What Most People Get Wrong About MRI Results: Why Facet Pain Often Goes Undetected as a Cause of Back Pain in Dallas, Texas

What Most People Get Wrong About MRI Results: Why Facet Pain Often Goes Undetected as Back Pain in Dallas

Many individuals with demanding, high-performance lives are told their MRI is “normal,” yet they continue to struggle with persistent low back pain—especially during activities requiring extension, rotation, standing, or prolonged sitting.

One of the most overlooked reasons for this disconnect is facet joint dysfunction.

Facet joints are small but critical stabilizing joints located on each side of the spine. They guide motion and bear load, especially in extension and rotation. Yet:

Facet-mediated pain frequently does not show up on an MRI.

MRI scans capture the lumbar spine at rest, in a neutral, non–weight-bearing position.But facet pain does not occur at rest. It occurs under load, motion, and mechanical stress.

As a result, countless patients are left without answers—told their imaging is “fine,” despite ongoing pain that affects performance, movement, and daily function.

A Diagnosis is Achieved with More than just Imaging

A more precise evaluation focuses on function, not just structure.

Facet joints can be irritated or overloaded even when the MRI does not show:

• Joint space narrowing

• Capsular thickening

• Cartilage wear

• Synovitis

• Hypertrophic changes

Clinical reality: facet joints can behave abnormally long before they look abnormal.

That is why my evaluation includes:

• Facet loading maneuvers (extension, rotation, quadrants)

• Segmental stability testing

• Assessment of deep stabilizers such as the multifidus

• Evaluation of compensatory movement patterns

• Palpation of segmental tenderness

• Assessment of capsular tension under motion

• Dynamic ultrasound when appropriate

When indicated, image-guided diagnostic blocks can confirm whether the facet joint is the pain generator.

This method reflects a commitment to precision, clarity, and high-quality medical judgment so patients receive answers that imaging alone cannot provide.

Schedule Your Comprehensive Back Assessment

If you’ve been told your MRI is “normal” but you continue to experience persistent back pain especially pain worsened by extension or rotation your facet joints may be contributing even if the imaging does not reveal pathology.

A more detailed, functional evaluation can help determine whether precision regenerative treatments may be appropriate.

You may schedule a consultation through Pain Experts for a comprehensive spine assessment.

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