You finally got an MRI because your back pain wasn’t improving.
Then you read your report and saw words like:
“Disc bulge”
“Disc herniation”
“Degenerative changes”
“Spinal stenosis”
Suddenly, your pain feels worse both physically and mentally.
Are these findings normal?
Is this why you’re in pain?
Do you need surgery?
If your lumbar spine MRI left you confused or alarmed, you’re not alone and understanding the difference between disc herniation and degenerative changes matters more than most patients realize.
Why Lumbar MRI Findings Are So Common
Lumbar spine MRIs are ordered for:
- Persistent low back pain
- Sciatica or leg pain
- Numbness or tingling
- Sports or lifting injuries
The challenge? Most adults show “abnormal” findings on MRI even without pain.
Imaging findings don’t always equal symptoms, and that disconnect creates confusion and anxiety.
Disc Herniation vs Degenerative Changes: What’s the Difference?
Lumbar Disc Herniation
A disc herniation occurs when the inner portion of a spinal disc pushes through the outer layer.
Key points:
- Can compress nearby nerves
- Often associated with leg pain or sciatica
- Can be acute or chronic
- Size, location, and nerve contact all matter
Not all herniations cause pain and not all pain is caused by herniations.
Degenerative Changes
Degenerative changes describe age-related wear and tear of the spine.
This may include:
- Disc bulging
- Disc height loss
- Arthritic facet joints
- Mild spinal stenosis
These changes:
- Are extremely common with age
- Often appear in people without symptoms
- Progress slowly over time
The word “degeneration” sounds alarming, but it does not automatically mean damage or disability.
Why MRI Reports Can Sound Scarier Than They Should
Radiology reports are written for clinicians, not patients.
As a result:
- Technical terms are used without context
- Findings are listed without explaining relevance
- Normal aging changes are documented carefully even when expected
Seeing multiple findings in one report doesn’t mean all of them are causing your pain.
This is where interpretation beyond just identification matters.
Why Spine Imaging Requires Expertise
Two radiologists may describe the same MRI differently depending on:
- Subspecialty training in neuroradiology, musculoskeletal, or spine imaging
- Experience correlating imaging with symptoms
- Understanding which findings are clinically meaningful
A subspecialized neuroradiologist, MSK, or spine radiologist focuses on:
- Nerve compression and laterality
- Severity and clinical relevance
- Distinguishing incidental findings from pain generators
- Clarifying whether imaging supports surgical or non-surgical care
That distinction can directly impact treatment decisions.
When a Radiology Second Opinion Can Help
A second opinion is especially valuable if:
- Your report lists multiple findings but no clear explanation
- You’re being advised to consider injections or surgery
- Different providers gave different interpretations
- Your symptoms don’t match what you were told
- You want reassurance before making invasive decisions
In many cases, an expert second opinion can clarify whether your imaging truly explains your symptoms or whether conservative care is appropriate.
Surgery Decisions Should Never Be Based on One Opinion Alone
Spine surgery can be life-changing for the right patient but unnecessary surgery carries real risk.
Clear imaging interpretation helps ensure:
- Surgery is truly indicated
- The correct spinal level is targeted
- Expectations are realistic
A second opinion isn’t questioning your doctor. It's imperative to ensure your imaging is fully understood.
What a Radiology Second Opinion Does
A radiology second opinion:
- Reviews the actual MRI images
- Provides an independent expert interpretation
- Explains findings in plain language
- Helps guide informed next steps
It does not:
- Replace your physician
- Make treatment decisions
- Create new findings
It simply adds clarity. If a subspecialized radiology second opinion raises questions or offers a different interpretation, it’s reasonable to expect your care team to review and consider it. But what if a surgeon is unwilling to discuss or incorporate expert imaging input before recommending invasive treatment? That's a sign to seek another surgical opinion. Gathering multiple opinions before going down the route of spinal surgery is an important step in ensuring your decisions are fully informed.
Confidence Comes From Understanding
Hearing “you have a disc herniation” isn’t the same as understanding whether it matters.
At MDView, patients connect with board-certified, subspecialized radiologists who review spine MRIs and explain what’s relevant so you can move forward with confidence instead of fear.
Get peace of mind today. Upload your exam to https://app.mdview.com to get an expert second opinion. You will have the opportunity to provide the radiologist with details on your condition and your concerns, see the matching eligible body imaging radiologists, and submit for a fast, expert second opinion report. Don't have your exam? No problem! MDView can get it on your behalf at no cost to you! Just click Have MDView Get My Exam within your MDView account.