Why Your MRI Might Not Explain Your Whole Back Pain Story
We get it—when you're experiencing back pain, seeing an X-ray or MRI of your spine can feel reassuring. There's something tangible 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 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 Vancouver Disc Centers, we need to share an important fact: imaging doesn't always expose the real source of your discomfort.
THE IMAGE-PAIN DISCONNECT
Research steadily demonstrates a surprising 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 dependably 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 suffer considerably.
Studies have also reported 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 set aside imaging entirely. Rather, it emphasizes why your clinical examination is just as—if not more—key. When your chiropractor assesses your movement patterns, muscle strength, reflexes, and pain response to specific positions, they're gathering crucial information that images simply cannot suppy.
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 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 invaluable. By integrating imaging findings with hands-on examination, movement assessment, and your symptom history, they come up with a comprehensive understanding of your condition. This balanced approach leads to more accurate diagnosis and effective treatment plans just for your specific individual needs, rather than just treating what you see on a scan.
TRUST THE PROCESS
Yes, uncertainty can be uncomfortable, and desiring concrete answers through imaging is absolutely normal. But trust that your clinical evaluation at Vancouver Disc Centers—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 Vancouver Disc Centers
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.
