Some magnetic resonance imaging findings may predict future low back pain and disability: a systematic review

Christopher S. Han*, Christopher G. Maher, Daniel Steffens, Ashish Diwan, John Magnussen, Emma C. Hancock, Mark J. Hancock

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

4 Citations (Scopus)
58 Downloads (Pure)

Abstract

Questions: Do magnetic resonance imaging (MRI) findings predict future low back pain (LBP), associated disability and global recovery in people with current LBP? Do MRI findings predict these outcomes in people with no current LBP? Do MRI findings predict these outcomes in a mixed sample of people with and without current LBP? Design: This review is an update of a previous systematic review investigating the relationship between lumbar spine MRI findings and future LBP. Participants: People with or without LBP with lumbar MRI scans. Outcome measures: MRI findings, pain and disability. Results: Of the included studies, 28 reported on participants with current LBP, eight reported on participants with no LBP and four reported on a mixed sample. Most results were based on single studies and did not demonstrate clear relationships between MRI findings and future LBP. In populations with current LBP, pooling demonstrated that the presence of Modic type 1 changes alone or Modic type 1 and 2 changes were associated with slightly worse pain or disability outcomes in the short term, and the presence of disc degeneration was associated with worse pain and disability outcomes in the long term. In populations with current LBP, pooling demonstrated no evidence of an association between the presence of nerve root compression and disability outcomes in the short term, and no evidence of an association between the presence of disc height reduction, disc herniation, spinal stenosis, high-intensity zone and clinical outcomes in the long term. In populations with no LBP, pooling demonstrated that the presence of disc degeneration may increase the likelihood of experiencing pain in the long term. In mixed populations, no pooling was possible; however, single studies demonstrated that Modic type 1, 2 or 3 changes and disc herniation were each associated with worse pain in the long term. Conclusions: The results suggest that some MRI findings may have weak associations with future LBP; however, larger high-quality studies are needed to resolve uncertainty. Systematic review registration: PROSPERO CRD42021252919.

Original languageEnglish
Pages (from-to)79-92
Number of pages14
JournalJournal of Physiotherapy
Volume69
Issue number2
Early online date11 Mar 2023
DOIs
Publication statusPublished - Apr 2023

Bibliographical note

Copyright the Australian Physiotherapy Association 2023. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

Keywords

  • Diagnosis
  • Low back pain
  • Magnetic resonance imaging
  • Musculoskeletal
  • Predict

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