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 tangible 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 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 trusted chiropractic partncer at Old Mill Chiropractic, we need to share an important truth: imaging doesn't always expose the real source of your discomfort.
THE IMAGE-PAIN DISCONNECT
Research consistently demonstrates a surprising 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 seen on MRI have minimal pain, while others with minimal imaging changes are quite painful.
Studies have also reported that many people without any back pain have disc bulges, herniations, and arthritis visible on their MRIs. If we relied 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 emphasizes why your clinical examination is equally—if not more—key. When your chiropractor assesses your movement patterns, muscle strength, reflexes, and pain response to specific positions, they are gathering critical information that images simply cannot provide.
THE COMPLETE CLINICAL PICTURE
Think of imaging as one chapter in your health story, not the entire book. 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 just how it looks.
This is where your chiropractor's experience becomes important. By incorporating imaging findings with hands-on examination, movement assessment, and your symptom history, they create a comprehensive understanding of your condition. This balanced approach leads to more accurate 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 uncomfortable, and desiring 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 plan based on the best available evidence and your individual presentation, not only the images.
CONTACT Old Mill 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 leads the care of spine pain for best relief.
