You’ve been having some tingling in your hand and your doctor orders an MRI. The results showed you have several bulging discs in your neck! Things must be pretty bad, right?!
Not necessarily, and decisions on treatment should never be based on MRI results alone.
In a 2015 study, Nakashima et al looked at MRI results from the necks of 1,211 symptom-free individuals in Japan. This included 100 individuals of each gender, for each decade ranging from 20 to 79 years, as shown in Table 1.
Table 1. Age and Sex of 1,211 Asymptomatic Subjects
Of these healthy individuals, 87.6% of them presented with at least 1 bulging disc, and these weren’t just the older folks! Of those in their 20s, 73% of guys and 78% of girls had at least 1 disc bulge. The number of individuals and the number of disc bulges increased with each decade from age 20 to 50 years. More severe images were seen after 50 years, such as spinal cord compression (5.3% of participants), but again, these individuals had no symptoms of any problem!
If there are no symptoms, is it a problem? Not really. Our bodies will tell us when we need to intervene. And when symptoms do arise, such as weakness, numbness, and/or tingling in your hands and arms, a good 1st step is to seek physical therapy! You may find that your symptoms resolve without an MRI. If your symptoms don’t improve with conservative treatment, imaging may be helpful as plans are made for surgery, but the mere presence of a disc bulge or two is irrelevant since almost everyone else has them too!
Nakashima H, Yukawa Y, Suda K, et al. Abnormal findings on magnetic resonance images of the cervical spines in 1211 asymptomatic subjects. Spine 2015;40:392-398.