A lot of people come in with real spine pain—neck pain, low back pain, headaches, stiffness, or pain that flares with certain movements—and they’ve already been told:
“Your X-rays look normal.”
“MRI is clear.”
“Nothing looks wrong.”
That can feel discouraging, especially when your body is telling you the opposite.
Here’s the truth: X-rays and MRIs are excellent at finding certain problems, like fractures, major disc herniations, tumors, or severe degeneration. But many common pain conditions don’t show up clearly on routine imaging—especially when the issue is mechanical.
“Clear imaging” often means:
It does not always mean:
One of the simplest ways to understand spine pain is to separate it into two major categories.
This is pain driven by inflammatory chemicals and nerve sensitivity.
Steroids and anti-inflammatory meds can help
Some medications can reduce pain signals
Rest and time can calm symptoms down
Chemical pain is real—and sometimes medication can be the right tool.
This is pain driven by how the spine moves and how the supporting tissues handle load.
Certain positions trigger it
Movement patterns flare it up
It can feel “stuck,” “tight,” “unstable,” or “off”
Symptoms often return as soon as you resume normal activity
Mechanical pain is where proper diagnosis of tissue and function can make a huge difference—because this isn’t just about reducing inflammation. It’s about restoring stability and normal motion.
Your spine is supported by more than bones and discs. It relies heavily on soft and connective tissues:
ligaments (stabilizers)
joint capsules
muscles and tendons
connective tissue that controls motion
These structures can be injured or overstretched without leaving a dramatic “smoking gun” on an X-ray. And many MRIs are done in a neutral position, lying still—while your pain shows up during real-life movement.
Whiplash is often associated with car wrecks, but the same tissue problem can happen with sports collisions, falls or other injuries.
In many whiplash-type injuries, nothing is “broken,” but the stabilizing tissues can be strained—especially ligaments.
Ligaments don’t have to completely tear to cause long-term issues. They can experience what biomechanics researchers call a subfailure injury: tissue fibers are damaged enough to change function, even if they aren’t fully ruptured.
This is one reason a car accident chiropractor may focus on more than just “did anything break?”—because mechanical injury doesn’t always show up on basic imaging.
Think of a ligament like a rope. A rope can be strong (it won’t snap), but also loose (it has slack).
After certain injuries, the ligament may not be “broken,” but it can become lax—meaning it has extra slack in the early part of movement.
That matters because ligaments are supposed to provide early stability—guiding and limiting joint motion during the small, everyday movements you do all day long.
When a ligament gets “slack,” the spine can shift more than it should before the tissue tightens. People may describe this as:
recurring flare-ups with small movements
catching, clunking, or “it slips”
pain that’s positional
headaches from neck dysfunction
back pain that returns when bending, sitting, or lifting
So the tissue can still test “strong” in a basic way, but it’s no longer functioning normally in the range that matters most: daily life motion.
When stability is reduced—even slightly—the body adapts.
Muscles start guarding. Posture changes. Other joints compensate. That can create ongoing irritation and trigger cycles of stiffness, tightness, reduced mobility, pain with activity, and that “good days and bad days” pattern.
This is one reason some people don’t fully recover with rest alone.
If your pain is primarily chemical, medications, heat, ice and rest may help reduce inflammation and calm symptoms.
But if your pain is primarily mechanical, the solution usually needs to include:
Better tissue-focused diagnosis (not just “scan is normal”)
Restoring motion where it’s restricted
Improving stability where it’s lacking
Progressively rebuilding capacity so the spine tolerates real-life loads again
That’s also where a chiropractor can add value—because athletic injuries often involve movement faults, tissue overload, and stability problems that don’t always show up on routine imaging.
“Clear” X-rays can be reassuring—and they matter. But they’re not the whole story.
If you have spine pain that keeps returning, especially after an injury or a change in activity, it may be mechanical spine pain: a problem of tissue function, stability, and movement quality.
If you’re searching for a chiropractor near me in Charleston, SC, the goal shouldn’t be temporary symptom masking. It should be identifying what’s driving the problem and building a plan that restores function and resilience.
