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Low Back Pain & MRI Results: Here’s What You Should Know

by | Nov 15, 2023 | Back Pain

abstract blue skeleton clutching a red ball at the base of their spine
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When you are dealing with pelvic pain, bladder leaks, or postpartum core weakness, asking for help can feel incredibly daunting. Many women avoid seeking treatment simply because they don’t know what to expect. The idea of a pelvic floor evaluation sounds intimidating, leading too many active women to just accept their discomfort as “normal.”

At PRO Therapy, our goal is to completely demystify this process. Seeing a women’s health physical therapist shouldn’t be scary or mysterious.

It is a highly clinical, empowering experience designed to give you back control of your body. Here is exactly what happens behind closed doors during a consultation, and how we help you return to the active life you love.

What Actually Happens During a Pelvic Floor Evaluation?

Your initial assessment is entirely focused on uncovering the root cause of your symptoms. We move at your pace, and you are always in the driver’s seat regarding your care.

Here is the three-step process you can expect during your first visit:

Step 1: The Conversation. We start by simply sitting down and talking. We want to know your health history, when your symptoms flare up (like leaking during double-unders or pain while running), and what your specific athletic or lifestyle goals are.

Step 2: The External Assessment. Your pelvic floor does not operate in isolation. We perform a full-body movement assessment to check your breathing mechanics, hip mobility, core stability, and spinal alignment to see how they impact your pelvis.

Step 3: The Internal Assessment (With Consent). With your explicit permission, we may perform an internal musculoskeletal exam. This is the gold standard for accurately diagnosing whether your pelvic floor muscles are too weak, too tight, or lacking coordination.

When Should You See a Women’s Health Physical Therapist?

You do not have to wait until your symptoms are severe to seek help. Professional physical therapy is highly effective for both active rehabilitation and injury prevention.

It is time to book an assessment if you are experiencing:

Leaking during impact: Losing urine when you sneeze, cough, run, or lift heavy weights.

Pelvic or pain with intercourse: Experiencing a deep, aching pain in your pelvis, hips, or lower back, or pain during sex (dyspareunia).

Heaviness or pressure: Feeling a dragging sensation or a noticeable “bulge,” which are common signs of pelvic organ prolapse.

Postpartum recovery issues: Struggling with abdominal separation (diastasis recti), core weakness, or painful C-section scar tissue.

physical therapist guiding a patient through a pelvic floor exerciseQuick Answers About Pelvic Floor Physical Therapy

Does a pelvic floor exam hurt?
No, a pelvic floor exam should not be painful. While you may feel some light pressure or muscle tenderness when the physical therapist assesses tight trigger points, the evaluation is gentle and always guided by your comfort and explicit consent.

Do I have to have an internal exam at pelvic floor PT?
No, an internal exam is never mandatory. While it provides the most accurate clinical picture of your pelvic floor muscle strength and coordination, our physical therapists can also successfully assess and treat your core using highly effective external evaluation techniques.

How long after birth should I see a pelvic floor physio?
You can typically begin specialized pelvic floor physical therapy around four to six weeks postpartum, once cleared by your physician. However, even if you gave birth years ago, it is never too late to start rehabilitating your core and resolving pelvic dysfunction.

Take the First Step Toward Confidence

You deserve to train, run, and live your life without constantly mapping out the nearest public restroom or worrying about pelvic pain.

If you are ready to take control of your core health, our doctoral-level specialists are here to help. Book a discreet, 1-on-1 evaluation for specialized pelvic health physical therapy in Minneapolis or schedule with a women’s health physio in Coon Rapids today.

When seeking medical advice for low back pain, you may have been recommended to have an MRI. Or perhaps you’ve attempted to manage low back pain alone and you might be thinking an MRI can provide you all the answers to help solve your pain. Either way, it can be confusing to decipher MRI results.

In this blog, we’ll help clear up all the confusion surrounding MRI results and low back pain.

Read Now: How to Manage Back Pain Without Surgery

What Do MRIs Show You?

If suffering from chronic low back pain or experiencing a sudden (acute) onset of pain, the first question is usually going to be, “What’s injured?” Once we identify the injured body part, we’ll know how to fix it and reduce the pain. This is where we once thought an MRI would fit in the picture. However, that’s not the case.

Instead, researchers have found that an MRI does not help predict your outcomes of acute or chronic low back pain. It may also simply increase your risk of having dangerous surgery, unnecessary injection or be prescribed use of addictive opioids.

As we’ll cover below, it’s common that MRI results won’t be able to show you exactly what’s causing your pain.

Why Isn’t an MRI Always Helpful?

The “Good News”…is abnormal MRI results are typically normal. There is a low or “poor” correlation between the amount of low back pain you’re suffering from and the amount of injury found on an MRI. Finally, discs and other soft tissue structures at your spine can heal on their own. In other words, an MRI result of your back today will look different than the results taken 6 months from now.

Over the years, researchers have completed MRI studies on people who have no complaints of low back pain. After having these pain-free individuals undergo an MRI at their low back, here is what they found:

  1. Over 50% of the individuals age 40+ had a disc bulge and no back pain
  2. Over 50% of the individuals aged 30+ had disc degeneration and no back pain
  3. 90% of those 60 years and older had disc bulges and spine degeneration without back pain
  4. 36% of those 60 years and older had Full Herniated Disc and no back pain
  5. 27% of those 40 years and older had a Full Herniated Disc and no back pain

Here are some pictures to help further explain this.

X-ray of a spine

Take a closer look at both of the above MRI results. One picture belongs to someone who has suffered from chronic and severe low back pain, while the other picture belongs to someone who has dealt with occasional and mild low back pain.

Image on the right: 62-year-old male who has had both of his hips replaced. MRI results show significant lumbar degenerative changes with multiple disc herniations. When he had his MRI, complaints were of intermittent low back pain, and he was able to make a Full Recovery after 9 visits of physical therapy.

Image on the left: 32-year-old male who had complaints of chronic and severe low back pain that resulted in him having to be put on leave from work. MRI results were deemed “unremarkable” with signs of only mild disc bulge. He required 24 visits of physical therapy over 9 months before returning to work.

So…What Now?

I’m sure you’re now asking: “What do I make of all this information?” OR “How does this information help my back feel better?”

The vital message is that we have no evidence that your MRI results will be an indication of prolonged pain and disability. It’s simply a “picture” of a single moment in time. In almost all cases of low back pain, there is no serious damage or disease at the spine.

Regardless of what an MRI imaging shows, the majority of low back pain cases resolve fairly quickly with appropriate care. Chances are also very high that your MRI findings were already present before you had low back pain.

Have questions about your low back pain and MRI results? Are you looking for the next steps to solve your low back pain? We would be happy to connect you with one of the expert physical therapists at PRO Therapy. Our specialist providers have extensive experience managing low back pain. In fact, it’s the most common condition we treat at PRO Therapy!

If you want the quickest path to returning to a life that is no longer limited pain or discomfort, book a FREE discovery visit.

Dr. Kevin Spahr
Dr. Kevin Spahr
Dr. Kevin Spahr has extensive expertise in post-surgical rehab, work-related injuries, sports injuries and motor vehicle accidents. He has clinical experience in treating all regions of the body including neck, back, shoulder, elbow, hand/wrist, hip, knee, and ankle/foot orthopedic conditions.
Dr. Kevin Spahr
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My experience with Dr. Grace was fantastic! She listened to the entirety of my concerns, even those that didn’t directly relate to physical therapy, and developed a treatment plan based on the full picture. Each session I learned something new, and I left with the resources I need to continue on my own. Highly recommend!
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This was my first time doing PT and I had a wonderful experience. I went from not being able to walk at all from my right foot to having full mobility and extension and it's as if I never lost function in my right foot. I would like to thank the PT grace for my full recovery and if you can, you should pick her because she did incredible work and it really did not take long. I highly recommend this place because they'll get in and out of the door with your happiness and mobility back.
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The folks at pro therapy were so helpful and kind. This was my first PT experience and they were very empowering and understanding and encouraged me to continue with my hobbies while also giving me clear and impactful exercises to manage my pain. The dry needling with Dr. Lily was amazing, highly recommend!
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