08/07/2025
MRIs and Musculoskeletal Pain: Why More Imaging Isn’t Always Better
A therapist’s perspective on when scans help — and when they may lead you astray
As a massage therapist and posture specialist, I work with people every day who are in pain — back pain, shoulder pain, knee pain, or tension they just can’t shake. One thing I hear often is:
“My MRI said I have degeneration… so now what?”
There’s no denying that MRIs are powerful tools. When used appropriately, they can rule out serious conditions like fractures, tumors, or infections. But when it comes to everyday musculoskeletal issues — the kind caused by posture imbalances, stress, repetitive movement, or ergonomics — MRIs are often overused, and even misleading.
Let’s break down why:
1. MRIs Can Trigger Unnecessary Fear
Being told “something is wrong” on a scan can create anxiety, fear of movement, and a belief that your body is damaged or fragile. This fear often causes people to stop moving or limit activity — which actually worsens the issue over time.
In the clinic, I see people tighten up physically and emotionally the moment they receive an MRI report. They begin to guard their movements, which creates even more tension and pain.
2. What Shows Up on an MRI Isn’t Always the Source of Your Pain
Here’s something most people don’t know:
Research shows that 43% of joint pain (in places like the shoulder, elbow, hip, or knee) actually originates from the spine. Yet if you go in for an MRI of your painful joint, the scan will likely pick up normal age-related changes — things like arthritis, disc bulges, or degeneration — and label them as the cause.
But in many cases, those changes have been there for years and aren’t actually the pain source.
3. Degeneration Is a Natural Part of Aging
Think of it this way:
Just like we get wrinkles or gray hair as we age, our joints and discs go through changes, too. Studies have shown that many pain-free individuals — including young adults in their 20s and 30s — already have signs of disc bulges or degeneration on their MRIs.
These findings are normal, and often don’t need fixing. But once something is labeled as “degenerative” or “abnormal,” it can lead to over-treatment, including unnecessary injections or surgeries.
4. The Risk of Misdiagnosis and Overtreatment
Because MRIs zoom in on where the pain is felt, not where it comes from, they can sometimes point us in the wrong direction.
Example:
You have knee pain. An MRI of the knee finds some degeneration or a meniscus tear. But the real issue might be tight hips, poor alignment, or even nerve tension stemming from your lower back. Treating the knee — rather than the source — may lead to repeated interventions without long-term relief.
In fact, studies show that low back pain patients who receive early MRIs are 2–3 times more likely to have surgery — yet they don’t have better outcomes than those who didn’t get scanned early on.
So, When Should an MRI Be Used?
MRI is valuable when:
There are signs of serious pathology (e.g. trauma, infection, tumor, or neurological deficits)
Conservative care has been tried and symptoms persist without improvement
The results of imaging will change the course of treatment
But for everyday aches, pains, or movement dysfunctions, your body often tells us more than an image ever could.
The Bottom Line:
Before rushing into a scan, ask:
Have I explored posture, alignment, and movement first?
Are there red flag symptoms that truly warrant imaging?
Will this scan change how I’m being treated, or just give me a label?
Your body is more than a picture — it’s a system that works as a whole. Pain is often a signal, not a sentence.