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 reassure you that there is a reason for your pain. There's something clear about holding an image in your hands, pointing to a specific area, and saying "that's where it hurts." As one recent study stated, patients often 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 trusted chiropractic partncer at Johnson Chiropractic, we want to share an important fact: imaging doesn't always expose the real cause of your discomfort.
THE IMAGE-PAIN DISCONNECT
Research steadily demonstrates 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 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 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 set aside imaging all together. Rather, it highlights 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 critical information that images just cannot suppy.
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 solely 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 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 wanting concrete answers through imaging is completely normal. But trust that your clinical evaluation at Johnson Chiropractic—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 Johnson Chiropractic
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 made soon!
