The Word on Your MRI Is Changing Your Back — Here's How
A client sat in my office this week holding his MRI report. One line was highlighted: multi-level lumbar disc degeneration. He looked up and asked the question I hear more than almost any other.
"How bad is it?"
It's a fair question. But it's built on an assumption — that the answer lives in the scan. That somewhere in those images is a number that tells him how much trouble he's in.
The truth is more surprising, and far more hopeful: the words on that report have already started shaping his pain. Not because of what they reveal about his spine, but because of what they do to the way he thinks about it.
"Degeneration" Describes Change, Not Decay
Start with the word itself, because the word is doing real work. Degeneration sounds like rot — like a spine quietly dissolving on a countdown clock. But that's not what it describes. It describes change: the ordinary remodeling a spine undergoes over a lifetime of load.
How ordinary? By their forties, most people with no back pain at all show the same finding on a scan. It's one of the most common things a human spine does as it ages. Which leads to an unavoidable conclusion: if a finding shows up just as often in people who feel fine, the finding alone cannot be what's generating pain. The story has to be bigger than the disc.
How a Diagnosis Feeds the Pain It Names
Here's where the science gets genuinely interesting. There's a framework from health psychology — Leventhal's Common Sense Model, developed in the early 1990s — that maps what happens when a person receives a diagnosis. It's a loop.
You feel something. You interpret it. You build a story. You act on the story. And the result of that action loops back to confirm or revise the story.
The interpretation step is the hinge. It's shaped by what you've been told, what you've read, what your scan said, what happened to someone you know. And from that interpretation you construct a mental model of your pain: what it means, what caused it, how long it will last, and whether you have any control over it.
Now watch the loop run with the story "my discs are degenerating." You brace. You stop bending. You quit lifting. You move as though the next wrong motion is the one that breaks you. Deprived of movement and load, the back grows stiffer, weaker, and more sensitive — which appears to confirm the frightening story, which deepens the protective behavior. The loop tightens around you.
The diagnosis didn't just describe the pain. It started feeding it.
Same Scan, Different Story, Different Future
Run the identical loop with a different interpretation. Same images. Same back. But now the story is: this is a normal age-related change, my spine is strong, and it adapts to load.
What follows? You keep moving. You load gradually. You stop treating your own body like glass. And the spine receives exactly what it has been asking for the entire time.
Same disc. Opposite outcome. The fork in the road was never the scan — it was the meaning assigned to it.
You Are Not a Stack of Parts
This is why I don't think about a spine as a tower of components that wear out. I think about a whole person continuously adapting to what life asks of their body. Tissue tolerance, sleep, stress, training history, and the story you've been handed about your back are all coupled together. Pain emerges from that whole relationship — a dynamic system — not from a single line on a report.
The enactive view of pain, drawn from the work of Maturana and Varela, makes this concrete: you are an organism structurally coupled to a changing environment, not a set of bio, psycho, and social boxes to be sorted. Pain and movement arise from the coupling. Change the coupling — including the story running inside your own head — and the experience changes with it.
What This Means for You
Your spine is still an adapting system. The changes on the scan are real — that part isn't being argued. What the report can't tell you is that the body those changes belong to is the same body that builds callus on a working hand, lays down denser bone where you ask it to carry weight, and responds to the demands of being alive. None of that capacity disappears the day a radiologist writes a word on a report.
Move more, not less. Motion is how a spine stays healthy. The very thing the frightening story tells you to avoid is what your back is asking for.
Load it on purpose. A spine that grows stronger grows more tolerant. Build capacity gradually, and symptoms tend to follow capacity downward.
Mind the story. Notice the model running in your head. If it's a story of fragility, it will steer your behavior toward fragility. You get to write a different one.
Your scan is a snapshot of a single moment. It is not a prophecy. The story you tell yourself about your back holds more power over your next ten years than anything printed on that report — and that story is yours to author.
That's the conversation we have at Ascension: not how to manage a damaged spine, but how to rebuild a confident one. If a diagnosis has been quietly shrinking your life, let's rewrite it together.
