Why Your MRI Might Not Explain Your Whole Back Pain Story
We understand—when you're feeling back pain, seeing an X-ray or MRI of your spine can reassure you that there is a reason for your pain. There's something tangible about having a picture to look at, pointing to a specific spot, and saying "that's where it hurts." As one recent study noted, patients frequently find "it's hard to trust an individual, it's easier to trust an image" when dealing with the uncertainty of low back pain. (1) However, as your well-trained chiropractic partncer at Chiropractic Spine Sports And Rehabilitation, we want to share an important truth: imaging doesn't always reveal the real source of your discomfort.
THE IMAGE-PAIN DISCONNECT
Research consistently shows a remarkable disconnect between what appears on imaging and what patients really feel. A comprehensive 2025 systematic review analyzing lumbar spinal stenosis—a condition that entails narrowing of the spinal canal—found that imaging findings don't dependably predict long-term outcomes or symptom severity. (2) Many patients with significant stenosis seen on MRI have minimal pain, while others with minimal imaging changes are quite painful.
Studies have also reported that many people without any back pain have disc bulges, herniations, and arthritis visible on their MRIs. If we depended solely on imaging, we might treat findings that aren't actually causing problems while [[missing}overlooking]31] the true source of your symptoms.
This isn't to dismiss imaging entirely. Rather, it emphasizes why your clinical examination is just as—if not more—vital. When your chiropractor reviews your movement patterns, muscle strength, reflexes, and pain response to specific positions, they're gathering critical information that images simply cannot suppy.
THE COMPLETE CLINICAL PICTURE
Think of imaging as one chapter in your health story, not the entire book. Your MRI might show disc bulges or arthritis, but these findings are incredibly common in pain-free individuals too. What matters most is how your spine functions, not solely how it looks.
This is where your chiropractor's training becomes invaluable. By integrating imaging findings with hands-on examination, movement assessment, and your symptom history, they develop a comprehensive understanding of your pain issue. This balanced approach leads to more precise diagnosis and applicable treatment plans tailored to your specific needs, rather than simply treating what you see on a scan.
TRUST THE PROCESS
Yes, uncertainty can be uncomfortable, and desiring concrete answers through imaging is completely normal. But trust that your clinical evaluation at Chiropractic Spine Sports And Rehabilitation—combined with thoughtful interpretation of any imaging—offers the most complete picture of your spinal health. Together, we’ll develop a treatment plan based on the best available evidence and your individual presentation, not just images alone.
CONTACT Chiropractic Spine Sports And Rehabilitation
Listen to this PODCAST with Dr. Mary Peterson on The Back Doctors Podcast with Dr. Michael Johnson as she describes the benefit of the system of Cox® Technic that guides care of spine pain for best relief.
Be sure you have your next chiropractic appointment with us scheduled soon!
