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 clear 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 often 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 Hollstrom & Associates Inc, we need to share an important fact: 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 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 seen on MRI experience minimal pain, while others with minimal imaging changes suffer considerably.
Research shows that many pain-free individuals 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 ignore imaging entirely. Rather, it emphasizes why your clinical examination is equally—if not more—important. When your chiropractor assesses your movement patterns, muscle strength, reflexes, and pain response to specific positions, they are gathering crucial information that images simply cannot suppy.
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 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 training becomes important. By integrating imaging findings with hands-on examination, movement assessment, and your symptom history, they come up with a comprehensive understanding of your pain issue. This balanced approach leads to more accurate diagnosis and applicable treatment plans tailored to your specific needs, rather than simply treating what appears on a scan.
TRUST THE PROCESS
Yes, uncertainty can be unsettling, and desiring concrete answers through imaging is completely normal. But trust that your clinical evaluation at Hollstrom & Associates Inc—combined with thoughtful interpretation of any imaging—delivers 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 Hollstrom & Associates Inc
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.
