For an interesting article on the relationship between back pain and the validity of MRI studies used to determine actual post-traumatic injuries, The New England Journal of Medicine published the above article in volume 331. Abnormalities that may present themselves on MRI, do not necessarily cause back pain. As this study shows, people with abnormalities do not necessarily have any symptomology. Of particular interest is the amount of natural abnormalities as age increases as well as their magnitude. Further, the discovery of a bulge or disk protrusion on an MRI in a patient with back pain may be coincidental in relation to the traumatic injury in question. In any event, careful clinical exam in conjunction with patient history, including age, and diagnostic studies like MRIs should be used for appropriate diagnoses. In many cases, an Independent Medical Examination is used to evaluate the patient's injuries and the careful IME consultant knows to keep the above in mind.

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