Mend Physical Therapy Blog and Injury Information

Why Imaging Only Tells Some Of The Story For Patients With Low Back Pain

July 12, 2023

Low back pain is one of the most common conditions treated by physical therapists. Studies have shown that up to 90% of people without low back pain have findings on imaging like MRIs and X-rays (Brinjikji 2014).

Because of this poor correlation between certain types of low back pain and imaging there can be more to the story. So, what are other reasons someone might develop low back pain? One reason is related to tissue tolerance. If the tissues in your low back (muscles, joints, tendons, etc.) are not conditioned to the level of activity that you partake in, you may be more likely to develop pain or other symptoms with more challenging activities. If your tissues are not tolerating the level of activity that you would prefer to do, there are generally two solutions. First would be to reduce your activity level to avoid pain. Second would be to work on improving the tolerance of your tissues so that they have a buffer for the activities you like.

 This is where it can get tricky. If you’re having low back pain it can be difficult to create the proper regiment to strengthen your tissues without creating more symptoms. That’s where physical therapy comes in. A skilled physical therapist can help you with (1) calming symptoms down and (2) assist in creating an exercise/strength program to help you return to your preferred level of activity symptom free.


Brinjikji W. Systematic literature review of imaging features of spinal disorders in asymptomatic population. Am J Neuroradiology. 2014