Your MRI Shows a Disc Bulge — But That’s Not Always the Cause of Pain

Myth:“If your MRI shows a disc bulge, that’s the cause of your back pain.”

Evidence:A large meta-analysis by Brinjikji et al. (2015) published in The American Journal of Neuroradiology found that disc degeneration, bulging, and protrusion are highly prevalent even among people with no symptoms.For instance, disc degeneration was found in 37% of asymptomatic 20-year-olds and increased to 96% in those over 80.

Interpretation:This means that imaging findings alone cannot reliably explain back pain. The presence of a “disc problem” on MRI often reflects normal age-related changes rather than an actual source of pain.

Conclusion:Pain is more about how your body moves and functions than what appears on a scan. A movement-based and functional approach—through manual therapy and exercise—is essential for meaningful recovery.

Reference:Brinjikji W, Luetmer PH, Comstock B, et al. Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations. AJNR Am J Neuroradiol. 2015;36(4):811–816. PMCID: PMC4464797