A very common scenario we see in the clinic is someone who has had a recent bout of pain, had an X-ray, and been told by the doctor their problem is caused by “degenerative changes.”
What are these mysterious degenerative changes?
It is a general term for various changes that occur within joints, over time. As they are caused by ‘wear and tear’ or previous injuries to the joint, they tend to become more prevalent as we age. Arthritis is one such change, which involves the thinning of cartilage (one of the barriers that smooths the surface of our joints and helps to cushion them from the impact of moving about).
Should I be worried?
The first thing to be aware of is that everyone, by the time they are middle-aged, will show some degenerative changes on X-ray. Additionally, there are common spots such as the lower neck, lower back, and knees. Recent research has made it very clear that an x-ray alone is not diagnostic. Additionally, evidence has found that the severity of degenerative changes does not necessarily correlate with pain intensity. In other words, someone can have quite advanced ‘wear and tear’ on their joints show up in an x-ray, but this does not mean that they will always have bad pain as a result.
So why get an X-ray?
There is still value in these findings – but they must be strongly linked with clinical findings. That is, the pain pattern and other tests must all line up with what see on the X-ray. Think of the X-ray as a way to confirm what we are already thinking, but not the other way around. Having a complete picture of what is driving the problem will help your physiotherapist make sure that you are getting the correct management.
If you have any questions, please don’t hesitate to contact us!