When people experience pain, one of the first questions they often ask is: “Should I get an MRI?”
Modern imaging technology can show us incredibly detailed pictures of what’s happening inside the body. MRIs, CT scans, and X-rays can reveal things like disc herniations, tendon tears, and degenerative changes with remarkable clarity.
But here’s something many patients don’t realize:
Not everything that shows up on an image is actually the source of pain.
In fact, research has consistently shown that many structural “abnormalities” appear on imaging in people who have no pain at all. These findings raise an important question for patients and clinicians alike: Are we always treating the real cause of the problem—or sometimes just the picture on the screen?
Recent research continues to reinforce a principle that rehabilitation professionals see every day: pain and imaging findings do not always match.
What Research Shows About Imaging, Pain, & Injuries
A new study out of Finland has shown an interesting principle that is seen in the rehabilitation world frequently. They performed MRIs on the shoulder of 602 adults, some with shoulder pain, and some without any shoulder pain. They found rotator cuff abnormalities present in both groups at nearly the same rates (96% abnormalities in the asymptomatic group, and 98% in the symptomatic group)[1]. This is an incredibly important finding with huge implications for patients who are making decisions on how to manage their pain.
In 2025, a similar study of a different area of the body showed that 30% of hospitalized patients who were given MRIs for non-spinal conditions had an asymptomatic disc herniation [2]. In other words, nearly 1 in 3 patients who received an MRI for some other condition turned out to have herniated discs in their lumbar spine that they were unaware of.
These studies, along with many others show how important it is to match up the findings from imaging with a patient’s actual symptoms. So many times, treatments such as injections, nerve blocks or surgeries are performed, and they aren’t actually treating the musculoskeletal pain being felt, just the image seen on a screen. Before committing to a surgery or procedure, it is a great idea to have an in-depth and hands-on assessment by a qualified rehab professional to determine what other problems may be causing pain that aren’t necessarily seen on an x-ray.
A key takeaway is to remember not to feel anxious about diagnoses you are given from imaging. Nearly every x-ray shows degeneration of some areas, and many MRIs will show disc problems, and tendon abnormalities that may or may not be symptomatic. Follow up these findings with an appt with a Proactive therapist, and we would be happy to bring together your images with your movements patterns, strengths, and weaknesses to get a more full picture of how your pain can improve!
Summary
The real takeaway from this research is not that imaging is useless—it can be incredibly valuable in the right context. Instead, these studies remind us that images should never be interpreted in isolation.
An MRI can show structural changes, but it cannot tell us how your shoulder moves, how your muscles work together, or how your body responds to different movements and loads. Those answers come from a thorough clinical evaluation and hands-on assessment.
That’s why the most effective approach to musculoskeletal pain is one that combines imaging findings with a detailed understanding of how the body functions in real life.
If you’ve received imaging results that sound alarming, don’t panic. Many findings that look concerning on a report are actually very common—even in people who feel perfectly fine.
At ProActive Rehabilitation & Wellness, our therapists focus on connecting the dots between what shows up on your images and how your body actually moves. By understanding your movement patterns, strength, and functional limitations, we can help determine what is truly contributing to your pain—and build a plan to help you move and feel better.
Sometimes the most important thing isn’t what the picture shows.
Schedule an appointment today or give us a call to start your journey to better health.
Or, you can check out our programs and online resources and save some time in the clinic.
References
[1] Ibounig T, Järvinen TLN, Raatikainen S, et al. Incidental Rotator Cuff Abnormalities on Magnetic Resonance Imaging. JAMA Intern Med. Published online February 16, 2026. doi:10.1001/jamainternmed.2025.7903
[2] Brinjikji W, Luetmer PH, Comstock B, Bresnahan BW, Chen LE, Deyo RA, Halabi S, Turner JA, Avins AL, James K, Wald JT, Kallmes DF, Jarvik JG. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol. 2015 Apr;36(4):811-6. doi: 10.3174/ajnr.A4173. Epub 2014 Nov 27. PMID: 25430861; PMCID: PMC4464797.
