The Magnetic resonance imaging (MRI) is a high resolution imaging process without radiation from x-rays. It is based on the application of strong magnetic fields and has no known undesirable effects today. In contrast to an x-ray, not only bones but also soft tissue can be depicted on MRI, e.g. muscle, joint capsule, articular discs, tendons, and ligaments. Therefore, when the MRI was introduced about 20 years ago, orthopedists had great hope to be able to find out which exact structures in the back cause pain. Furthermore, there was great hope to use the findings of MRI targeting to treat diseased structures. Unfortunately, these wishes have been largely disappointed because many patients with structural damage are painless, as well as patients with no structural damage do have severe pain. Therefore, damage to tissues and the pain caused are largely independent to each other, which provides us in only a few cases with a specific therapy derived from the beautiful findings of MRI.