Seventy-six years of age, having led a full life so far both professionally (as a manual therapist standing beside a plinth for over 55 years) and athletically (never performing recreationally in whatever I pursued but always seeking competition), it is no surprise to read the results of my MRIs of hips and pelvis which demonstrate a variety of pathological wear and repair changes, in some cases even extreme.
However, we always say to the patient that “We don’t treat the scans we treat the symptoms” so, in my case, if I want to pursue my professional and sporting career (despite the pains I suffer), I should not worry if I respect the rules of graded exposure after the recovery from my last “Flare”.
This is how I would explain the findings of their MRIs to my patients stressing that the findings do not necessarily have a relationship to their symptoms and that it is safe to move and pursue their chosen activities, but they should follow the given “rules of engagement” for their unique situation.
When they are your own MRIs (although being a medical professional with all the knowledge and experience that I may hold) I can see how challenging that is for the patient to accept.
If you stood at the beginning of a foot bridge over a deep ravine and read a sign at the entrance listing multiple structural faults but were assured that it was safe to cross, would you just go for it or would you reflect as to whether it is worth the risk?
Maybe next time when you sit with your patient discussing their MRI findings you might try to be more empathic as to how they might be feeling about their results: they might feel that the said results are being dismissed and that their experiences are not being heard.
Just because you say so doesn’t make it true for them……
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