As we age, it’s no secret that our bodies go through all sorts of changes. Most of these changes are completely normal, but when it comes to our muscles, joints, and bones, it’s easy to feel concerned—especially when you get a scan that highlights degenerative changes. The medical terminology on these scans can feel overwhelming, and often, the results don’t differentiate between normal, age-related changes and the possible causes of symptoms. This can lead to a lot of confusion and stress. It’s not uncommon for people to misinterpret their scan results, believing they are in worse condition than they actually are.

In this blog, we’re going to break down some common age-related degenerative changes, how to understand your scan results, and highlight the importance of working with a physiotherapist to properly interpret them. Plus, we’ll touch on some incidental findings—things that show up on scans but may not be as concerning as they sound.

The Complexity of Pain and Scans

Before we dive into the specifics, it’s important to understand that pain is a complex process. It’s our body’s natural defence mechanism, designed to protect us from harm. But here’s the tricky part: damage doesn’t always cause pain, and just because you feel pain, it doesn’t mean there’s necessarily damage.

Thanks to ongoing research, we now know that scans don’t always paint the full picture when it comes to pain. Studies comparing the scans of people with and without symptoms have revealed that many people walk around with some form of “damage” or pathology on their scans, but they experience no pain at all. In fact, many of these individuals go about their daily lives without any issues. This is where things can get confusing—just because something shows up on a scan doesn’t mean it’s causing your pain or needs to be treated.

Age-Appropriate Degenerative Changes: What’s Normal?

As we age, there are a few changes that naturally occur in our musculoskeletal system. These changes might sound scary when you see them listed on a scan, but the reality is that they’re a normal part of the aging process. Here’s a look at some common age-appropriate degenerative changes:

1. Joint Health

As we get older, the cartilage that cushions our joints naturally starts to wear down. This can lead to conditions like osteoarthritis, where the joints become stiff and painful. However, just because you see signs of wear and tear in a joint on your scan doesn’t mean you’ll experience symptoms. Many people have signs of joint degeneration on their scans but experience little to no discomfort.

2. Bone Density

Our bones naturally lose density as we age, which makes them more susceptible to fractures. This is why conditions like osteoporosis become more common in older adults. Decreased bone density can show up on a scan, but it’s something that can often be managed with diet, exercise, and, in some cases, medication.

3. Muscle Mass and Strength

As we age, we also lose muscle mass and strength—a condition known as sarcopenia. This loss of muscle can impact mobility and increase the risk of falls, but it’s a gradual process that can often be slowed or reversed with regular strength training and physiotherapy.

4. Posture and Alignment

Changes in our spinal discs and ligaments are a common part of aging, and these changes can sometimes lead to alterations in posture or spinal alignment. For example, you might develop a slight hunch or notice that your range of motion isn’t what it used to be. While these changes are normal, they can sometimes contribute to discomfort, which is why maintaining flexibility and mobility through exercise is key.

5. Flexibility and Range of Motion

As we get older, our connective tissues, like tendons and ligaments, become less flexible. This can lead to a gradual reduction in range of motion, which is why it’s so important to stay active and keep those muscles and joints moving.

Incidental Findings on Scans: What Do They Mean?

Now that we’ve covered some common degenerative changes, let’s talk about incidental findings—those things that show up on your scan that might sound alarming but are often completely normal. Here are a few examples based on common areas of the body:

1. Shoulder

A study conducted in 2013 looked at the prevalence of full-thickness rotator cuff tears across different age groups. They found that:

• 0% of people in their 20s to 40s had full-thickness tears.
• 10% of people in their 50s had full-thickness tears.
• 15% of people in their 60s had full-thickness tears.
• 36% of people in their 80s had full-thickness tears.

Interestingly, 65% of the people with rotator cuff tears didn’t experience any symptoms. That means that a significant number of people were walking around with these tears but were pain-free and functioning normally. If something like this shows up on your scan, it doesn’t necessarily mean it’s causing your pain or needs surgical intervention.

2. Knee

A study focused on individuals aged 50 to 90 looked at the prevalence of meniscal tears in this age group. The results showed:

• 19% of females aged 50-60 had meniscal tears.
• 56% of males aged 70-90 had meniscal tears.

What’s surprising is that only 61% of these individuals reported experiencing knee pain in the past month. This highlights that, while meniscal tears are common as we age, they aren’t always associated with symptoms.

3. Back

There’s been a lot of research done on back pain and how it correlates (or doesn’t) with scan results. A recent study showed that:

• 37% of pain-free 20-year-olds had evidence of disc degeneration on their scans.
• A whopping 96% of pain-free 80-year-olds had disc degeneration.

Again, this shows that degenerative changes in the spine are common as we age and don’t always result in pain. If your scan comes back showing disc degeneration, it’s important to remember that it’s a normal part of aging and may not be the root cause of any discomfort you’re experiencing.

Why You Are Not Your Scan

Here’s the takeaway: you are not your scan. Medical imaging is incredibly useful for diagnosing certain conditions, but it has its limits. Scans can pick up every little detail—things that may have been there for years without causing any issues. Just because something abnormal shows up doesn’t mean it’s causing your pain or needs treatment.

That’s why it’s so important to consult with a physiotherapist who can assess your symptoms, examine your scan results, and give you a comprehensive, real-world interpretation. A physio will be able to help you understand which findings on your scan are normal for your age and which ones might be contributing to your symptoms. They’ll also guide you through a treatment plan that’s focused on getting you back to feeling your best, without unnecessary worry about incidental findings.

Physiotherapy for Age-Appropriate Degenerative Changes

Physiotherapy is one of the best ways to manage age-related changes in your musculoskeletal system. Here are some of the interventions that a physiotherapist might use to help you stay active and healthy as you age:

1. Exercise Prescription

Staying active is one of the most effective ways to manage degenerative changes and maintain your overall health. A physiotherapist can design a tailored exercise program that includes strength training, flexibility exercises, and cardiovascular activities. This type of program will help you build muscle, maintain joint health, and improve your balance and coordination.

2. Pain Management Techniques

If you’re experiencing pain related to degenerative changes, a physiotherapist can use a variety of techniques to help manage it. These might include manual therapy (such as massage or joint mobilisation), heat and cold therapy, and even dry needling. The goal is to reduce pain while improving your overall function.

3. Balance and Fall Prevention

As we age, our risk of falls increases, particularly if we’ve lost muscle strength or balance. Physiotherapists can guide you through balance exercises and functional training to improve your stability and reduce your risk of falling. This is especially important for older adults, as falls can lead to serious injuries like fractures.

4. Joint Mobilisation and Soft Tissue Techniques

If joint stiffness or muscle tightness is limiting your range of motion, physiotherapists can use hands-on techniques to help. Joint mobilisation can improve the movement of stiff joints, while soft tissue techniques can address tight muscles and help you move more freely.

Conclusion

Aging is a natural process, and age-appropriate degenerative changes are nothing to fear. In fact, understanding these changes is the first step toward maintaining a healthy, active lifestyle well into your later years. Physiotherapy plays a crucial role in this journey, offering targeted interventions that can help you manage pain, maintain mobility, and stay strong.

Remember, the next time you get a scan back, don’t be alarmed by every detail. Work with one of our physiotherapists at XPhysio who can help you interpret the results and provide a clear path forward. By staying proactive and taking care of your body, you can enjoy a fulfilling, active life, no matter your age!