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 that needed to be addressed. 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.
COX® TECHNIC’S VIEW
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 ordering additional imaging or
testing or referring for surgical consultation. (6)
CONTACT Chiropractic Associates
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