Don’t Let Your MRI Define You

Your MRI Is a Piece of the Puzzle — Not the Whole Story

I see this all the time in the clinic.

Someone comes in after getting an MRI and says, “My back is a mess,” or “My knee is bone-on-bone,” or “I have three bulging discs.”

And sometimes the biggest challenge isn’t the imaging finding itself. It’s what that finding has made the person believe about their body.

Imaging can be incredibly valuable. It can help identify fractures, significant tissue injuries, tumors, neurological compromise, and other conditions that may change how we manage someone.

But imaging also comes with an important limitation:

Finding something on an MRI does not automatically mean we’ve found the cause of someone’s pain.

“Abnormal” Is Often Normal

When we image people who have absolutely no pain, we find a surprising amount of structural change.

For example, research looking at asymptomatic individuals has found:

• About 30% of 20-year-olds have a lumbar disc bulge.

• By age 40, that number is around 50%.

• By age 60, it’s roughly 69%.

• Nearly 1 in 5 adults over 40 without knee symptoms have a meniscal tear on MRI.

• In one study, 69% of people without hip pain had a labral tear.

These findings are real. The MRI isn't necessarily “wrong.”

The mistake is assuming that because something appears abnormal on imaging, it must be responsible for the pain.

When Imaging Changes How Someone Sees Their Body

This is where I think we need to be careful as healthcare providers.

Words like degeneration, tear, bulge, arthritis, and wear and tear can sound pretty scary when nobody puts them into context.

A patient can walk into an

MRI feeling like an athlete with a sore back and walk out feeling like someone with a damaged spine.

That change in perception matters.

If someone believes their back is fragile because they have a disc bulge, they may stop lifting. They may avoid bending. They may stop running, skiing, paddling, or doing the things they enjoy because they're worried about causing more “damage.”

Over time, that can lead to less activity, less confidence, and potentially less capacity.

Treat the Person, Not the Picture

This doesn't mean we should ignore imaging.

It means imaging needs to be interpreted alongside the rest of the clinical picture.

What are your symptoms? How did they start? What movements bother you? What can you tolerate? How strong are you? What has your training looked like? And, importantly, what are you trying to get back to doing?

An MRI can give us useful information about your anatomy.

But it can't tell us everything about your pain, your function, or what your body is capable of.

So if your imaging report sounds scary, remember:

You are more than your MRI.

Structural findings are one piece of the puzzle. They don't automatically determine your symptoms, and they certainly don't have to determine your future.

Best,

Dr. Nick PT, DPT