Decoding X-Rays and MRIs: What They Really Mean for Shoulder Pain

"Decoding X-Ray's and MRI's: What They Really Mean for Shoulder Pain" is an excerpt from Dr. Andrew Gorecki's & Dr. Ben Fuson's book, The Truth Unveiled: Secrets to Shoulder Pain Relief.  See below on how you can request your FREE Copy.

When people experience shoulder pain, they often come to me with a diagnosis based on imaging results, such as X-ray's or MRI's. Common diagnoses include rotator cuff tears, arthritis, and labral tears. However, relying solely on imaging as the primary diagnostic tool has its limitations. Recent research has shown that a significant portion of the pain-free population, particularly those over the age of fifty, also exhibit structural changes and damage in imaging studies. This means that many individuals can have visible damage without experiencing any symptoms at all.

To shed light on this matter, let’s explore several studies that highlight this discrepancy. A study published in the Journal of Bone and Joint in 1995 found that fifty-four percent of participants who had no pain exhibited signs of a rotator cuff tear on their shoulder images. Similarly, a study published in the American Journal of Radiology in 2017 revealed that eighty-nine percent of individuals over the age of forty had evidence of shoulder osteoarthritis on their images yet remained pain-free. Another study published in the Journal of Orthopedics in 2013 found that sixty-five percent of participants had a rotator cuff tear on their images, despite not experiencing any pain. These are just a few examples among many, underscoring the fact that imaging alone cannot definitively determine the cause of pain. It is only one piece of the puzzle.

Another limitation of imaging is that it provides a static snapshot of a dynamic space. Imagine if I were in the room with you while you underwent an X-ray of your shoulder. If I pulled on your arm, the X-ray would show a larger joint space, but when I released your arm, the joint space would decrease. This dynamic nature of joint space is not accounted for in radiologists’ assessments, which often rely on measuring joint space as an indicator of arthritis. However, joint space naturally changes throughout the day, and this fluctuation can contribute to shoulder pain, particularly at night when lying down reduces joint space.

Furthermore, imaging focuses solely on the structural aspects of the shoulder and neglects its functional movement. It fails to consider that the body operates as a connected system, with each part influencing and affecting the others. Improper motion and dysfunctional movement patterns are often the root causes of pain.

Imaging, such as X-ray's or MRI's, only examines one isolated part at a time without considering movement. Consequently, it falls short as a comprehensive assessment tool for shoulder pain.

It is crucial to recognize that relying primarily on imaging can lead to unnecessary surgeries. Surgery should not be the go-to solution based solely on imaging findings. It is an inadequate approach to determine the most appropriate treatment for an individual. Unfortunately, this reliance on imaging has contributed to the rise in surgical procedures and increased healthcare costs. It’s time to put a stop to this trend. In the upcoming chapters, I will present alternative options that are far more effective than surgery and carry a significantly lower risk.

Want to read the whole book? Get your FREE copy here: Shoulder Pain Book | Superior Physical Therapy (thesuperiortherapy.com)

Or you can buy it on Amazon! The Truth Unveiled: Secrets to Shoulder Pain Relief