He’d been told he had the best 60-year-old MRI his surgeon had ever seen.
He was still in pain every single day. Nine out of ten on a bad day. His last two toes felt like aliens – numb and uncomfortable for so long he’d stopped mentioning it to anyone. It had just become part of the furniture.
This is one of the most common and most frustrating experiences I see in clinic. Someone has done everything right. They’ve had the scans, seen the specialists, followed the advice. The imaging comes back unremarkable. And yet their body is telling them something is very wrong.
The problem is that a scan shows structure. It doesn’t show load.
It can tell you whether a disc is herniated or a joint is arthritic. It cannot tell you that your thoracic spine has stopped rotating entirely, forcing your lower back to compensate for every single movement you make – sitting, walking, driving – until eventually that compensation breaks down and stops working.
That breakdown is what most people experience as pain. But because the scan looked at the disc and not at the movement driving the overload, the disc gets the diagnosis. The actual problem goes unaddressed.
This is what I mean when I talk about hidden dysfunction. The body is extraordinarily good at finding workarounds. When one part stops moving well, another part quietly takes on the extra load. For months, sometimes years, it manages. You might notice a niggle here, some stiffness there. Then one day the workaround fails, and the pain arrives – often nowhere near where the original restriction started.
By the time someone reaches my clinic, they’ve usually been through several rounds of treatment aimed at the place that hurts. Sometimes it helps temporarily. It keeps coming back because nobody has assessed what’s driving the overload in the first place.
My approach as an osteopath is to start with a full movement assessment – not just the painful area, but how the whole body is loading and distributing force under real functional demand. Standing, walking, moving the way you actually move in daily life. This is where the pattern usually reveals itself.
With this patient, the restriction wasn’t in the discs his surgeon had been looking at. It was in his thoracic spine – completely locked, no rotation – forcing his lower back to compensate for every movement. Once we addressed that, the picture changed.
A clean MRI doesn’t mean nothing is wrong. It means nothing is structurally damaged enough to show up on a picture. Those are not the same thing.
If you’ve been told your scan looks fine but you’re still not fine, that’s not in your head. It just means nobody has looked at the right thing yet.
Not sure what’s actually driving your pain? The quiz below takes two minutes and identifies the movement pattern most likely behind your symptoms.
