Disc Findings on MRI in People With No Pain: What It Means for an Injury Claim

By Dr. Justin M. Dick, DC, CNMT, ARRT(N)(CT) | Clear Life Scoliosis and Chiropractic Center, Charlotte, NC | Published October 16, 2026

Disc bulges, protrusions, and degeneration show up on MRI in many people who have no pain at all. That fact is usually the first argument raised against a disc finding in a car accident claim. A second body of evidence shows that some of the same findings are more common in people with back pain than in people without it. Both sets of data are real, and neither one decides an individual case. This is how I explain it to patients and attorneys in Charlotte.

Findings in Pain-Free Adults: The Lumbar Spine

A systematic review pooled 33 studies covering 3,110 people with no back pain who had CT or MRI (Brinjikji, AJNR 2015). Every finding rose with age.

Disc degeneration rose from 37% at age 20 to 96% at age 80. Disc bulge rose from 30% to 84%. Disc protrusion rose from 29% to 43%. Annular fissure rose from 19% to 29%. The authors concluded that many of these features are likely part of normal aging and have to be read in the context of the patient's clinical condition.

Findings in Pain-Free Adults: The Neck

A cross-sectional study imaged the cervical spines of 1,211 healthy volunteers aged 20 to 70, with roughly 100 people per decade per sex (Nakashima, Spine 2015). Disc bulging was present in 87.6%. Even in their 20s, 73.3% of men and 78.0% of women had bulging discs. Spinal cord compression was rare, at 5.3%, and increased signal within the cord was found in 2.3%. Both became more frequent after age 50.

For a neck injury claim, that means a bulge on a cervical MRI is close to the expected finding at almost any adult age. Cord compression and cord signal change are not.

The Other Side of the Data

A separate meta-analysis by the same Mayo Clinic group compared 1,193 asymptomatic and 1,904 symptomatic adults aged 50 or younger (Brinjikji, AJNR 2015). Several findings were significantly more common in people with low back pain. Disc bulge had an odds ratio of 7.54, spondylolysis 5.06, disc extrusion 4.38, Modic type 1 endplate change 4.01, disc protrusion 2.65, and disc degeneration 2.24. Annular fissures, high-intensity zones, spondylolisthesis, central canal stenosis, and Modic changes as a group were not significantly associated with pain.

The confidence interval for disc bulge was wide, 1.28 to 44.56, so the size of that association is uncertain. Extrusion and protrusion had tighter intervals. The study covered the lumbar spine in adults 50 or younger. It does not apply to the neck or to older adults.

What This Means for an Injury Claim

Neither data set establishes that a specific finding in a specific person came from a specific collision. Prevalence in pain-free people shows that a finding can exist without causing symptoms. The association with pain shows that some findings are more likely in people who hurt. Neither one dates the finding.

Three things move an individual case. The first is prior imaging of the same level, which shows whether the finding existed before the collision. The second is the timing of symptoms relative to the crash. The third is a neurologic exam that matches the level of the finding, since a disc that is the source of arm symptoms should produce findings in the territory of the nerve root at that level. The disc terms themselves, as defined in the 2014 consensus nomenclature, are a system for describing disc morphology on imaging (Fardon, Spine J 2014). A label such as protrusion or extrusion records what the disc looks like on the scan. How the law treats a pre-existing condition that was made worse is a legal question for the patient's attorney.

For an example of how post-collision imaging findings and outcomes are documented in the peer-reviewed literature, read Dr. Justin Dick's published case report on refractory lumbar pain following a motor vehicle accident in a geriatric patient.

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Frequently Asked Questions

How common are disc bulges in people with no back pain?

Very common. A systematic review found disc bulges in 30% of pain-free 20-year-olds and 84% of pain-free 80-year-olds (Brinjikji, AJNR 2015).

How common are bulging discs in the neck in people with no symptoms?

In 1,211 healthy volunteers, 87.6% had cervical disc bulging, including 73.3% of men and 78.0% of women in their 20s (Nakashima, Spine 2015). Spinal cord compression was found in only 5.3%.

Are any MRI findings more common in people with back pain?

Yes. In adults 50 or younger, disc extrusion, disc protrusion, disc bulge, Modic type 1 change, spondylolysis, and disc degeneration were all significantly more common in people with low back pain (Brinjikji, AJNR 2015 meta-analysis).

Does a disc bulge on MRI mean my car accident caused it?

Not by itself. Disc findings are common in people without pain. Prior imaging, symptom timing, and a neurologic exam that matches the level are what connect a finding to a collision. Dr. Justin Dick reviews these in personal injury cases in Charlotte, NC.

Can MRI tell how old a disc herniation is?

The standard disc terms from the 2014 consensus nomenclature are a system for describing disc shape and position on imaging. Prior imaging of the same level is the most direct way to show whether a finding existed before a collision.

Who reviews MRI findings for car accident cases in Charlotte, NC?

Dr. Justin Dick, DC, CNMT, ARRT(N)(CT), reviews MRI findings for personal injury patients at Clear Life Scoliosis and Chiropractic Center, 8814 Rachel Freeman Way, Suite 103, Charlotte, NC 28278, phone 980-368-0766. Personal injury patients are treated on a lien basis, with no out-of-pocket payment at the time of care.

Sources and Evidence Tiers

1. Brinjikji W, Luetmer PH, Comstock B, et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol. 2015;36(4):811-816. PMID 25430861. LinkEvidence tier: Systematic review
2. Nakashima H, Yukawa Y, Suda K, Yamagata M, Ueta T, Kato F. Abnormal findings on magnetic resonance images of the cervical spines in 1211 asymptomatic subjects. Spine. 2015;40(6):392-398. PMID 25584950. LinkEvidence tier: Cross-sectional study
3. Brinjikji W, Diehn FE, Jarvik JG, et al. MRI findings of disc degeneration are more prevalent in adults with low back pain than in asymptomatic controls: a systematic review and meta-analysis. AJNR Am J Neuroradiol. 2015;36(12):2394-2399. PMID 26359154. LinkEvidence tier: Systematic review and meta-analysis
4. Fardon DF, Williams AL, Dohring EJ, Murtagh FR, Gabriel Rothman SL, Sze GK. Lumbar disc nomenclature: version 2.0. Spine J. 2014;14(11):2525-2545. PMID 24768732. LinkEvidence tier: Expert consensus (NASS, ASSR, ASNR task forces)

Service Area

Clear Life Scoliosis and Chiropractic Center sees personal injury and spinal imaging patients from Charlotte NC, Huntersville NC, Ballantyne NC, Matthews NC, Concord NC, Mooresville NC, Rock Hill SC, and Fort Mill SC.

Related Pages

• Personal injury and car accident spinal care in Charlotte
• Dr. Justin Dick's research
• Case report: refractory lumbar pain after a motor vehicle accident
• Research and evidence at Clear Life
• Questions and answers
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• Contact Clear Life

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This article is educational and is not a diagnosis. Imaging decisions depend on an in-person examination.