Why Scans Don’t Tell the Full Story About Pain

When the Scan Doesn’t Match the Pain

If you have ever had a scan — an MRI, X-ray, or CT — you might have seen words like “disc degeneration,” “arthritis,” or “disc bulge” on your report and felt your heart drop.

It is easy to think, “No wonder I am in pain,” or even, “My spine must be fragile.”

But the reality is often different.
Many people with “abnormal” scans live without pain.
Many people in pain have scans that look completely normal.

What the Research Says

Several studies over the past two decades have shown that age-related findings on scans are incredibly common in people who have no symptoms.

• A 2015 systematic review published in the American Journal of Neuroradiology looked at over 3,000 asymptomatic people and found that disc degeneration was present in 37 percent of 20-year-olds, and increased to 96 percent of 80-year-olds — all without back pain (Brinjikji et al., 2015).

• A study in Spine (Jensen et al., 1994) found that 52 percent of people without back pain had at least one disc bulge, and 27 percent had a disc protrusion.

• There are even clinical reports of individuals with serious findings — like a pregnant woman with a grade 3 spondylolisthesis (a significant vertebral slippage) — walking around completely pain free (Elliott et al., Journal of Orthopaedic & Sports Physical Therapy, 2010).

So when we treat every scan finding as a “problem,” we often miss the bigger picture.

Why Scans Don’t Tell the Whole Story

Scans show structure. They cannot show:

• How sensitive your nervous system is

• How much stress or fear is amplifying your pain

• Whether your muscles and joints are moving well

• How safe your brain feels in your body

Pain is not just about damage. It is a signal from the brain designed to protect you, and it is influenced by stress, beliefs, past injuries, and even how much you fear what the scan says.

If you have been told your spine is “degenerating” or “worn out,” that language alone can actually make your pain worse by teaching your brain to treat your back as fragile — even when it is not.

When Are Scans Actually Useful?

Scans are important when there are red flags — things like fractures, cancers, severe nerve compression, or unexplained neurological symptoms.

But for most back and neck pain, especially chronic pain, a scan is not the thing that tells us how to help you get better.
In fact, relying on it too much can delay your recovery.

What Matters More Than Your Scan

Your body is adaptable. Movement, strength, and nervous system regulation are far more reliable predictors of recovery than an image on a screen.

At Obsidian Physiotherapy, I help people move past what their reports say, so they can start trusting their bodies again.
We work on building safety, restoring function, and reprogramming how the brain interprets pain signals.

You are not your scan.

Your spine is not as fragile as the report makes it sound.
And you do not need to live in fear because of what an image shows.

If you want help understanding your pain and rebuilding trust in your body, book a session here. Let’s help your nervous system feel safe again.

Move always & all ways.
Kai

xx