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 newer 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 trusted chiropractic partncer at Layden Chiropractic, we need to share an important fact: imaging doesn't always reveal the real cause 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 examining 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 visible on MRI feel minimal pain, while others with minimal imaging changes are quite painful.
Studies have also shown that many people without any back pain 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 just as—if not more—vital. When your chiropractor assesses your movement patterns, muscle strength, reflexes, and pain response to specific positions, they're gathering critical information that images just cannot provide.
THE COMPLETE CLINICAL PICTURE
Think of imaging as one part 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 experience becomes important. By integrating imaging findings with hands-on examination, movement assessment, and your symptom history, they develop a comprehensive understanding of your condition. This balanced approach leads to more accurate 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 desiring 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 strategy based on the best available evidence and your individual presentation, not only the images.
CONTACT Layden Chiropractic
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 guides care of spine pain for best relief.
Be sure you have your next chiropractic appointment with us scheduled soon!
