Some people jump into surgery for low back pain and sciatica too quickly as a result of something that was found on an MRI scan. A 2017 review of 12 studies in the journal Spine found that in less than a year, up to 93% of herniations and up to 91% of nerve root compressions reduced in size or disappeared. Yes, these abnormalities went away naturally, without surgery! However, the study did not note whether the pain was alleviated. Experiencing pain does indicate some kind of tissue damage, so it is important to find a practitioner who can do a thorough physical exam and assessment to determine the right structures to treat, versus relying solely on MRI findings.
We frequently see that abnormalities noted on the MRI report are not the actual structure causing the pain. For instance, complaints of low back pain and “sciatica” are generally caused by ligament injuries in the sacroiliac joint, and any MRI finding is only incidental. An abnormal MRI finding can, however, show the result of ligament injury. Once injured, ligaments weaken due to a poor blood supply and generally do not regain pre-injury strength on their own. Weakened ligaments cause more low back pain and spinal degeneration than any other entity. Ligament laxity causing sacroiliac joint instability is the top reason for “sciatica” complaints and can also cause feelings of leg numbness. Experiencing back pain does not necessarily mean having to undergo an MRI and surgery. There are good conservative options, such as physical therapy, chiropractic care, Pilates and other exercise and posture work. Additionally, regenerative treatments, including Prolotherapy, can directly stimulate the repair and strengthening of ligaments and other soft tissue in the low back. For most people, once the ligament tissue is repaired, pain is relieved…naturally.