An MRI report describes pictures, not how you feel. Most of the words on it describe normal ageing, and people with no pain at all often have the same findings. What matters is whether a finding matches your symptoms.
Reviewed by Dr. Kshitij Chaudhary, Last reviewed October 2026
I am a spine surgeon at P.D. Hinduja Hospital, Mahim, Mumbai. Almost every week, a patient sits down in my clinic holding a spine MRI report and already looks worried. Words like "degeneration", "tear" and "compression" sound like damage. Usually they are not. Here is how I read a report, so you can read yours more calmly.
📄 Why does my report sound so frightening?
The radiologist's job is to list everything the scan shows, level by level. Most of the time they have not met you or examined you. So the report describes the pictures, not you.
The words matter more than people think. In a study from Ganga Hospital, Coimbatore, people with back pain who had every finding on their report explained to them did worse after six weeks than people who were told the findings were normal for their age. Both groups had the same treatment. Fear from the report slowed recovery.
🦴 Does "severe" mean I need surgery?
No. "Severe" describes how a structure looks on the scan. It does not describe your pain, your future or your treatment.
A large review of 33 studies looked at the MRI scans of more than 3,000 people with no back pain at all. These "abnormal" findings were everywhere, and they became more common with every decade:
- Disc degeneration was seen in 37% of 20-year-olds, 80% of 50-year-olds and 96% of 80-year-olds.
- Disc bulges were seen in 30% of 20-year-olds, half of 40-year-olds and 84% of 80-year-olds.
- Annular tears were seen in about 1 in 5 young adults.
I show this chart to many of my patients. These are people without pain. So when your report lists the same words, they may simply be your age showing, much like disc degeneration is. I ask one question: does this finding match your symptoms? Same level, same side, same kind of pain. If it doesn't, it is probably not the cause.
🔤 What do the common words on an MRI report mean?
On your report | What it means | Usually |
Disc desiccation, dehydration, "black disc" | The disc has lost some water with age, like grey hair | Normal ageing |
Degenerative changes | Age changes in the disc or joints | Normal ageing |
Disc bulge | The disc spreads a little beyond its edge, all round | Common, often no pain |
Protrusion, herniation | Part of the disc pushes out in one spot | Matters if it matches leg or arm pain |
Extrusion | A larger piece has pushed out | More likely to cause symptoms, often settles |
Annular tear, fissure, HIZ | A small crack in the outer ring of the disc | Common, not an injury |
Nerve root "contact" or "abutment" | The disc touches a nerve | Often no symptoms |
Nerve root "compression" | The disc presses on and flattens a nerve | Matters if symptoms match |
Foraminal stenosis | Narrowing of the hole where a nerve leaves the spine | Matters only on the side you feel it |
Canal stenosis | Narrowing of the main tunnel for the nerves | Judged by how far you can walk |
Facet arthropathy | Wear in the small joints at the back | Common with age |
Modic changes | Changes in the bone next to a disc | Sometimes linked to back pain |
Straightening of lordosis | The normal curve looks flat | Usually muscle spasm or how you lay |
🔍 Which findings do I take seriously?
A few findings change my plan. In the neck, a change in the signal of the spinal cord, together with clumsy hands or unsteady walking, points to cervical myelopathy. In the lower back, a large disc pressing on the bundle of nerves, with bladder or bowel trouble, is cauda equina syndrome. Infection, tumours and fractures also need prompt attention.
These are uncommon. And it is usually your symptoms, not the report, that tell me something is urgent. I explain why a large disc on its own rarely leads to paralysis in Will my slipped disc cause paralysis?
Get seen urgently if
- Numbness around your private parts or inner thighs
- New trouble passing urine, or losing control of your bladder or bowels
- Weakness in your legs or arms that is getting worse
- Walking that is becoming unsteady, or hands becoming clumsy over weeks
✅ What should I do with my report?
- 💿 Bring the images, on a CD or a link, not just the paper report. I look at the pictures myself.
- 🧭 Check the side and level. If your pain is in the right leg and the report talks about the left side, mention it.
- ❓ Ask the right question: "Does this finding explain my symptoms?" is more useful than "Is this serious?"
- 📵 Don't search each word online. The internet shows the worst stories first.
- 🩺 If you have been advised surgery mainly because of what the report says, get a second opinion on your MRI.
Most people with a frightening-sounding report get better without an operation. For a plain guide to what helps, read The Back Pain Guide and Common myths about low back pain. If you have leg pain, Lumbar Disc Herniation & Sciatica and Lumbar Spinal Stenosis explain those conditions.
Sources: Brinjikji W et al. AJNR Am J Neuroradiol 2015;36:811-6. Rajasekaran S et al. Eur Spine J 2021.
This page is for general information and does not replace a medical consultation. Please see a doctor for advice about your own symptoms.