MRI reports and your recovery

How much can the language used in MRI reports affect your recovery?

• Medical jargon often has different meanings from general, everday usage

• Language can influence patient optimism and therefore accelerate or impair recovery

• Reports are written for the referring health professional, rather than the patient

• The report needs to be interpreted in the context of the clinical symptoms

• Find a health professional you trust who is a good communicator

LANGUAGE IS LOADED

In times past, we wouldn’t necessarily have had access to our MRI reports and we certainly wouldn’t have been able to rely on Dr Google to fill in the gaps. And while it’s wonderful that we’re now better informed, there is something of a language barrier that exists between us, as patients, and the medical fraternity.

For instance, when you consider the word ‘tear’ in a colloquial sense it’s understandable that we fear the worst when it’s being used in relation to our soft tissues! But when the word ‘tear’ is replaced with more neutral alternatives such as ‘signal abnormality’ or ‘defect,’ us patients feel a lot more positive about our reports and thus optimistic about recovery – the power of positive thinking.

STONE AGE MAN

It’s not our fault that we are hard-wired for catastrophic thinking – it’s a natural human tendency that has served an important evolutionary purpose. After all, had our ancestors presumed the wooly mammoth was something far cuddlier, it could have meant the end of the human race. But while we are programmed to think the worst, it pays to be aware of catastrophic thinking in relation to pain, as it can hinder your recovery.

Individual behaviour and the social environment are fast being recognised as playing a vital part in managing persistent pain. Anecdotal evidence suggests that a patient’s outlook or perspective can have a significant effect on pain and expectations can also change the experience of pain. As a general rule, research has shown that pain increases along with the expectation that it will.

LEAVE IT TO THE EXPERTS

Most people have some disc bulges on MRI but most aren’t symptomatic. For example, we might have a disc bulge at four different levels but only one, or even none, of these may be causing pain. There is even a one study that looked at the prevalence of lumbar spine damage in people without pain – check out the table below as it clearly illustrates that many asymptomatic people have degenerative findings. Interpretation of MRI images is complicated, and it’s equally complicated for the health professional interpreting what the report means.

We love this video by Dr Bahram Jam explaining how the normal process of aging is represented by change both on the outside and within the physical body. How the level of mechanical changes seen in scans may not be as worrying as we have been led to believe. He summarises the current scientific understanding of pain and the body in regards to imaging. It could be the most important 6 minutes you give you body in a long time.

Interpretation of the findings needs to be done by a health professional taking into account both the report and an examination of the patient’s physical symptoms. Resist the urge to analyse your report yourself or simply make like an ostrich and don’t read it!

REFERENCES

Bossen JK, Hageman MG, King JD & Ring DC, ‘Does rewording MRI reports improve patient understanding and emotional response to a clinical report?’ Clin Orthop Relat Res. 2013 Nov;471(11):3637-44. doi: 10.1007/s11999-013-3100-x. Epub 2013 Jun 13.

W. Brinjikji, P.H. Luetmer, B. Comstock, B.W. Bresnahan, L.E. Chen, R.A. Deyo, S. Halabi, J.A. Turner, A.L. Avins, K. James, J.T. Wald, D.F. Kallmes, and J.G. Jarvik
, Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations’ AJNR Am J Neuroradiol. 2015 April ; 36(4): 811–816. doi:10.3174/ajnr.A4173.