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I have pain, but the doctor says my X-ray is normal.

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Is it all in my head?

Well yes, and no. Technically all pain is felt in your brain. Pain signals travel along nerves from the body, and the brain makes its best guess as to where the pain is located. The brain is very good at this when it comes to pain from the surface of the skin, but the brain can make mistakes when processing pain signals from internal structures like joints, muscles, and organs. Famous examples of the brain’s miscues include phantom limb pain in amputees, and arm pain during a heart attack. During a heart attack, there is nothing happening in the left arm that would warrant pain, but because of the way we are wired, the brain interprets the pain as coming from the arm.

So in regards to your X-ray, normal findings on X-rays do not necessarily mean a lack of symptoms. It is also true that significant findings on X-rays and MRI’s, i.e. degeneration, do not directly correlate with pain. For example, for those individuals with no low back pain, 37% of 20 year olds and 96% of 80 year olds have some disk degeneration. These are people without pain, yet they still have degeneration. The opposite is true. There are plenty of people with no findings on X-rays that have pain.

Well what is causing the pain?

X-rays normally only visualize bones. Yes, chest X-rays can visualize some soft tissue like lungs, etc., but most X-rays are looking at the structure and integrity of bone. Bones and joints are not the only source of pain. Muscles, ligaments, cartilage and vertebral discs can all cause pain, but they can’t be seen on an X-ray. When pain occurs with no findings on an X-ray, it is likely coming from one, or more, of these tissues.

To find out the source of your pain, the underlying cause and how to fix it, as well as how to keep it from coming back,
call First State Health & Wellness for a consultation today!

By Dr. Trip DelCampo, Doctor of Chiropractic, First State Health & Wellness—Rehoboth

22 Join the Conversation

  1. Stuart says
    Sep 10, 2018 at 3:52 PM

    I have bad pains in my left leg from bum cheeks and traveling down towards my ankle. Doctors first thoughts were sciatica or piraformis but now my X-ray has came back as normal but doctors want to take a blood test. What else could be wrong?

    • skelly@firststatehealth.com says
      Sep 10, 2018 at 4:05 PM

      Sorry to hear that. X-Rays are not going to show issues with soft tissues like discs, nerves or muscles. They can show evidence of disc issues If say the space between the vertebrae are decreased, but it won’t show a bulge or herniation. It sounds like there is irritation to a nerve. That nerve can be impinged at a few different locations. A physical exam would be needed to differentiate, and even then it can be a little of column A, a little of Column B. My advice is to seek out an evidence based chiropractor and see if they can help. Best of luck, Dr. DelCampo

  2. Kenda Rhynes says
    Oct 17, 2018 at 6:26 PM

    Pain in upper Right thigh had ultra sound done and no clots had xray and no issues found.

    • Lindsey Gainer says
      Oct 24, 2018 at 10:15 AM

      Thank you for your question. Pain in the front of the upper thigh can occur for a few different reasons. Conditions that can cause pain include : -Lumbar spinal nerve irritation, -Tightness or trigger points in the Psoas(hip flexor) and Quadriceps, -Conditions of the ligaments, tendons and other soft tissues of the hip joint Good news is those conditions are treatable. None of them would be visible on an X-ray or ultrasound. A thorough history and exam would be needed to diagnose your condition. If we can help, please call 302-645-6681. Feel your best, Dr. D

  3. says
    Nov 09, 2018 at 2:37 PM

    Beverley salih. I have pain i my left knee for quite awhile now xray results have come back normal. Finding stretch excercises very painful also taking very strong painkillers which are not working . Please help do i keep going back to the doctor or shall I just carry on. What else can it be

  4. Bradley Van Der Linde says
    Nov 11, 2018 at 4:11 AM

    I've had back pain for 2 years and I'm only 15. I've had an X-ray but everything looked fine they said. But my pains been getting worse and worse to the point I try to avoid running or doing anything to physical because I get really sore through my whole back. As well as this sometimes it causes pain in stomach and hip area as well as my neck always being in severe pain. Should I get an MRI? Or is there any way I can figure out what's wrong? Thank you.

    • Lindsey Gainer says
      Nov 12, 2018 at 12:15 PM

      Thank you for your question. Persistent pain in someone your age is abnormal. Because of the variety in areas of pain, it’s difficult to give you a definitive answer. A thorough exam would be needed to help get you some answers. Further imaging like an MRI may be a part of that. Best of luck. Return to your primary physician and/or consult a well-esteemed chiropractor in your area for further help. -Dr. D.

  5. Rose Crippen says
    Nov 20, 2018 at 3:29 PM

    My 12 year old had been complaining of lower back pain since July. She recently had multiple xrays performed on her back and it showed up normal. She says it hurts when she gets up from a sitting or laying down position and when she carries her laundry basket up and down the stairs. What other test could possibly help to determine the root cause of her back pain? Is there anything she could take? I have informed her pediatrician multiple times about it.

    • Lindsey Gainer says
      Nov 26, 2018 at 1:33 PM

      Hello, thank you for your question. I know it can be very troubling when one of your kids are in pain. Lingering back pain in children is not normal, but is not always an indicator of something seriously wrong. Their bodies are quickly growing and adapting to the new normal. There are a multitude of possible pain generators in the low back. And her issue would be impossible to diagnose without a full exam and history, but your comments may have provided some insight. It is possible her issue may be related to the muscles of the low back, specifically the gluteals including the gluteal medius. It usually presents as belt line pain, made worse by arising from bending (sit to stand) and single leg weight loading (climbing stairs). Have her sit in a chair, with her knees bent, and cross her leg over the other with the outside of the ankle on top of her opposite knee. Then bend forward slightly, applying light pressure to the knee of the leg that is crossed. Compare to the other side. If there is pain with that stretch or a difference in flexibility between the legs it is a good indicator there is some gluteal involvement. Hold that light stretch for 30 seconds, 3 times each side, 3 times a day. Visit a reputable chiropractor for possible sacroiliac joint disfunction. As always, please consult with a doctor for further evaluation, and do not take the word of someone who has not evaluated a patient as gospel. I normally don’t offer this much in the way of testing/treatment without an exam, but I know what it’s like when your kid is in pain. Oh, and also, no chores or laundry for 2 weeks (you’re welcome, kid) ;). -Dr. D.

  6. Dylan Adams says
    Nov 26, 2018 at 3:53 PM

    Mild pain in left lung, left side of stomach, left shoulder, and occasionally left shoulder, pain reliever medications don't work in the slightest, and it's giving me death anxiety. Especially over the fact that I got two different x-rays and both say that my lungs are "100% fine".

  7. says
    Nov 27, 2018 at 5:55 AM

    I have pain in my left knee, and numbness in my left thigh on the outer side. I had an x ray, came back nothing wrong. Now Doctor won't call me back to look further. I have been a hairstylist for 36 years, and have back issues also with foot pain. Doctor says nothing wrong, what is it then?

    • Lindsey Gainer says
      Dec 19, 2018 at 3:40 PM

      Thank you for your comment, for a private consultation please call (302) 645-6681 and we will be happy to help!

  8. Dawn says
    Nov 29, 2018 at 8:20 AM

    I have chest pain. I have had every xray, cat scan, blood work and ultrasound you can think of... and the only thing they can find are a few gallstones. Could that really be causing all this intense pain?

    • Lindsey Gainer says
      Dec 19, 2018 at 3:39 PM

      Thank you for your comment, for a private consultation please call (302) 645-6681 and we will be happy to help!

  9. Lubabalo says
    Nov 29, 2018 at 1:46 PM

    Hello, I was involved in a car accident in May of this year with only an abdominal wall contusion, whiplash and inability to walk for a month. Xrays and CTs were all okay. When I went back to work as a teacher, my lower back started to ache horribly. I was unable to stand for a full hour. It got worse in August and in September, I started feeling numbness, weakness and pain in my left arm and leg. The lower back pain got so bad this month, I went to a Dr. Xrays revealed a lumbus vertebrae/possible avulsion fracture. I was s referred to a neurologist who took a look and said everything is normal with my back. He says it is all soft tissue injuries. He has ordered more x-rays of my neck (for my arm). I am however still very concerned. My back pain literally has me unable to bend, keep straight or sometimes walk. What could this be?

    • Lindsey Gainer says
      Dec 19, 2018 at 3:38 PM

      Thank you for your comment, for a private consultation please call (302) 645-6681 and we will be happy to help!

  10. Constance Mpofu says
    Dec 04, 2018 at 12:50 PM

    My mother had been getting severe pains in the elbow joint. She can't sleep at night, the moment she lies down the pain starts, she can't go go to work either . The joint gets red and she went to the doctor for an x-ray but the doctor found nothing wrong. Any idea what could

    • Lindsey Gainer says
      Dec 19, 2018 at 3:38 PM

      Thank you for your comment, for a private consultation please call (302) 645-6681 and we will be happy to help!

  11. Ash says
    Dec 09, 2018 at 2:00 AM

    I Have backache & pain is in the last disc of my back. My X_ray & MRI show No Disc problem then why i Feel Pain in my Last Disc of Back ? Is it Muscular Problem?

    • Lindsey Gainer says
      Dec 19, 2018 at 3:37 PM

      Thank you for your comment, for a private consultation please call (302) 645-6681 and we will be happy to help!

  12. Donna says
    Dec 11, 2018 at 6:58 PM

    Had blood tests done a few weeks ago and all came back clear . It started off with pins and needles in my arms and hands had a x-ray done last week and something showed up have to go to the doctors tomorrow for more tests . Has anyone ever experienced this before