Almost everyone gets a hernia, but that often means nothing at all

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Many people are shocked when the doctor says, “You have a hernia” or “your vertebrae are worn out.” But what if these findings occur in the majority of people? And are often not a problem at all?

In broad terms, the back consists of vertebrae, intervertebral discs and the spinal cord. Between each vertebra is an intervertebral disc, which acts as a shock absorber and allows the back to move smoothly. The nerve canal runs through the middle of the spinal column, through which the spinal cord and nerve roots pass. These nerves transmit signals to and from the rest of the body.

In a hernia, the intervertebral disc bulges, which can put pressure on a nerve root. This can lead to pain, loss of sensation, loss of strength or – in rare cases – paralysis of an arm or leg. But not every hernia causes complaints.

Do you suffer from back pain? Read tips from an exercise scientist in this Metro article .

In a large review study published in the American Journal of Neuroradiology , researchers looked at over 3,000 MRI scans of people without back pain. The results:

• 30 percent of 20-year-olds already had signs of a hernia. Among 80-year-olds, this rose to 84 percent.
• Disc wear was seen in 37 percent of 20-year-olds and in 96 percent of older adults.
• Vertebral displacements occurred in over 50 percent of elderly people.

What we see on a scan does not always say anything about how someone feels. As a reminder: the people who were examined in this study did not have any form of back pain . In the medical world, we call this a false positive finding: something is visible on a scan, but it is not related to physical complaints.

As we age, our structures change – just like we get wrinkles or gray hair. Discs may bulge. Vertebrae may wear out or shift a little. That is part of it and not necessarily a problem.

In some countries, such as the United States, annual health checks are standard practice – often including imaging. This may seem reassuring, but it often leads to overdiagnosis: abnormalities that are discovered but do not cause any symptoms. In countries such as Japan and South Korea, where preventive full-body MRIs are becoming increasingly popular, doctors are also warning of an increase in false-positive findings. People are told that “something is wrong” while they feel perfectly healthy – with all the stress, unnecessary treatments and additional medical costs that entail.

A hernia, wear and tear or a worn-out back sounds worrying, but is only one piece of the puzzle and not necessarily a problem. What counts are your symptoms: what you feel, what you can do, and how you function. Always consult your GP or physiotherapist in case of persistent complaints. They can best assess which policy is appropriate.

If you have no complaints, a scan is often unnecessary. Unless of course you want to know how exceptionally normal your back is.

Please note: this is not medical advice. If you have any concerns about your health, always consult a doctor.

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