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MRIs - The Positives and the False Positives

Tests – what are they good for?

In the realm of back pain tests, of MRIs that question must be questioned. What are MRIs good for when the proportion of useful, influential MRI studies is so little? False positive MRI results distress those who get these results. They inspire fear or caution where it’s not always warranted. MRIs like this blur the proper treatment plan. They cost quite a bit. Chiropractic Associates carefully evaluates the need for MRI in the Preston chiropractic treatment plan of Preston back pain relief.


MRI interpretations by radiologists often vary.  The true-positive finding rate was 56.4%, and the miss-rate was 43.6%. (1) MRI imaging may cause false suspicion. When following the guidelines of the American College of Radiology, 93% of lumbar spine MRIs were proper. Of those, only 13% found anything suspicious. Of the 36 MRIs that caused suspicion of cancer or infection, 81% were false-positive. 59% of the follow-up MRIs on those suspicious findings were false positives. (2) MRI imaging may mislead. For example, MRI shows that the appearance of disc degeneration in asymptomatic persons – persons with no back pain – grows with age:  37% in 20 year olds and 96% in 80 year olds; disc bulges: 30% to 84%; disc protrusion: 29% to 43%; annular fissures 19% to 29%. These imaging findings suggest that these are signs of normal aging. They remind all doctors, remind chiropractors like yours at Chiropractic Associates, to correlate all such findings with patient symptoms. (1,3) Your Preston chiropractor does this!


Choosing Wisely guidelines for American chiropractors recommend not repeating spinal imaging and not obtaining spinal imaging for patients with acute low back pain in the first 6 weeks of back pain (unless there are “red flags” – issues that suggest something more disturbing). (4) A review of the effectiveness of the Canadian Choosing Wisely recommendations for imaging nonspecific spinal pain and symptoms stated that there is very low risk of missing a worrying cause of back pain. (5) The goal of guidelines is less imaging, fewer false positives.  Chiropractic Associates wants what’s best for our Preston chiropractic care patients.


Chiropractors like yours at Chiropractic Associates study all the symptoms, tests and images our Preston chiropractic back pain patients [[present on|bring with them39] their first Preston chiropractic visit. So many back pain patients come to Chiropractic Associates with MRI images already in-hand. Chiropractic Associates will look at them but will depend more on clinical exam findings and correlate them to what the MRI reveals. A rule of thumb with the Cox Technic System of Back Pain Relief is to seek 50% reduction of back pain in the first 30 days of care before arranging additional imaging or testing or referring for surgical consultation. (6)

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Listen to this PODCAST with Dr. Dan Clark on the Back Doctor’s Podcast with Dr. Michael Johnson as he describes imaging for back pain in the scheme of treatment for pain relief.

Schedule your Preston chiropractic appointment with Chiropractic Associates today. Let’s explore together the best path to Preston back pain relief – with or without MRI imaging!

Chiropractic Associates carefully decides when and if MRI images are needed to guide the Preston chiropractic treatment plan.  
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