The MRI scan showed the disc. It didn’t show the years your body spent working around it. Scans show structure. What gets missed is where the answer always is.
Getting an MRI result can feel like a moment of clarity — finally, something visible, something that explains the pain. But for many people, the scan raises more questions than it answers. The disc finding is there, but it does not explain why the pain started when it did, why it behaves the way it does, or why treatment aimed directly at the disc has not produced lasting relief.
The reason is that a scan captures a single moment in time. It cannot capture the years of adaptation, compensation, and accumulated load that preceded that moment.
What Scans Show — and What They Cannot
MRI and other imaging tools are genuinely valuable. They can identify significant structural pathology, rule out serious conditions, and guide clinical decision making. But their limitations are equally important to understand.
- Scans Capture Structure, Not History
A disc bulge visible on an MRI did not appear overnight in most cases. It developed over time — often years — as the result of accumulated load, movement patterns, and postural habits. The scan shows the end point of that process. It does not show the compensations the body made along the way, the muscles that became overactive to protect the area, the joints that stiffened to reduce movement through a vulnerable segment, or the neural tissue that became progressively more sensitised as a result.
- Structural Findings Are Common in People Without Pain
Research has consistently shown that disc bulges, degeneration, and other structural changes are found on imaging in large proportions of people who have no pain whatsoever. A landmark systematic review found that disc degeneration was present in over 37 percent of asymptomatic 20-year-olds, rising to over 80 percent by the age of 50. This does not mean the findings are irrelevant — but it does mean that a structural finding on a scan is not automatically the explanation for someone’s pain.
- The Body’s Compensations Are Invisible on Imaging
When one area of the body is painful or restricted, surrounding structures adapt to protect it. Muscles change their recruitment patterns. Joints alter their movement strategies. Nerves adjust their tension and sensitivity. Over time these compensations become habitual — and they often become contributors to pain in their own right, independent of the original structural finding.
These adaptations are clinical findings, not imaging findings. They require a hands-on assessment to identify.
- Neural Sensitivity Is Not Visible on a Scan
One of the most important contributors to persistent pain following a disc injury is the sensitisation of the nerve tissue associated with that disc. A nerve that has been compressed or irritated — even briefly — can remain in a heightened state of sensitivity long after the structural compression has resolved. This sensitised state drives ongoing symptoms that appear disproportionate to the scan findings, and it requires specific clinical assessment and management.
Looking Beyond the Scan
Finding the answer that the scan missed requires a different kind of assessment — one that is focused on how the body is moving, how the nervous system is responding, and what compensations have developed over time. This is where the most clinically meaningful information is found.
At Aret Chiropractic, our approach is built around identifying what imaging cannot show. We assess the mechanical, neurological, and functional contributors to pain — the layers of the problem that have built up over time and that will not resolve simply by targeting the structural finding on the scan.
If you have had imaging that has not given you the answers you were looking for, call us on (02) 8018 8883 to speak with Aret Aboulian at Aret Chiropractic in North Ryde, or book online for a consultation.
References
Brinjikji, W., et al. (2015). Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. American Journal of Neuroradiology, 36(4), 811–816.
Moseley, G. L., & Butler, D. S. (2015). Fifteen years of explaining pain: the past, present, and future. Journal of Pain, 16(9), 807–813.
Nijs, J., et al. (2018). Central sensitisation in chronic pain conditions: latest discoveries and their potential for precision medicine. The Lancet Rheumatology, 1(2), e76–e85.
Shacklock, M. (2005). Clinical Neurodynamics: A New System of Musculoskeletal Treatment. Elsevier.
Waddell, G. (1998). The Back Pain Revolution. Churchill Livingstone.