Many individuals with chronic pain find that their imaging results don’t align with their pain. You might have significant discomfort, yet your MRI or X-ray appears normal. Or your scan might show issues like disc bulges or arthritis, but you feel little to no pain.

Imaging reveals structure, not pain. Pain comes from complex interactions involving nerves, inflammation, and how the brain processes signals—factors that scans can’t always detect. Research shows that chronic pain is linked to subtle but widespread changes in brain regions involved in pain processing, including the amygdala, thalamus, and insula. These changes are not visible on standard imaging but can influence how pain is experienced.

Another study on knee osteoarthritis found that some patients with severe pain had little visible joint damage, while others with significant joint changes reported minimal pain. This suggests that pain sensitivity and nerve function, not just structural damage, play a major role in how pain is felt.

Chronic pain is complex, and imaging alone doesn’t always explain symptoms. That’s why treatment focuses on managing pain effectively rather than relying only on scan results. If your imaging doesn’t match your pain, know that you’re not alone. Your pain is real, and the goal is to treat it, regardless of what a scan shows.