La Grande Cervical Spine Pain: MRI-Seen Changes, & Plan for Care
Analyzing the cervical spine of neck pain sufferers with MRI imaging can be interesting, confusing, and/or (non)directive for treatment planning. Dr. Paulette Hugulet, DC, LLC always considers imaging through the lens of the clinical symptomatology and spinal examination. La Grande neck pain with imaging-revealed changes in the cervical spine will get a treatment plan based on both imaging (if/when available) and clinical exam findings.
MRI is an amazing technology. It is used commonly to evaluate intervertebral disc degeneration. When spine pain continues without relief while undergoing 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 direct the care for optimal relief. Modic Changes – vertebral bone endplate and bone marrow changes - are typically 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 fewer. 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) Recently, one MRI study of cervical spines of neck pain and shoulder stiffness patients stated that no classification system of cervical disc degeneration showed any relationship to clinical symptoms. However, the researchers did explain that vertebral endplate changes may be connected to clinical symptom presentations. (2) Chiropractic care can help pain due to disc degeneration and vertebral changes.
TREATMENT PLANNING
When it comes to chiropractic treatment of patients with MRI imaging showing Modic changes, researchers and clinicians have been challenged to correlate effective non-surgical treatment options. Review of studies already published about the care of Modic change related back pain, in this case it was low back pain, found that spinal manipulation was advocated as an option. The review recorded insufficient support for medication use and rigid lumbar brace wearing, controversial use of antibiotics, and low evidence for exercise therapy to decrease pain intensity. (3) Talk about imaging being interesting, confusing, and/or (non)directive! One thing your La Grande chiropractor knowledgeably and safely provides is spinal manipulation for neck pain and back pain relief often before and/or in spite of imaging. Dr. Paulette Hugulet, DC, LLC stays the course with what we see helps our patients.
CONTACT Dr. 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 Dr. Paulette Hugulet, DC, LLC. MRIs and Modic changes will not confuse your chiropractor when it comes to setting up a neck pain relieving treatment plan for your cervical spine issues.
