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 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 coping with the vagueness of low back pain. (1) However, as your well-trained chiropractic partncer at Connected Chiropractic, we want to share an important truth: imaging doesn't always reveal the real source of your discomfort.
THE IMAGE-PAIN DISCONNECT
Research consistently demonstrates a remarkable 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 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 ignore imaging entirely. Rather, it highlights why your clinical examination is just as—if not more—key. 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 chapter in your health journey, not the entire trip. Your MRI may reveal 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 training becomes invaluable. By integrating imaging findings with hands-on examination, movement assessment, and your symptom history, they create a full understanding of your condition. This balanced approach leads to more accurate diagnosis and effective treatment plans just for your specific individual needs, rather than simply treating what you see on a scan.
TRUST THE PROCESS
Yes, uncertainty can be unsettling, and wanting concrete answers through imaging is absolutely natural. But trust that your chiropractor's clinical evaluation—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 Connected Chiropractic
Listen to this PODCAST with Dr. Mary Peterson on The Back Doctors Podcast with Dr. Michael Johnson as she explains the benefit of the system of Cox® Technic that leads the care of spine pain for best relief.
