Studying the cervical spine of neck pain patients who have MRIs noting some changes in the spine can be interesting, confusing, and/or (non)directive for treatment planning. Moriarty Chiropractic always views imaging through the lens of the clinical symptomatology and spinal examination. Nashua neck pain with imaging-revealed changes in the cervical spine will receive a treatment plan based on both imaging (if/when available) and clinical exam findings.
MRI-SEEN CHANGES IN DISC AND VERTEBRA
MRI is an amazing technology. It is used commonly to evaluate intervertebral disc degeneration. When spine pain continues without relief while undergoing care for an extended period of time, doing imaging is logical and follows today’s guidelines for back pain management. The imaging findings must be linked with the clinical symptomatology seen in the clinical exam to direct the care for optimal relief. Modic Changes – vertebral bone endplate and bone marrow changes - are typically noted when radiologists review the MRI and classify the level of disc degeneration: level 1 being the least degenerated and level 3 being the most degenerated. In the lumbar spine, more studies have been performed to correlate back pain symptoms with imaging findings. In the cervical spine, the studies are fewer. A review of 14 research studies about the connection between neck pain and/or cervical spine disc degeneration to MRI-revealed Modic changes reported that cervical spine Modic changes were seen in 5% to 40% of the images. Patients whose MRIs revealed Modic changes stated more neck pain and disability. Their imaging also showed more cervical disc degeneration. (1) Of late, one MRI study of cervical spines of neck pain and shoulder stiffness patients stated that no classification system of cervical disc degeneration showed any relationship to clinical symptoms. However, the researchers did mention that vertebral endplate changes may be connected to clinical symptom presentations. (2) Disc degeneration and vertebral changes causing pain can be addressed with chiropractic care.
When it comes to chiropractic treatment of patients with MRI imaging displaying Modic changes, researchers and clinicians have faced correlating effective non-surgical treatment options. Review of studies already published about the care of Modic change associated back pain, in this case it was low back pain, revealed that spinal manipulation was proposed as an option. The review recorded insufficient support for use of medication and rigid lumbar brace wearing, controversial use of antibiotics, and low evidence for exercise therapy to decrease pain intensity. (3) Do you see how imaging can be interesting, confusing, and/or (non)directive? One treatment your Nashua chiropractor competently and safely provides is spinal manipulation for neck pain and back pain relief often before and/or despite imaging. Moriarty Chiropractic stays the course with what our experience tells us helps our patients.
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Listen to the PODCAST with Dr. Matthew Scott on the Back Doctors Podcast with Dr. Michael Johnson as he explains the effectiveness and gentleness of the Cox® Technic System of Spinal Pain Management for his patient with cervical spine disc degeneration and herniation that allowed him to avoid spine surgery.
Make your next Nashua chiropractic appointment with Moriarty Chiropractic. MRIs and Modic changes will not mislead your chiropractor when it comes to setting up a neck pain relieving cervical spine treatment plan.