The role of advanced medical imaging in pain management

This post was written by Dr. Andrius Giedraitis, Pain Management at Parkview Bryan Hospital.

Imaging is one of the most powerful tools in present-day pain management—but it’s also one of the most misunderstood. Many patients assume that if an MRI is normal, their pain can’t be severe, or that an abnormal scan always explains the pain. Pain specialists use imaging not to label patients, but to visualize their unique anatomy, identify hidden pain generators and guide safe, targeted treatment plans.

Why imaging matters in pain care

Advanced imaging provides detailed information on structures that may contribute to pain—including bones, discs, nerves, joints, tendons, ligaments and soft tissues. This helps clinicians:

• locate inflammation

• identify nerve compression

• assess joint injury

• detect spinal instability

• rule out dangerous conditions

But imaging is only one piece of the puzzle. These findings must always be interpreted in the context of symptoms and physical examination.
 

Types of imaging used in pain management

MRI (magnetic resonance imaging) is the gold standard for evaluating soft tissues, discs, nerves and ligaments. It is especially useful when pain radiates into the arms or legs. It helps identify:

• disc herniations

• nerve inflammation

• spinal stenosis

• tumors or infections

• joint swelling

CT (computed tomography) scans offer high-resolution images of bone and are often used after trauma or when an MRI is not possible. It is best for evaluating:

• fractures

• bone spurs

• spinal arthritis

• structural alignment

Ultrasound is excellent for real-time imaging during injections. It is painless, radiation-free and ideal for guiding precision treatments. It visualizes:

• tendons

• nerves

• joint spaces

X-rays are often the first step in diagnosis. Although simple, they provide essential information about:

• arthritis

• bone alignment

• degenerative changes

How imaging improves treatment

Here are a few ways this visual data contributes to your care experience:

1. Boosting diagnostic accuracy – Imaging helps confirm or eliminate potential causes of pain. When paired with a physical exam, it provides a more complete picture.

2. Guiding precision procedures – Many injections, including epidurals, facet injections, SI joint injections and nerve blocks—require fluoroscopy or ultrasound to ensure accuracy and safety.

3. Monitoring progress over time – Imaging allows clinicians to evaluate healing, track degenerative changes or ensure there are no complications.

4. Personalizing treatment plans – Advanced imaging helps create customized strategies that correspond to your anatomy, symptoms and goals.

Understanding the limits of imaging

Imaging does not always match the level of pain. Many people have abnormal MRIs without pain, while others have severe pain with normal imaging. Pain is a neurological experience, not just an anatomical one. That’s why imaging should support—not dictate—the clinical plan.

Conclusion

Diagnostic imaging is an important tool that helps pain specialists diagnose conditions, plan procedures and guide long-term management. When paired with patient history, physical examination and focused treatments, imaging increases accuracy and improves outcomes. The goal is always the same: safer care, clearer answers and better results.

 

At Parkview Bryan Hospital's Pain Management Clinic in Ohio, our team offers personalized and balanced care, with no referral necessary. To learn more or schedule an appointment with one of our providers, call 419-633-7343.

At PPG—Pain Management in Indiana, appointments are by referral only. If you suspect you need to see a pain management specialist, contact your primary care physician.