Should you get a scan before you see a Physiotherapist?
A common question we get asked as Physiotherapists is “should I get a scan?”
To answer this question, lets look at the research.
Recently a study was conducted on 30 people between the ages of 55 and 75. They were split into three groups, those with no shoulder pain, those who previously had shoulder pain and those who currently had shoulder pain.
Then they took an Xray of their shoulders.
The result? 70% of people without pain had arthritis in their shoulder while only 50% of those currently experiencing pain had arthritis.
Then they performed an MRI.
60% of people without pain had mild bursitis compared to 70% of people with shoulder pain. In addition 30% of people with or without shoulder pain had moderate bursitis.
There was also minimal differences in the presence of partial rotator cuff tears or tendinopathic changes between the no pain and shoulder pain groups.
Other studies have looked at people with shoulder pain in one arm and compared it to their non-painful arm. Often both shoulders have the same structural “problems”, such as a tendon tear or inflamed bursa, but they only get pain on one side.
Another study was conducted on 51 men between the ages of 40 and 70 years who had no shoulder pain. When an ultrasound was performed (used to check for tendon tears and bursitis) they found “abnormal” findings on 96% of the participants, despite none of them reporting shoulder pain before the scan.
The take home message from these studies is this: “abnormal” findings on ultrasound, Xray or MRI are extremely common in everyone, including those without pain.
This is why physiotherapists treat you according to the findings from clinical tests rather than the results of scans.
However, if the diagnosis is uncertain and our management would change depending on the condition then imaging would be beneficial. But in most cases early scans hinder rather than help your recovery.
So if you are getting any shoulder pain (or other muscle or joint pain) call us for a clinical assessment of your problem.
Miami Physio : 9534 4111
Lakelands Physio: 9542 9999