Michelle is so right about innocuous structures on MRI or other imaging being big pain generators. I'm lucky enough to have a fabulous injectionist for a PM doc and he always tells me "the needle doesn't lie". I have facet arthritis behind my ADR and alway ask my PM doc if the amount of degeneration means I should have more or less pain. He tells me that he has seen perfect-appearing facet give intense pain, and horribly arthritic facet that are painless.
Moral of the story, if your imaging studies don't show a clear culprit for your pain, don't give up. Ask for injection-based tests like discograms, medial branch blocks, selective nerve root blocks, etc. Spine structures don't have to look bad to hurt.
Best,
Laura
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