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 area, and saying "that's where it hurts." As one recent study noted, 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 trusted chiropractic partncer at Dr. Paulette Hugulet, DC, LLC, we need to share an important truth: imaging doesn't always reveal the real cause of your discomfort.
THE IMAGE-PAIN DISCONNECT
Research steadily demonstrates a surprising disconnect between what appears on imaging and what patients actually feel. A comprehensive 2025 systematic review analyzing 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 experience 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 all together. Rather, it highlights why your clinical examination is equally—if not more—important. 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 important. By incorporating imaging findings with hands-on examination, movement assessment, and your symptom history, they come up with a comprehensive understanding of your condition. This balanced approach leads to more accurate 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 uncomfortable, and desiring concrete answers through imaging is completely normal. But trust that your clinical evaluation at Dr. Paulette Hugulet, DC, LLC—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 Dr. Paulette Hugulet, DC, LLC
Listen to this PODCAST with Dr. Mary Peterson on The Back Doctors Podcast with Dr. Michael Johnson as she describes 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!
