Replying to @barbschilling #greenscreen 1. The presence of a fissure on an MRI may be indicative of pain with correlation of one's symptoms. But also remember, and this is very important, that these can be present without any pain at all. So just like disc bulges, whether they cause pain or not the focus should be on management and what one is doing to work through pain and discomfort. conservatively that can mean chiropractic or physical therapy as a good stepping stone to foster ones own active exercise program that they are doing on a consistent basis. to me this is the very best way to ultimately treat spinal mediated pain. So disc pain, in my opinion, can come from irritation to these outer fibers in the disc without any sort of bulge or herniation at all. When people hear pain coming from a disk they automatically think a herniation or bulge but I don't think that is always the case with disc mediated pain. 2. Yes there are other treatments that are necessary in some cases But even those, including injections and surgery, should still be a stepping stone to help one move better and foster a consistent exercise program. It always should come down to that. 3. pain is very multifactorial and has a lot of facets that aren't always easily solved. That's why different things need to be addressed in certain cases.