You’re hurting, and you want answers—we get it. Nothing feels more reassuring than seeing an actual image of your spine and pointing to what might be causing your pain. But here’s something that might surprise you: what shows up on your MRI or X-ray often doesn’t match what you’re actually feeling. An interesting 2025 study found that people with severe spinal stenosis visible on scans sometimes have zero pain, while others with “perfect-looking” spines are in agony. (1) Wild, right? Another recent study captured what many patients feel: “it’s hard to trust an individual, it’s easier to trust an image.” (2) We understand that completely. But here’s the truth—your chiropractor’s hands-on assessment, combined with thoughtfully interpreting your imaging, tells your real story. It’s not about dismissing those scans; it’s about getting the complete picture of what’s really going on with your body so we can help you feel better. Let’s discuss both your imaging and clinical assessment findings to develop a comprehensive treatment approach tailored specifically to you.

Listen to this PODCAST with Dr. Keith Bartley on The Back Doctors Podcast with Dr. Michael Johnson as he discusses the benefit of using The Cox® Technic System of Spinal Pain Management with spinal stenosis patients.

CHIROPRACTIC TIP OF THE MONTH: Try Exercise to Help Reduce Lumbar Spinal Stenosis Pain

Exercise provides substantial benefits for lumbar spinal stenosis patients, effectively reducing pain and improving function through flexibility, strengthening, and aerobic components. Importantly, stenosis severity does not affect treatment responsiveness, meaning even patients with advanced stenosis can achieve meaningful improvements. This evidence supports exercise as a primary conservative treatment, offering a non-invasive approach to manage symptoms and enhance mobility before considering surgical options. (3,4) Let’s chat at your next appointment about the best exercise for you.

In this month of Thanksgiving, we are thankful for you and your partnership for your spinal health! 

References:

Shahidi B, Zavareh A, Richards C, Taitano L, Raiszadeh K. Severity of lumbar spinal stenosis does not impact responsiveness to exercise-based rehabilitation. medRxiv [Preprint]. 2024 Sep 23:2024.09.20.24314088. doi: 10.1101/2024.09.20.24314088. PMID: 39399031; PMCID: PMC11469385.

Mc Auliffe S, Kirby E, Mockler D, Farooq A, Trine Fogh Johansson S, Krüger Jensen R, Nim C, O’Sullivan K. The long-term clinical course of non-surgically treated lumbar spinal stenosis: a systematic review and meta-analysis. Eur Spine J. 2025 Oct 28. doi: 10.1007/s00586-025-09502-8. Epub ahead of print. PMID: 41148274.

Haslam-Larmer L, Norman KE, Patey AM, Thomas IM, Green ME, Grimshaw JM, Hayden JA, Hartvigsen J, Ivers NM, Jenkins H, French SD. “It’s hard to trust an individual, it’s easier to trust an image”-patients with low back pain want imaging as a means of coping with uncertainty. BMC Prim Care. 2025 Oct 31;26(1):332. doi: 10.1186/s12875-025-02998-5. PMID: 41174481; PMCID: PMC12576980.

Comer C, Williamson E, McIlroy S, Srikesavan C, Dalton S, Melendez-Torres GJ, Lamb SE. Exercise treatments for lumbar spinal stenosis: A systematic review and intervention component analysis of randomised controlled trials. Clin Rehabil. 2024 Mar;38(3):361-374. doi: 10.1177/02692155231201048. Epub 2023 Sep 16. PMID: 37715644; PMCID: PMC10829420