That’s the mistake I see all the time. People chase the scan. They try to treat the report. They see “disc bulge, facet degeneration, stenosis” written down, and they panic, and they start chasing every single finding — when often, none of those is even the real driver.

So the report that was meant to give them answers ends up doing the opposite. It hands them a list of scary-sounding labels, sends them into a spin, and points them at problems that may have nothing to do with why they actually hurt.

Let me give you two real examples, because this is where it really hits home.

I had a person come in with chronic lower back pain — years of it. Their MRI was a list of problems: disc issues, facet degeneration, the lot. But when I actually assessed them, when I watched them move, their back moved really well. What didn’t move well was their hip — one really stiff, restricted hip. So we treated the hip, got it moving properly, and the back pain cleared up. Nothing to do with all those scary things on the scan.

Here’s another. Same picture — all sorts going on in the lower back on the scan. But when I assessed them, the thing I found was a leg length difference: one leg slightly longer than the other. So we put a small heel lift in to balance it out, and the back pain went. Again, the scan was a distraction. The real answer wasn’t on it at all.

So this is what I want you to take away. A scan shows you what your back looks like. It does not tell you what’s driving your pain — and the two are often completely different things.

In fact, the scan can make the whole thing seem more complicated and more frightening than it actually is. You read “degeneration” and “bulge” and you think your back is falling apart, when the real fix might be something simple, somewhere else entirely. That’s why, when it comes to an MRI and back pain, the image is only ever part of the story — and often not the most important part.

The answer usually isn’t found by staring harder at the scan. It’s found by assessing the person.

A good physio looks at the whole picture — the entire chain. The hips, the legs, the feet, how you actually move. They work out what’s good, what’s not, and what’s genuinely driving your pain. And then they build a plan around you, not around your scan report. So often, that’s the thing that gets people out of pain, while the MRI — the thing they put all their faith in — turned out not to be helpful at all.

So if you’ve had a scan, and a long list of scary-sounding findings, and you’re still in pain and still confused, please don’t lose hope, and don’t assume your back is wrecked. That scan is one piece of the puzzle. It is not the whole answer, and very often it’s not even the important bit. Get assessed properly, as a whole person, by someone who looks beyond the scan. That’s usually where the answer’s been hiding all along.

Joe Sharp
BSc (Hons) Physiotherapy