Why Do Some Patients Have Severe Back Pain but a Normal MRI?

By: Dr. Sourabh Chachan

Feb 20, 2025

Back and neck pain are common, but sometimes, people have severe pain for a long time even when their MRI looks normal. This can be confusing and frustrating. There are two main reasons for this. First, some spine issues only appear when you move, so a regular MRI may not detect them. Second, the pain might be coming from other areas like muscles, nerves, or nearby joints. Knowing these causes can help find the right treatment. Consulting a good doctor for back pain can help find the real cause and the best treatment.

Dynamic Spinal Issues: The Hidden Culprit

One of the most common reasons for persistent back or neck pain despite a normal MRI is that the problem is dynamic in nature. During an MRI or X-ray, the patient lies still in a resting position. If the pain is caused by problems in how the spine moves or how the muscles work together, these issues may not show up in a regular scan.

The spine has many parts, like bones, joints, discs, and muscles that work together when we move. If they don’t work properly, it can cause pain. A regular MRI only shows still images and might not catch problems that happen during movement, especially in the early stages. That’s why some people still feel pain even when their MRI looks normal. In such cases, a doctor may recommend a dynamic X-ray or dynamic MRI, which shows the spine in motion and helps find hidden issues.

Pain Originating from Another Area

Another possible reason for severe back or neck pain with a normal MRI is that the pain is being referred from another part of the body. The human body is interconnected, and pain felt in one region may originate elsewhere. This is particularly common in conditions such as:

- Flat feet: Patients with flat feet often experience back pain due to improper weight distribution and posture.

- Knee arthritis: Arthritic knee joints can alter gait and spinal alignment, leading to chronic back discomfort.

- Hip joint problems: Dysfunction in the hip joint can radiate pain to the lower back.

- Shoulder conditions: Many neck pain sufferers have underlying issues in the shoulder joints, such as the glenohumeral or acromioclavicular joints, which can cause pain that mimics a spinal problem.

In such cases, an MRI that only looks at the back or neck might not find the real cause of pain. A back pain specialist may check your whole body, from head to toe, to find the exact problem. Once the root cause is known, treatment can be more effective.

Finding the Right Treatment and Doctor

To treat back and neck pain the right way, it's important to find the actual cause instead of just using painkillers for quick relief. Dr. Sourabh Chachan, a back pain specialist, can diagnose the problem and recommend the best treatment. Thanks to modern medical technology, tests like dynamic MRIs and full skeletal checkups can find hidden issues that regular scans might miss.

If you have long-term back or neck pain but your MRI looks normal, don’t lose hope. Most spine problems can be treated or managed with the right care. Dr. Sourabh Chachan, a spine specialist, can help by recommending the right tests to find the real cause of your pain. With proper treatment, you can get relief and enjoy a better quality of life.

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