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 reassure you that there is a reason for your pain. 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 noted, patients frequently find "it's hard to trust an individual, it's easier to trust an image" when dealing with the vagueness of low back pain. (1) However, as your well-trained chiropractic partncer at Executive Chiropractic of Iowa, we want to share an important fact: imaging doesn't always reveal the real source of your discomfort.
THE IMAGE-PAIN DISCONNECT
Research consistently 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 reliably 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 suffer considerably.
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 aren't 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 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 just 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 training becomes invaluable. By incorporating imaging findings with hands-on examination, movement assessment, and your symptom history, they develop a comprehensive understanding of your pain issue. This balanced approach leads to more accurate diagnosis and effective treatment plans tailored to your specific needs, rather than just treating what you see 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—delivers 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 Executive Chiropractic of Iowa
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!
