Why Your MRI Might Not Explain Your Whole Back Pain Story
We understand—when you're experiencing back pain, seeing an X-ray or MRI of your spine can feel reassuring. 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 recent study stated, patients frequently find "it's hard to trust an individual, it's easier to trust an image" when coping with the uncertainty of low back pain. (1) However, as your well-trained chiropractic partncer at Most Chiropractic Clinic, we need to share an important fact: imaging doesn't always expose the real source of your discomfort.
THE IMAGE-PAIN DISCONNECT
Research steadily demonstrates a surprising disconnect between what appears on imaging and what patients actually 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 reliably 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.
Research shows that many pain-free individuals have disc bulges, herniations, and arthritis visible on their MRIs.. If we relied 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 set aside imaging entirely. Rather, it highlights why your clinical examination is equally—if not more—important. 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 part in your health story, not the entire book. Your MRI may reveal 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 training becomes important. By integrating imaging findings with hands-on examination, movement assessment, and your symptom history, they come up with a comprehensive understanding of your pain issue. This balanced approach leads to more precise diagnosis and applicable treatment plans just for your specific individual needs, rather than simply treating what appears on a scan.
TRUST THE PROCESS
Yes, uncertainty can be unsettling, and wanting concrete answers through imaging is absolutely natural. But trust that your clinical evaluation at Most Chiropractic Clinic—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 just images alone.
CONTACT Most Chiropractic Clinic
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 leads the care of spine pain for best relief.
