After any injury, many individuals’ first question is “Do I need to get imaging?” This turns out to be a very loaded question, as it is entirely dependent on a number of factors including the mechanism of your injury, chronicity of symptoms, and lack of progress with conservative treatments among many others. Many studies have shown that financial resources are wasted and imaging is over prescribed for a number of musculoskeletal injuries. Although your licensed physical therapist cannot order imaging directly, musculoskeletal conditions can be evaluated and recommendations for imaging can be discussed with your medical doctor if needed. However, physical therapists are uniquely trained to determine if there is a structural problem that would need to be more specifically diagnosed through an X-ray, MRI, or CT scan. Physical therapists use a variety of special “hands on” testing to help determine structural issues that would require more advanced diagnostic testing and treatments such as injection or surgical intervention. The next step in the process would be a referral to an orthopedic, neurological, or pain management specialist.

I have imaging with me, and many “structural problems” were found. What do I do now?

Ironically, many of us can have “structural problems” (i.e. degeneration, arthritic changes, bone spurs, tears) but not any symptoms. Likewise, your specific pain, tightness, or restriction may not be caused by the structural issues. A licensed physical therapist can help you interpret and read images and reports and match the information with what is found during your evaluation. If there are inconsistencies (and oftentimes there are!), then there may be another cause of your pain. When it is determined that the structural changes found on imaging are not the cause of your pain, that leaves a variety of sources remaining such as muscle, joint, ligament, and tendon.

Key Takeaways from Imaging

1. Don’t take the image for face value! Just because something is found doesn’t mean it’s causing your pain!
2. Talk to or get evaluated by a physical therapist before you get imaging! This will save you both time and money!
3. A physical therapist can read imaging! Use them as a resource.
4. Only a medical doctor can order imaging, but a physical therapist can always recommend it and collaborate with your primary care physician or specialist.

If you have any specific questions regarding previous or recent imaging you have, please don’t hesitate to reach out to one of our physical therapists directly at (949) 502-3388 via phone or text. You can also email us at [email protected]