How do you know if back pain is muscular or structural?

Back pain is one of the most common reasons people seek medical care, yet it remains one of the most misunderstood symptoms in medicine.

Many people assume that pain automatically means injury, degeneration, or structural damage. If an MRI report mentions a bulging disc, arthritis, stenosis, or degeneration, it can seem logical to conclude that the source of pain has been identified.

In clinical practice, however, the relationship between pain and physical structures is often far more complex. Research over the past two decades has demonstrated that many structural findings commonly seen on imaging are also present in people who have no pain at all.