Analyzing the cervical spine of neck pain patients
with MRI imaging can be
interesting, confusing, and/or (non)directive for treatment planning.
Paulette Hugulet, DC, LLC always considers imaging through the lens of the
clinical symptomatology and spinal exam. La Grande
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 persists even with 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 correlated
with the clinical symptomatology seen in the clinical exam to guide
the care for optimal relief. Modic Changes – vertebral bone endplate and bone
marrow changes - are commonly noted when radiologists review
the MRI and classify the level of disc degeneration with level 1 being
the least degenerated and level 3 being the most degenerated. In the lumbar
spine, more studies have been done
to correlate back pain symptoms with imaging findings. In the cervical spine,
the studies are scarcer. A review of 14 research studies regarding
the link between neck pain and/or cervical spine disc
degeneration to MRI-revealed Modic changes described that
cervical spine Modic changes were present in 5% to 40% of the
images. Patients whose MRIs revealed Modic changes
stated more neck pain and disability. Their imaging
also demonstrated more cervical disc degeneration. (1) Of late,
an MRI study of cervical spines of neck pain and shoulder stiffness
patients reported that no system of classification
of cervical disc degeneration correlated with
clinical symptoms. However, the researchers did mention that
vertebral endplate changes may be linked to clinical symptom
presentations. (2) Chiropractic care can help pain due to disc degeneration
and vertebral changes.
TREATMENT PLANNING
When [[companyname treats patients with MRI imaging showing
Modic changes, researchers and clinicians have faced correlating effective non-surgical treatment options. Review of
studies previously published about the treatment
of Modic change related back pain, in this case
it was low back pain, found that spinal manipulation was proposed
as an option. The review recorded insufficient support for medication use and rigid lumbar brace wearing, controversial use of antibiotics, and exercise
therapy’s use to lower back pain intensity as having low evidence
support. (3) Do you see how imaging can be interesting, confusing,
and/or (non)directive? One thing your La Grande
chiropractor knowledgeably and safely delivers
is spinal manipulation for neck pain and back pain relief often
before and/or despite imaging. Paulette Hugulet, DC, LLC stays the course with what our experience tells us helps our patients.
CONTACT Paulette Hugulet, DC, LLC
Listen to the PODCAST
with Dr. Matthew Scott on the
Back Doctors Podcast with Dr. Michael Johnson as he
explains the effective, gentle treatment with 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.
Schedule your next La Grande
chiropractic appointment with Paulette Hugulet, DC, LLC. MRIs and Modic changes won’t confuse your chiropractor when it comes to establishing a neck pain relieving cervical spine treatment plan.