Do You Need MRI, X-ray Medical Imaging for Physical Therapy?

Medical imaging is a tool that can help physical therapists identify sources of your pain and discomfort.

In specific situations, imaging is another puzzle piece that can help us form the whole picture of your injury and path to recovery. Whether medical images are needed or not, each PRO~PT patient’s treatment plan depends on their specific combination of symptoms, experiences, habits, and goals.

Medical imaging for physical therapy consists of images showing physical issues that may not be visible without the help of technology. X-rays and MRIs are most commonly utilized for musculoskeletal and neuromuscular conditions, some of which are seen and treated in PRO~PT clinics. They may be used in conjunction with physical therapy evaluation to create holistic treatment plans. Some other types of medical imaging include:

• CT scan
• PET scan
• Ultrasound

Typically, medical professionals call for imaging with traumatic injuries, like bone fractures, to assess the severity and rule out the immediate need for surgery, casting, or orthotics. Arthritis, degenerative diseases, and chronic injuries may require imaging for complete diagnosis, as well.

For the majority of our patients, medical imaging simply isn’t necessary. Our experienced physical therapists at PRO~PT are qualified to assess, diagnose, and treat your condition without reviewing imaging or diagnostic test results. Even when it is necessary, imaging is only a fraction of the information that goes into designing the best care for you.

Yes! Your physical therapist will use tests and measures, your reports of your pain, their own observations, and clinical reasoning to assess how appropriate physical therapy is for your pain or injury. These tests also identify red flags in the rare case that physical therapy is not appropriate for your condition.

If your therapist thinks physical therapy will help, a safe, effective, and individualized treatment plan will be developed based on the findings. However, these special tests may also identify something that requires you to head back to your referring physician for further evaluation. (Remember that physical therapists can’t refer patients for imaging.)

Your physical therapist at PRO~PT has special movement-based tests that help confirm or rule out a condition. Your therapist is experienced with the research and clinical practice guidelines that help them determine if these tests can identify specific neuromuscular or musculoskeletal conditions.

The tests can tell your therapist whether you need an X-ray or MRI or not. Treatment decisions heavily rely on these evidence-based, clinical tools as opposed to traditional imaging.

Images created by X-rays or MRIs are still-frame images that may help identify physical injury or structural abnormalities. That’s why if imaging is necessary, it’s typically utilized as one portion of a larger evaluation, along with other tests and physical assessments.

Ultimately, the data we gather from even the most advanced imaging is limited and lacking context—it may show us some possible issues, but it won’t identify biomechanical or movement disorders. Imaging cannot connect the internal problems to the pain you’re experiencing as our patient.

Physical Therapists: The Body’s Mechanics

If your car is having engine problems, you don’t send the mechanic a picture of the engine. You bring the car into the shop, where the mechanic will examine it thoroughly, moving, listening, driving, and testing to identify the source of the issues. Static visuals only provide context for the larger story, and a hands-on assessment is the best way for our physical therapists to begin understanding your experiences, challenges, and needs.

X-rays mainly show a bone’s pathology, including fractures. Soft tissue such as muscles, tendons, cartilage, and ligaments aren’t visible, but there’s a chance you can see some evidence of soft tissue involvement, like a large pocket of fluid.

MRIs show many more structures of your body, including the brain and spinal cord, tumors, muscles, tendons, cartilage, and ligaments.

There are some sources of pain that won’t show up in imaging, including:

• Low-grade muscle strains or ligament sprains
• Very small acute fractures where fluid may prevent imaging from accurately showing the fractures
• Movement pattern disorders that lead to pain

Studies show that pain-free patients often come back with issues identifiable by imaging, showing that a positive X-ray or MRI won’t always be relevant to the source of your pain. More importantly, medical imaging does little to suggest the right physical therapy methods that will succeed.

PRO~PT’s staff of competent, experienced, and enthusiastic therapists can help you whether you have imaging of your pain’s source, or not. Our commitment to your recovery on your terms, with your own schedule, will leave you feeling safe and secure. Request an appointment today at your nearest PRO~PT clinic today.