Hey ,
Hooray! Spring 🌱 yoga session starts next week; I'll talk a little bit more about what's in store for spring session in the next post. Today, I want to wrap up the MRI topic and answer some of your questions.
In the last post I've shared several study
findings that confirmed - no shadow of a doubt - that MRI scans are inconclusive, at best, for musculoskeletal pain.
Naturally, many readers asked, “What is MRI good for, then?”
MRI is exceptionally useful, but mainly for very specific problems - not for explaining our everyday aches and pains.
What is MRI actually good at?
MRI is an incredible tool when used for the right reasons. It shines when there is a clear, specific question to answer, such as:
- Red flag situations. MRI is excellent for spotting serious but uncommon problems like spinal cord compression, tumours, infections, or fractures that need urgent care.
- Clear trauma or major injury. After a significant fall, accident, or sports injury, an MRI helps identify torn ligaments, complete tendon ruptures,
cartilage damage, hidden fractures, and bone bruises that X‑rays can miss.
- When surgery is on the table. If someone is considering an operation, an MRI helps surgeons see the exact structure, size, and location of the problem.
- Unresolved symptoms after good rehab. Guidelines often suggest MRI only after a solid period of conservative care has failed, and the result would actually change the plan (e.g., deciding between continued rehab, injection, or surgery).
In
situations like the ones described above, MRI helps doctors see structures in precise detail to make safer decisions. It can be life‑changing and even life‑saving at times.
An MRI is a lot less helpful for the everyday, familiar aches and pains many of us live with: sore backs, stiff necks, grumpy knees or shoulders that feel “off.” In those
scenarios, scans often show a lot of “changes” that are common in people with and without pain – they don’t tell us much about why we hurt, or what we can safely do.
What MRI can (and cannot) tell us about pain?
An MRI can tell us:
- What our tissues look like at a particular moment in time.
- Whether there is a big, obvious injury or disease.
- Where certain structures are torn, inflamed, or swollen.
An MRI cannot tell us:
- How much something
hurts.
- How long will it hurt for?
- How safe is it for us to move, to load the tissues, and live our lives?
- How sensitive or protective your nervous system has become.
One can have a very “messy‑looking” scan and feel just fine.
You can also have a “clean” scan and be in a lot of pain.
Pain is created by our nervous system as a protection signal, and it responds to many inputs at once: stress, sleep, past experiences, beliefs about your body, and current load on the tissues. The scan is only one small piece of that big picture.
Can scans do more harm than good?
You betcha!
An
unnecessary MRI can quietly fan the flames of worry, which in turn can turn up the volume on pain. When a scan is ordered “just in case,” without a strong medical reason, something unhelpful often happens.
The report comes back full of heavy words: “degeneration,”
“tear,” “disc bulge,” “narrowing,” “chondral loss.” On paper, it looks like your body is falling apart, even if, in fact, many of these changes are common, expected, and not dangerous.
And if no one explains this to us clearly, it is easy to
think:
- “My spine is irreparably damaged.”
- “My shoulder is torn; I can’t use it.”
- “My knee is bone‑on‑bone; I must be extra careful. I can’t afford to fall.”
This kind of fear is not imagined. Our nervous system takes these words - especially when they come from people with medical authority - extremely seriously. And when you believe you are fragile:
- You move
less and tense more.
- You pay very close attention to the paining area, scanning for danger; this heightened focus can make sensations feel sharper and “louder.”
- Fear and anxiety activate the fight-or-flight response, which lowers pain thresholds and keeps pain circuits switched on.
In this situation, pain, which is meant to protect you, can intensify and become much stronger. This doesn’t mean that the tissues have changed – but the story around them has, and that matters. That matters a lot.
The story we tell ourselves about our bodies can go from “a bit sore, but adaptable” to “fragile and broken.” The story alone is enough to increase pain and disability, even if our tissues have not changed at all.
Reassurance for your practice and your body:
If you’ve ever read your MRI report and felt your stomach drop, you are not alone. I’ve seen so many people walk into yoga class carrying a list of “findings” that sound absolutely
frightening.
Guess what?
You are still allowed to be hopeful.
- Many scan findings are normal, age‑related changes.
- Pain does not always mean damage, and damage on a scan does not always mean pain.
- With gentle, progressive movement, tissues can often tolerate more than the report
suggests, and your nervous system can learn to feel safer again.
In our yoga practice, this looks like:
- Exploring movements that feel possible.
- Using props, walls, and a smaller range of motion as acts of kindness, not signs of weakness.
- Listening to your body with curiosity instead of fear, and letting trust grow slowly over time.
Your body is not just an image on a screen.
It is living, changing, and learning. MRI can be a helpful tool when used wisely – but it should not get the final say on what is possible for you.
