Why Your MRI Might Not Explain Your Whole Back Pain Story
We understand—when you're having back pain, seeing an X-ray or MRI of your spine can feel reassuring. There's something clear about holding an image in your hands, pointing to a specific spot, and saying "that's where it hurts." As one newer study stated, patients frequently find "it's hard to trust an individual, it's easier to trust an image" when coping with the vagueness of low back pain. (1) However, as your well-trained chiropractic partncer at Medical Spine and Sports Injury and Rehab Centers, we need to share an important fact: imaging doesn't always expose the real source of your discomfort.
THE IMAGE-PAIN DISCONNECT
Research steadily shows a remarkable disconnect between what appears on imaging and what patients actually feel. A comprehensive 2025 systematic review assessing lumbar spinal stenosis—a condition where the spinal canal narrows—found that imaging findings don't reliably predict long-term outcomes or symptom severity. (2) Many patients with significant stenosis visible on MRI have minimal pain, while others with minimal imaging changes suffer considerably.
Studies have also reported that many people without any back pain have disc bulges, herniations, and arthritis seen on their MRIs. If we relied solely on imaging, we might treat findings that are not actually causing problems while [[missing}overlooking]31] the true source of your symptoms.
This isn't to dismiss imaging entirely. Rather, it highlights why your clinical examination is just as—if not more—important. When your chiropractor assesses 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 appear frequently in pain-free individuals too. What matters most is how your spine functions, not just how it looks.
This is where your chiropractor's experience becomes invaluable. By integrating imaging findings with hands-on examination, movement assessment, and your symptom history, they come up with a comprehensive understanding of your condition. This balanced approach leads to more accurate diagnosis and effective treatment plans just for your specific individual needs, rather than just treating what you see on a scan.
TRUST THE PROCESS
Yes, uncertainty can be unsettling, and wanting concrete answers through imaging is completely natural. But trust that your clinical evaluation at Medical Spine and Sports Injury and Rehab Centers—combined with thoughtful interpretation of any imaging—provides the most complete picture of your spinal health. Together, we’ll come up with a treatment plan based on the best available evidence and your individual presentation, not only the images.
CONTACT Medical Spine and Sports Injury and Rehab Centers
Listen to this PODCAST with Dr. Mary Peterson on The Back Doctors Podcast with Dr. Michael Johnson as she describes the value 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 made soon!
