Why Your MRI Might Not Explain Your Whole Back Pain Story
We get it—when you're having back pain, seeing an X-ray or MRI of your spine can feel reassuring. 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 stated, patients frequently find "it's hard to trust an individual, it's easier to trust an image" when dealing with the vagueness of low back pain. (1) However, as your trusted chiropractic partncer at Manchester Chiropractic & Sports Injuries, we need to share an important fact: imaging doesn't always reveal the real cause of your discomfort.
THE IMAGE-PAIN DISCONNECT
Research steadily 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 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 feel minimal pain, while others with minimal imaging changes suffer considerably.
Research shows that many pain-free individuals have disc bulges, herniations, and arthritis visible 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 dismiss imaging all together. 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 are gathering crucial information that images just cannot provide.
THE COMPLETE CLINICAL PICTURE
Think of imaging as one part 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 training becomes important. By incorporating 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 tailored to your specific 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 completely normal. 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 come up with a treatment strategy based on the best available evidence and your individual presentation, not only the images.
CONTACT Manchester Chiropractic & Sports Injuries
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.
Be sure you have your next chiropractic appointment with us scheduled soon!
