Signs Don’t Mean Symptoms

People often bring reports of MRI scans and x-rays detailing problems with wear and tear, bulging or narrowed discs, impingement or compression of nerves which purportedly explain the pain they are experiencing.  However, similar problems have been found in dissections of cadavers where no complaint of back pain was made during that lifetime.  More studies show that there are people walking around with the same signs and with no pain.  An example of this is the 22 week pregnant woman who had no idea she had a grade 4 spondylolisthesis (lumbar detachment).  So how come the same pathological signs can cause pain in one person and not in another?  Are some people more susceptible to pain than others and if so why?  We await further research with eager anticipation. What is becoming clear is that the body is capable of functioning pain free within a wide range of what is considered “normal”.  It remains to be discovered whether those people with signs and pain can continue to have the signs without pain. If that’s possible then surely this will revolutionise musculoskeletal medicine as we know it and the sky will truly be the limit.

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