Back Pain – does the imaging reflect the cause?


Often when patients experience back pain they are referred for diagnostic imaging – an xray or maybe a CT (computerised tomography) scan or MRI (Magnetic resonance imaging) scan. These technologies enable us to view a patient’s bony structure via xray, and the soft tissue like vertebral discs, ligaments and muscle tissue using CT and MRI. They are an essential part of diagnostics and enable doctors and other healthcare providers (like osteopaths!) to ‘look inside’ a patient to find a cause for a patient’s symptoms.

Commonly reported findings from imaging regarding back pain include degeneration of the vertebrae, reduction of disc heights, tears in the discs and degeneration of the facet/intervertebral joints.
Last year a study was published by Brinjikji ( which looked at studies of patients with no back pain symptoms, and the results raised serious questions regarding the findings of imaging related to the pain experienced by patients.



From the table from the study it is apparent that, as we age, findings from imaging increase in prevalence, however the important fact to note is that these findings are from patients with no back pain – asymptomatic patients. What we can conclude from this is that findings from imaging may not be the cause of symptoms. If you are referred for imaging by a doctor or healthcare provider because of back pain and the report from the radiologist looks alarming don’t despair – many people who do not experience back pain would have similarly alarming radiology reports. Consulting an osteopath will often be helpful to see if treatment can help reduce pain and improve function, regardless of what a radiology report states.