings. Our goal is to make sure you benefit from the treatment we provide and in some instances, we do need imaging to determine if Physical Therapy is the appropriate course of treatment for your particular problem.

Keep in mind, research shows a majority of people, even those who are asymptomatic, will have some sort of an abnormal finding on an image. So just because something shows up doesn’t necessarily mean it will be problematic!