“But my x-ray looks terrible!”

I have heard this from many patients. So many people are being told how “bad” their x-rays look by medical providers. Interestingly there is evidence even talking about or showing a patient their x-ray makes them more likely to have a knee replacement.

We know, however, that x-ray findings don’t often correlate with a patient’s pain.  Often patients with severe pain can have no significant x-ray findings. It’s much more important to think of how the patient presents clinically. Do they move well? What movements hurt? What movements reduce their pain?

I can’t change your x-ray findings, but I have taken many patients with severe degenerative changes on imaging studies and gotten them back to function with minimal or no pain. I heard a surgeon I like say recently “I can make your x-rays look pretty but that may not make you feel any better”. 

A better way to think of imaging studies is that they help rule out serious conditions. We often look for tumors, fractures, or infections. Then without any of these findings we know most patients are safe for therapy. 

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