Why Your MRI Might Not Explain Your Whole Back Pain Story
We get it—when you're feeling 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 newer study stated, patients often 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 Apple Country Chiropractic, we want to share an important truth: imaging doesn't always reveal the real cause of your discomfort.
THE IMAGE-PAIN DISCONNECT
Research steadily demonstrates a surprising disconnect between what appears on imaging and what patients actually feel. A comprehensive 2025 systematic review assessing 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 reported that many people without any back pain have disc bulges, herniations, and arthritis seen 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 entirely. Rather, it emphasizes 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 simply cannot provide.
THE COMPLETE CLINICAL PICTURE
Think of imaging as one chapter 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 just how it looks.
This is where your chiropractor's expertise becomes important. By integrating 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 precise diagnosis and effective treatment plans just for your specific individual needs, rather than just treating what appears on a scan.
TRUST THE PROCESS
Yes, uncertainty can be unsettling, and desiring concrete answers through imaging is absolutely normal. But trust that your clinical evaluation at Apple Country Chiropractic—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 just images alone.
CONTACT Apple Country 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.
