What Does an MRI Actually Tell Us About Your Spine?

Words such as “degeneration,” “bulge” and “stenosis” can sound alarming. But an MRI is a picture, not a diagnosis.

Disc degeneration: a finding of aging, not necessarily disease

Disc degeneration describes changes that become increasingly common with age. On its own, the finding does not prove that the disc is the source of pain.

Disc bulge vs. herniation

A disc bulge is a broad extension of the disc beyond its usual boundary. A herniation is a more focal displacement of disc material. These terms describe anatomy, not automatically the severity of symptoms.

Spinal stenosis: narrowing, not automatically a problem

Stenosis means narrowing around the spinal cord or nerve roots. It becomes clinically relevant when the anatomy and the patient's symptoms match.

Incidental findings

Disc bulges and degenerative findings are common even in people without back pain, and their prevalence increases with age. An abnormal-sounding report therefore needs context.

The correlation that matters

An MRI finding becomes meaningful when it correlates with the patient's symptoms, neurological examination and clinical history. Imaging should confirm a clinical diagnosis rather than replace it.

The bottom line

The skill in spine care is not simply identifying abnormalities on an MRI. It is determining whether the abnormality actually explains the patient's problem.