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 spot, and saying "that's where it hurts." As one recent 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 Dr. Hoang's Chiropractic Clinic, we need to share an important fact: 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 actually feel. A comprehensive 2025 systematic review assessing lumbar spinal stenosis—a condition where the spinal canal narrows—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 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 dismiss imaging all together. Rather, it emphasizes why your clinical examination is equally—if not more—key. When your chiropractor reviews your movement patterns, muscle strength, reflexes, and pain response to specific positions, they are gathering crucial 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 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 invaluable. By incorporating imaging findings with hands-on examination, movement assessment, and your symptom history, they come up with a full understanding of your condition. This balanced approach leads to more precise diagnosis and effective treatment plans just for your specific individual needs, rather than simply treating what you see on a scan.
TRUST THE PROCESS
Yes, uncertainty can be unsettling, and wanting concrete answers through imaging is completely natural. But trust that your clinical evaluation at Dr. Hoang's Chiropractic Clinic—combined with thoughtful interpretation of any imaging—delivers 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 Dr. Hoang's Chiropractic Clinic
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.
