A Picture of 1000 Words and Zero Answers - Why Your Pain May Not Show Up in Imaging

You’ve been feeling pain for quite some time. Figuring it would pass; you give it some time. Unfortunately, it stays and, in some cases, even gets worse which prompts you to see a doctor about it. It is likely that they will order imaging of your problem area. Not that you were hoping to have something wrong with you, but you are a bit discouraged to find that the images come back unremarkable. You’re not crazy! 

This happens because pain

is an experience and not necessarily something physical or an object. The images will show anatomical structures such as bones, tissues, and organs but not something subjective such as pain. When someone experiences pain it communicates through the body’s nerve endings that there is a threat and converts that to electrical signals. Those signals travel through the spine where the various fibers there will process what type of pain it is— sharp, dull, burning, etc. Lastly, the brain receives the information and is able to communicate the location, feeling, and frequency. 

It sounds a bit complex, and that is because it is. Not everyone experiences the same pain. Two people could receive the same injury and experience it differently. This can be caused by a common issue like inflammation or even structural abnormalities. All this to say- do not be discouraged by imaging results. Radiology is less likely to detect abnormal pain processing, central sensitization, many functional disorders, and some types of nerve dysfunction. Some painful conditions even occur at the microscopic level such as small-fiber nerve damage or microscopic inflammation. 

It is important to further consult with your primary care physician to find the source of your pain to best treat it. Pain can creep up and affect all areas of your daily life and that is no way to live! If you or a loved one believes that your pain can be addressed through physical therapy, please reach out to us. We are here to help and to listen in order to guide you to being the best version of yourself.