Degenerative Changes on MRI: Why Wear and Tear Does Not Always Mean Pain

If you have ever had an MRI of your neck or back, you may remember opening the report and immediately focusing on words like degeneration, disc bulge, stenosis, or arthritis. For many patients, those terms create anxiety and the assumption that something is seriously wrong.

One of the most important things to understand is this.

Degenerative changes on imaging are common and do not automatically explain pain.

Degeneration Is Often a Normal Finding

MRI findings often sound worse than they are. Disc degeneration, bulges, and arthritic changes are frequently seen in people who have no pain at all. These changes are often part of normal aging and adaptation and can begin earlier than most people expect, sometimes even in the twenties or thirties.

This does not mean your symptoms are imagined or unimportant. It means that imaging alone does not tell us why someone hurts.

Structure and Symptoms Are Not the Same Thing

Pain is not determined by anatomy alone. It is influenced by how joints move, how muscles support the spine, how sensitive the nervous system is, and how well the body tolerates everyday stress. Two people can have nearly identical MRI findings and feel completely different. One may function normally, while the other struggles with daily activities. The image itself rarely explains that difference.

When Imaging Is Truly Important

MRI is a valuable tool when there are progressive neurological symptoms, significant trauma, or findings that suggest more serious conditions. In most cases of neck or back pain, however, imaging is only one part of the overall clinical picture and should be interpreted alongside the physical examination and how symptoms behave.

A Functional Evidence-Based Perspective

In an evidence-based chiropractic setting, MRI findings are never looked at in isolation. The focus is on how the spine and surrounding tissues function in real life. This includes joint motion, muscle coordination, load tolerance, and how symptoms respond to care over time.

Rather than trying to fix an image, care is guided by measurable changes in movement, tolerance, and day to day function.

The Bigger Picture

Seeing degenerative changes on an MRI does not mean your spine is fragile or permanently damaged. In many cases, these findings reflect normal human variation rather than a clear cause of pain.

What matters most is how your body moves, adapts, and responds to the right type of care. When function improves, symptoms often follow, regardless of what the MRI report says

Baştuğ BT. Exploring Variations in Lumbar Canal Width: An MRI Study on Asymptomatic Patients by Age and Gender. Journal of Clinical Medicine. 2024.

Han CS, Maher CG, et al. Some magnetic resonance imaging findings may predict future low back pain and disability: a systematic review. Journal of Physiotherapy. 2023.