Why Your MRI Might Not Explain Your Whole Back Pain Story

We get it—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 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 uncertainty of low back pain. (1) However, as your trusted chiropractic partncer at Moriarty Chiropractic, we need to share an important truth: imaging doesn't always expose the real cause of your discomfort.

THE IMAGE-PAIN DISCONNECT

Research steadily demonstrates a remarkable disconnect between what appears on imaging and what patients really feel. A comprehensive 2025 systematic review examining 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 seen 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 are not 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 just as—if not more—important. When your chiropractor reviews 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 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 experience becomes important. By integrating 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 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 desiring concrete answers through imaging is absolutely natural. But trust that your clinical evaluation at Moriarty Chiropractic—combined with thoughtful interpretation of any imaging—delivers the most complete picture of your spinal health. Together, we’ll come up with a treatment strategy based on the best available evidence and your individual presentation, not just images alone.

CONTACT Moriarty Chiropractic

Listen to this PODCAST with Dr. Mary Peterson on The Back Doctors Podcast with Dr. Michael Johnson as she explains the value 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!