Low Back Pain Without a “Bad Disc”: What Else Could Be Going On?

By Dr. Andrew Kakishita, DC

Why Discs Get Blamed So Often

Low back pain is common, and discs are often blamed quickly. Many people are told they have a bulging or degenerated disc and assume that must be the reason they hurt.

The confusing part is that many people have disc changes on imaging and feel no pain at all. Disc findings are common as we age and do not always explain symptoms.

Why Imaging Does Not Always Match Pain

Imaging shows structure, not how the body is functioning.

A disc can look abnormal and cause no pain. On the flip side, someone can have significant pain with normal imaging. This is why pain needs to be understood in context, not just by a scan.

Pain is influenced by movement, load, muscle support, joint motion, and nervous system sensitivity.

Other Common Sources of Low Back Pain

Low back pain often comes from a combination of factors.

Muscles can become overworked or guarded. Joints can move less than they should. The body may be reacting to repeated stress from sitting, lifting, or sudden changes in activity.

Pain can also be referred from nearby joints, which makes it feel deeper or harder to pinpoint.

Why Pain Can Linger Without Ongoing Damage

Sometimes the original issue has already healed, but pain continues.

When pain lasts longer, the nervous system can stay protective. This does not mean damage is still present. It means the system needs help calming down and rebuilding tolerance.

How Care Is Approached

Care focuses on restoring movement and support.

This may include manual care, soft tissue work, movement based rehab, and activity modifications. In some cases, shockwave therapy is helpful for improving tissue health and load tolerance when pain has lingered.

Research supports shockwave therapy for certain chronic musculoskeletal conditions when paired with active care.

Why This Is Reassuring

Low back pain without a “bad disc” is common.

It often responds well to the right approach. Pain does not automatically mean something is seriously wrong.