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 clear about holding an image in your hands, pointing to a specific spot, 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 dealing with the uncertainty of low back pain. (1) However, as your trusted chiropractic partncer at OrthoIllinois Chiropractic, we want to share an important truth: imaging doesn't always expose the real source of your discomfort.
THE IMAGE-PAIN DISCONNECT
Research steadily shows a surprising disconnect between what appears on imaging and what patients really 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 have 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 set aside imaging entirely. Rather, it highlights why your clinical examination is equally—if not more—vital. 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 part in your health story, not the entire book. Your MRI may reveal 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 expertise becomes invaluable. By integrating imaging findings with hands-on examination, movement assessment, and your symptom history, they create a full understanding of your condition. This balanced approach leads to more precise diagnosis and applicable treatment plans tailored to your specific needs, rather than simply treating what you see on a scan.
TRUST THE PROCESS
Yes, uncertainty can be uncomfortable, and desiring concrete answers through imaging is absolutely natural. But trust that your clinical evaluation at OrthoIllinois Chiropractic—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 OrthoIllinois 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 guides care of spine pain for best relief.
