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Updated September 3, 2026
An X-ray, CT scan, or MRI can provide valuable information about the body. But it doesn't tell the whole story of pain. Imaging findings can sometimes help identify a specific problem that needs treatment. But many findings that look abnormal are also common in people who don't have pain. Understanding this distinction can help prevent an imaging report from becoming a source of unnecessary fear. An image isn't a diagnosis of pain MRI and other imaging tests can sometimes contribute to a nocebo effect when common findings are interpreted as evidence that something is damaged, dangerous, or permanently wrong. A finding on an image may be real without being the primary cause of the pain. Research has shown that many spinal changes are common in people who don't have back pain and become more common with age. A systematic review of 33 studies involving more than 3,000 asymptomatic people found that findings such as disc degeneration, disc bulging, and disc protrusion were increasingly common with age. The authors concluded that many of these findings may represent normal age-related changes rather than disease requiring treatment. In other words: Abnormal-looking doesn't necessarily mean abnormal. Back pain is a good example Low back pain is one of the most common reasons people seek medical care. Yet most low back pain is classified as non-specific, meaning that no single specific structural cause can be identified. That's important because an MRI can show many things that may look concerning but aren't necessarily responsible for the pain. One 10-year longitudinal study found that several MRI findings, including disc degeneration, disc bulging, and other degenerative changes, didn't predict future low back pain in the study population. This doesn't mean that imaging findings are never relevant. It means that an imaging finding needs to be interpreted in the context of the person's symptoms, physical examination, history, and overall clinical picture. Imaging can be useful It's important not to misunderstand the message. Imaging isn't bad. An X-ray, CT scan, or MRI can be extremely useful when there is a clinical reason to look for a specific problem. For example, imaging may be appropriate when there is suspicion of serious disease, significant trauma, or when persistent or progressive symptoms make someone a candidate for an intervention. The problem occurs when every finding is assumed to explain the pain. A scan can show changes without telling us how much those changes contribute to the pain experience. Don't let an image define you It's understandable to become concerned when a radiology report contains words such as: degeneration, bulging disc, arthritis, stenosis, or disc protrusion. Those words can sound frightening. But they're descriptions of what can be seen on an image. They aren't a complete explanation of the pain experience, and they don't define the person. Try not to let an imaging report become a diagnosis of who you are or what you can do. You aren't your X-ray. You aren't your MRI. You aren't your CT scan. You're a person who experiences pain, and the image is only one piece of information that may or may not be relevant. Don't let the search become the solution It's understandable that people living with chronic pain may seek repeated medical evaluations in an attempt to find a biological cause and solution. Sometimes that search is appropriate. But repeated testing can also uncover additional findings that may increase worry without providing a useful explanation or improving function. That can lead to more testing, more treatments, and more attention focused on finding something wrong. Instead of continually asking: "What's wrong with me?" it may be more helpful to ask: "What can I do to improve my life and function?" That doesn't mean ignoring symptoms or avoiding appropriate medical care. It means recognizing that finding something on an image isn't necessarily the same as finding the answer. The bottom line Imaging can provide important information. But an image is not the same thing as a pain experience. A finding can be real without being the cause of the pain. And a normal scan doesn't mean that the pain isn't real. The most useful approach is to interpret imaging alongside the person's history, symptoms, physical examination, goals, and overall clinical picture. Don't let a picture become your identity. You aren't your X-ray. Learn more
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