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 reassure you that there is a reason for your pain. There's something clear about having a picture to look at, pointing to a specific spot, and saying "that's where it hurts." As one newer study stated, patients often 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 trusted chiropractic partncer at Chiropractic Solutions, we want to share an important truth: imaging doesn't always expose the real cause of your discomfort.
THE IMAGE-PAIN DISCONNECT
Research steadily shows a surprising 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 feel minimal pain, while others with minimal imaging changes are quite painful.
Research shows that many pain-free individuals have disc bulges, herniations, and arthritis that can be seen on their MRIs.. If we depended 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 ignore imaging entirely. Rather, it emphasizes why your clinical examination is equally—if not more—vital. When your chiropractor reviews your movement patterns, muscle strength, reflexes, and pain response to specific positions, they're gathering crucial information that images simply cannot provide.
THE COMPLETE CLINICAL PICTURE
Think of imaging as one chapter in your health journey, not the entire trip. 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 just how it looks.
This is where your chiropractor's expertise becomes important. By integrating imaging findings with hands-on examination, movement assessment, and your symptom history, they create a comprehensive understanding of your condition. This balanced approach leads to more accurate diagnosis and applicable treatment plans tailored to your specific needs, rather than just treating what you see on a scan.
TRUST THE PROCESS
Yes, uncertainty can be unsettling, and desiring concrete answers through imaging is completely natural. But trust that your chiropractor's clinical evaluation—combined with thoughtful interpretation of any imaging—delivers 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 only the images.
CONTACT Chiropractic Solutions
Listen to this PODCAST with Dr. Mary Peterson on The Back Doctors Podcast with Dr. Michael Johnson as she explains the value of the system of Cox® Technic that guides care of spine pain for best relief.
