MRI Scans — What They Show, What They Miss, and When They Actually Matter
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MRI scans are often seen as the definitive answer to back, neck, and joint pain — but in reality, they are only helpful in specific clinical situations. Many MRI findings sound alarming but represent normal, age-related changes rather than the true cause of pain.
Why most MRI findings are normal — and why the interpretation matters more than the scan itself
Condition Related Articles
I use MRI selectively, not routinely. When symptoms suggest nerve involvement, serious pathology, or red-flag concerns, MRI can be invaluable. In more common mechanical pain, scanning too early often adds confusion, fear, and unhelpful labels without improving outcomes.
This page explains when MRI genuinely helps, when it doesn’t, and how to understand scan results without assuming your spine is damaged.
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What an MRI scan actually is
An MRI (Magnetic Resonance Imaging) scanner is a sophisticated medical imaging device that uses powerful magnets and radio waves to create detailed images of the inside of your body. Unlike X-rays or CT scans, MRI does not use ionizing radiation, making it a safer option for many patients.
For spinal and joint problems, MRI is particularly good at showing:
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discs and disc bulges or herniations
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nerve roots and the spinal canal
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soft tissues such as ligaments and joints
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bone marrow changes that don’t appear on X-ray
It is the most detailed imaging test we have for many spinal conditions — but detail alone does not equal diagnosis.
What MRI is genuinely good at
MRI is most useful when there is a clear clinical reason to scan.
It can be extremely helpful for:
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suspected nerve compression causing leg or arm symptoms
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progressive neurological changes (weakness, numbness)
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suspected serious pathology such as infection, fracture, tumour, or inflammatory disease
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clarifying surgical or injection decision-making
In these situations, MRI can change management — which is when imaging earns its place.
What MRI does not reliably tell you
This is where most problems arise.
MRI:
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does not show pain
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does not tell us which finding is responsible for symptoms
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cannot distinguish “painful” from “painless” degeneration
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cannot predict recovery
Disc degeneration, bulges, and joint changes are very common in people without pain. Seeing them on a scan does not automatically mean they are the problem.
This mismatch between structure and symptoms is one of the most important concepts in modern musculoskeletal care.
Why MRI reports often sound alarming
Radiology reports are written to describe everything visible, not to diagnose pain.
Terms such as:
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degeneration
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disc disease
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facet arthropathy
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bulging discs
are descriptive, not judgemental. Unfortunately, when read without context, they can sound far more serious than they are.
Part of my role is helping people translate scan language into meaningful clinical information.
When MRI is not usually helpful
MRI is often overused in:
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early, uncomplicated back or neck pain
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mechanical pain without nerve symptoms
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flare-ups that are already improving
In these cases, scanning rarely changes treatment and often increases anxiety, fear-avoidance, and unnecessary medicalisation.
For many people, time, movement, and guided rehabilitation are safer and more effective first steps than imaging.
Why early MRI can sometimes make things worse
This is counter-intuitive but important.
Early MRI can:
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reinforce the idea that the spine is damaged
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shift focus away from recovery and function
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increase fear of movement
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lead to unnecessary interventions
This is why many clinical guidelines recommend against routine MRI for non-specific back pain in the absence of red flags.
How I decide whether MRI is appropriate
I don’t decide based on pain alone.
I consider:
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symptom pattern and duration
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neurological findings
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response to movement and load
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red-flag features
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whether the scan result would actually change management
If MRI will help guide decisions, I’ll recommend it.
If it won’t, I’ll explain why — and what makes more sense instead.
How MRI results should be interpreted
MRI findings should never be viewed in isolation.
I interpret scans by:
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matching findings to symptoms
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comparing left and right sides
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considering age-related expectations
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integrating clinical examination
A scan is a map, not a verdict. It supports clinical reasoning — it doesn’t replace it.
When MRI findings do matter
While many findings are benign, some are not — and this distinction matters.
MRI findings that require prompt action include:
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significant nerve compression with neurological deficit
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infection or inflammatory changes
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fractures or bone marrow abnormalities
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tumours or space-occupying lesions
In these cases, MRI can be critical and time-sensitive.
What is it like to have an MRI scan?
Most MRI scanners are still shaped like a long tunnel, with you lying on a padded bed that moves slowly into the scanner. While the design has evolved over time, this “tunnel” layout is still the most common — particularly within the NHS.
If you are very claustrophobic, open or upright scanners do exist and can feel less enclosed. However, these are less widely available, often come with longer NHS waiting times, and usually carry a significant additional cost if accessed privately. For most people, standard scanners are manageable with the right preparation and reassurance.
How long does an MRI take?
The length of an MRI scan varies depending on what is being examined.
Most scans last between 15 and 90 minutes. The expected duration will be explained to you in advance as part of the booking process, so you’ll know what to expect before you arrive.
Comfort and what you’ll feel during the scan
The professionals who look after you during the scan are called radiographers, sometimes supported by a radiology assistant. They are very experienced at helping people who feel nervous or uncertain.
They will:
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talk you through the process
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help you onto and off the scanner bed
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position you carefully so the best images can be taken
You may notice feeling comfortably warm during the scan. This is normal and happens because of heat generated by the powerful magnets as they charge and release during imaging.
The noise — what’s normal and what isn’t
MRI scanners are loud.
During the scan, you’ll hear a series of rhythmic banging or knocking sounds. This is simply part of how the magnets work and is not a sign that anything is wrong.
You’ll be given ear protection, and some scanning centres also offer music through headphones to make the experience more comfortable.
Safety and suitability
MRI is considered a very safe procedure and does not use radiation.
However, because it relies on strong magnetic fields, it isn’t suitable for people with certain metal implants or implanted medical devices. This is checked carefully before your scan, and you’ll be asked detailed safety questions to ensure MRI is appropriate for you.
Most people find MRI far less difficult than they expect. Knowing what will happen — and why — often makes the biggest difference.
If anxiety is a concern, it’s worth raising this at the time of booking so the radiographers can support you appropriately.
The key message
MRI is a powerful tool — but only when used for the right reasons.
Most MRI findings are normal and age-related.
Most pain is not explained by scans alone.
Good outcomes depend far more on clinical interpretation than image detail.
Used selectively, MRI brings clarity.
Used indiscriminately, it often creates confusion.
MRI Scans – Frequently Asked Questions
1. Do I need an MRI for my back or neck pain?
Not always.
Most back and neck pain improves without imaging. MRI is usually only helpful when there are nerve symptoms, red-flag signs, or failure to improve despite appropriate management. Scanning too early rarely changes treatment and often increases worry rather than clarity.
2. If my MRI shows degeneration, does that mean my spine is damaged?
No.
Degenerative changes on MRI are normal and expected with age. Many people with disc degeneration, bulges, or joint changes have no pain at all. These findings describe structure, not damage — and they don’t automatically explain symptoms.
3. Can an MRI tell what is causing my pain?
Sometimes — but not reliably on its own.
MRI shows anatomy, not pain. It can identify serious or specific problems (such as nerve compression or infection), but it cannot determine which finding is responsible for symptoms without clinical context.
4. Why do MRI reports sound so alarming?
MRI reports list everything that can be seen, using medical terminology.
Words like “degeneration,” “disc disease,” or “arthropathy” are descriptive, not predictive. Without explanation, they can sound far more serious than they are. Interpretation matters far more than the wording.
5. Can an MRI miss important problems?
Occasionally, yes.
MRI is excellent for many conditions, but early stress injuries, subtle instability, or some pain drivers may not be obvious. That’s why scans should always be interpreted alongside symptoms and examination — not in isolation.
6. Is MRI safe?
Yes.
MRI does not use radiation. The main considerations are metal implants, pacemakers, or severe claustrophobia. These are screened for carefully before scanning.
7. Should I avoid movement if my MRI shows abnormalities?
No.
Most MRI findings do not mean movement is unsafe. Avoiding activity based solely on scan findings often delays recovery. Movement and loading are usually part of the solution, not the problem.
8. Why was I told I don’t need an MRI when I’m in pain?
Because pain severity alone doesn’t determine whether imaging is useful.
MRI is recommended when results are likely to change management — not simply because pain exists. Many painful conditions are mechanical and recover well without imaging.
9. Can having an MRI make things worse?
Indirectly, yes.
Early or unnecessary MRI can increase fear, reinforce unhelpful beliefs about damage, and lead to over-treatment. That’s why scanning needs to be timed and justified, not routine.
10. How should I use my MRI results properly?
As one part of the bigger picture.
MRI results should be:
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matched to symptoms
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interpreted clinically
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explained in plain language
A scan supports decision-making — it doesn’t replace it.
Why You Should Choose Chris Heywood Physio
The most important thing when seeking help is finding a practitioner you trust—someone who is honest, responsible, and clear about your diagnosis, the treatment you really need, and whether any follow-up appointments are necessary.
I’m not here to poach you from another therapist, but if you’re looking for a new physiotherapist in Northamptonshire or simply want a second opinion, here’s why many people choose to work with me (read my reviews):
Over 25 Years of Experience & Proven Expertise
With 25+ years of hands-on physiotherapy experience, I’ve built a trusted reputation for clinical excellence and evidence-based care. My approach combines proven techniques with the latest research, so you can feel confident you’re in safe, skilled hands.
Longer Appointments for Better Results
No two people—or injuries—are the same. That’s why I offer 60-minute one-to-one sessions, giving us time to:
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Thoroughly assess your condition
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Provide focused, effective treatment
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Explain what’s really going on in a clear, simple way
Your treatment plan is tailored specifically to you, aiming for long-term results, not just temporary relief.
Honest Advice & Support You Can Trust
I’ll always tell you what’s best for you—even if that means you need fewer sessions, not more. My goal is your recovery and wellbeing, not keeping you coming back unnecessarily. I have low overheads nowadays and I do not have pre-set management targets to maximise patient 'average session per condition' (yes it does happen commonly and I hate it with a passion - read my article here)
Helping You Take Control of Your Recovery
I believe the best outcomes happen when you understand your body. I’ll explain your condition clearly, give you practical tools for self-management, and step in with expert hands-on treatment when it’s genuinely needed.
Looking for a physiotherapist who values honesty, expertise, and your long-term health?
Book an appointment today and take the first step towards feeling better.
Contact Info
On a Monday and Tuesday I work as a advance musculoskeletal specialist in primary care but I can still be contacted for enquiries. You are welcome to call but it is often faster for me to reply via an email or watsapp message, simply as my phone will be on silent in clinic. Either way, I will reply as soon as possible, which in the week, is almost always on the same day at the latest.
Clinic Opening Hours
The Clinic is located at 2 Old Road, Scaldwell, Northants, NN6 9LA
Tel: 07576 473422 (Feel free to watapp)
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