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 reassure you that there is a reason for your pain. There's something tangible about having a picture to look at, pointing to a specific spot, and saying "that's where it hurts." As one newer study noted, patients often find "it's hard to trust an individual, it's easier to trust an image" when coping with the vagueness of low back pain. (1) However, as your well-trained chiropractic partncer at Poulin Chiropractic of Herndon and Ashburn, we need to share an important fact: imaging doesn't always reveal the real source of your discomfort.
THE IMAGE-PAIN DISCONNECT
Research consistently shows a remarkable disconnect between what appears on imaging and what patients really feel. A comprehensive 2025 systematic review examining 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 seen on MRI feel minimal pain, while others with minimal imaging changes are quite painful.
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 are not actually causing problems while [[missing}overlooking]31] the true source of your symptoms.
This isn't to dismiss imaging entirely. Rather, it emphasizes why your clinical examination is equally—if not more—vital. When your chiropractor reviews your movement patterns, muscle strength, reflexes, and pain response to specific positions, they're gathering critical information that images simply cannot provide.
THE COMPLETE CLINICAL PICTURE
Think of imaging as one part in your health journey, not the entire trip. Your MRI might show 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 incorporating 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 effective 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 Poulin Chiropractic of Herndon and Ashburn—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 Poulin Chiropractic of Herndon and Ashburn
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.
