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 area, and saying "that's where it hurts." As one recent study noted, patients often find "it's hard to trust an individual, it's easier to trust an image" when dealing with the uncertainty of low back pain. (1) However, as your trusted chiropractic partncer at Cox Chiropractic Medicine Inc, 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 assessing 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 experience 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 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 dismiss imaging all together. Rather, it emphasizes why your clinical examination is equally—if not more—key. When your chiropractor reviews your movement patterns, muscle strength, reflexes, and pain response to specific positions, they are gathering critical information that images simply cannot suppy.
THE COMPLETE CLINICAL PICTURE
Think of imaging as one chapter in your health story, not the entire book. 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 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 come up with a full understanding of your pain issue. This balanced approach leads to more precise diagnosis and effective treatment plans tailored to your specific needs, rather than just 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 chiropractor's clinical evaluation—combined with thoughtful interpretation of any imaging—offers the most complete picture of your spinal health. Together, we’ll develop a treatment strategy based on the best available evidence and your individual presentation, not just images alone.
CONTACT Cox Chiropractic Medicine Inc
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.
Be sure you have your next chiropractic appointment with us scheduled soon!
