MRI Findings vs. Real Pain: Why Your Imaging Doesn’t Tell the Full Story

If you’ve ever had an MRI and felt your stomach drop while reading the report, you’re not alone.

Disc bulge. Degeneration. Tear. Arthritis. Those words sound serious—and they often make people believe their body is “broken.”But here’s the truth most people are never told: Your MRI does not equal your pain. Let’s unpack why imaging can be misleading—and what actually matters when it comes to feeling better.

MRIs Show Structure, Not Function

An MRI is incredibly good at showing anatomy.
What it cannot show is:

• How well you move

• How strong or coordinated your muscles are

• How your nervous system responds to load

• Whether a finding is actually causing symptoms

Pain is a complex experience, not just a structural issue. Two people can have the exact same MRI—one in severe pain, the other completely symptom-free.

“Abnormal” Findings Are Extremely Common (Even Without Pain)

Research consistently shows that people with no pain at all often have “abnormal” MRI findings.

Common examples seen in pain-free individuals:

• Disc bulges

• Disc degeneration

• Facet arthritis

• Labral tears

• Meniscus tears

As we age, our imaging changes—just like wrinkles on the skin. That doesn’t automatically mean something is injured or dangerous.

Imaging findings often reflect normal aging, not damage.

Why Imaging Can Actually Make Pain Worse

Seeing scary language on a report can create fear—and fear changes how the brain processes pain.

This can lead to:

• Guarding and stiffness

• Avoidance of movement

• Loss of confidence in the body

• Increased sensitivity to normal sensations

In other words, the scan can become part of the problem, even when the tissue is safe to load.

So Why Do You Still Hurt?

If imaging isn’t the full story, what is?

Pain is often influenced by:

• Poor load tolerance (your body can’t handle the demands placed on it)

• Movement compensations

• Loss of rotation or control

• Deconditioning

• Nervous system sensitivity

• Previous injury history

This is especially true in rotational sports like golf, where the spine and hips must handle repeated force—often without adequate preparation.

What Actually Matters More Than Your MRI

Instead of asking, “What does my MRI show?”
Better questions are:

• Can my body tolerate the loads I’m asking it to handle?

• Do I have the mobility and control required for my sport or daily life?

• Am I strong through the ranges I use?

• Does movement change my symptoms?

These answers come from a thorough physical examination, not a scan.

When Imaging Is Helpful

MRIs absolutely have a place. They’re valuable when:

• Serious pathology is suspected

• Symptoms aren’t improving over time

• Surgery is being considered

• Red flags are present

But for the majority of musculoskeletal pain, imaging is only one piece of the puzzle—not the diagnosis.

The Takeaway

Your MRI tells a story about structure. Your movement tells the story about function.

Pain doesn’t mean you’re broken, imaging findings don’t dictate your future, and improvement is often possible—even when the scan looks “bad.”

The goal isn’t to chase a perfect MRI, it’s to build a body that’s strong, confident, and resilient.