Your Imaging and Your Results: Not a Condemnation to Pain
- Philippe Dessaulles-Goudezeune
- May 6
- 4 min read
Disc herniation, degeneration, joint narrowing… When you receive an imaging report, the words can be terrifying. Yet most people without any pain have the exact same findings. Here's why medical imaging is a tool, not a verdict.
The Classic Scene
You've had back pain for a few weeks. Your doctor orders an MRI. A few days later, you're holding the report in your hands. You read words like "L4-L5 disc herniation," "moderate disc degeneration," or "foraminal protrusion."
Panic sets in.
You Google it. You land on forums filled with stories of surgeries, disabilities, and chronic pain. You're convinced your body is broken.
But it probably isn't.
Medical Imaging: The Pandora's Box of the Human Body
An MRI or X-ray is like opening Pandora's box. You'll always find something, and that's completely normal. The human body is a complex machine that wears, adapts, and changes over time.
A study published in the American Journal of Neuroradiology (Brinjikji et al., 2015) reviewed MRI results from people with no back pain whatsoever. The findings were striking:
At 20 years old: 37% had disc degeneration
At 40 years old: 68% showed disc degeneration
At 60 years old: 91% had disc changes
At 50 years old: 60% had a disc protrusion or herniation
All of this… with zero pain.
In other words, if you get an MRI, you'll probably find something. That's inevitable. But does that finding cause your pain? Not necessarily.
When Imaging is Actually Useful
Imaging isn't useless; it's invaluable in the right circumstances. It helps to:
Rule out serious pathology: fractures, tumors, infections, severe spinal cord compression
Guide surgical decisions when conservative treatments have failed
Clarify the clinical picture when significant neurological symptoms are present (strength loss, sensory loss, bladder or bowel issues)
But in the vast majority of common back, neck, or joint pain cases, imaging isn't necessary in the first weeks. It can even be harmful by creating anxiety that slows recovery.
So What About Disc Herniations?
Disc herniation is probably the most feared imaging diagnosis, yet it's most often managed very well without surgery.
An intervertebral disc is the cushion between two vertebrae. When the gel-like nucleus pushes outward, that's a herniation. It can irritate a nerve, causing pain, tingling, or even leg weakness (sciatica).
But here's what the research clearly shows:
Herniations Often Heal on Their Own
Follow-up imaging meta-analyses (Zhong et al., Pain Physician, 2017) show that 50 to 90% of disc herniations regress spontaneously over several months, without surgery. The body reabsorbs the herniated material on its own. That's remarkable.
Physiotherapy is the First-Line Treatment
International clinical guidelines, including those from the Cochrane Collaboration and NICE, are clear: for most disc herniations, physiotherapy is as effective as surgery in the medium and long term, with far fewer risks.
A physio works on:
Mobility and flexibility to reduce nerve compression
Muscle strengthening to stabilize the spine
Pain education to rebuild confidence in your body
Gradual activity progression to prevent fear of movement (kinesiophobia)
What If Things Don't Improve?
That's where your physiotherapist or physician plays a key role. Throughout your follow-up, your healthcare provider is trained to recognize signs that fall outside the expected recovery pattern, such as progressive strength loss, unusual neurological symptoms, or a lack of progress despite proper treatment, and to refer you to the right specialist at the right time if needed.
In the vast majority of cases, the body responds well to physiotherapy. But when it doesn't, you're not on your own: the team around you is there to recognize those situations and adjust the plan accordingly.
Taking Back Control
If you've just received an imaging report that worried you, here's what I recommend:
Breathe. Technical language is scary, but it rarely describes an irreversible catastrophe.
Consult a healthcare professional, not Google. A physiotherapist can explain what your results mean in the context of your pain, your body, and your life.
Stay active. Prolonged complete rest is rarely the solution. Moving at the right dose promotes healing.
Don't define your body by its imaging. You are not your MRI.
What a Physiotherapist Can Do For You
In practice, when a patient walks in holding an imaging report with fear in their eyes, my first step is always the same: explain.
Explain what the technical words mean. Explain the difference between a damaged structure and a painful one. Explain that the body heals remarkably well when given the right conditions.
Then we build a plan together: mobility, strengthening, activity progression, return to sport. Step by step.
The goal isn't a perfect MRI. It's to help you do what you love, without pain.
Your MRI Is Not Your Destiny
Medical imaging is a powerful tool in the right hands. But it's not a sentence. Millions of people live with imaging "abnormalities" and feel no pain at all. Others have significant pain with completely normal imaging.
Pain is complex. The body is resilient. And the good news is that in the vast majority of cases, it's treatable.
Don't let an imaging report dictate your quality of life. Book a comprehensive evaluation and together, we'll make sense of your results and build a plan to get you moving again.
