Tests – what are they good for?
When it comes to back pain tests, of
MRIs that question must be asked. What are MRIs good
for when the percentage
of useful, influential MRI studies is so little?
False positive MRI results distress those who receive
these results. They arouse fear or caution where it’s not always needed. MRIs like this blur the
proper treatment plan. They spend a lot of money.
Minster Chiropractic Center carefully evaluates the need for
MRI in the Minster chiropractic treatment plan of Minster
back pain relief.
MRI interpretations by
radiologists often differ.
The true-positive finding rate was 56.4%, and the miss-rate was 43.6%. (1)
MRI imaging may trigger false suspicion. When
following the guidelines of the American College of Radiology, 93% of lumbar
spine MRIs were proper. Of those, only 13% uncovered
anything that needed to be addressed. Of the 36 MRIs that raised
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 misinform.
For example, MRI shows that the appearance of
disc degeneration in asymptomatic persons – persons with no back pain – increases
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 imply that
these are signs of normal aging. They remind all doctors, remind chiropractors
like yours at Minster Chiropractic Center, to link all such
findings to patient symptoms. (1,3) Your Minster
chiropractor does this!
Choosing Wisely guidelines for American chiropractors suggest30
not repeating spinal imaging and not obtaining spinal imaging for
patients with acute low back pain in the first 6 weeks of back pain (except when “red flags” are present– issues that indicate
something more disturbing). (4) A review of the success
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. Minster Chiropractic Center wants what is
best for our Minster chiropractic care patients.
COX® TECHNIC’S VIEW
Chiropractors like yours at Minster Chiropractic Center review
all the symptoms, tests and images our Minster chiropractic back
pain patients [[present on|bring with them39] their first Minster
chiropractic visit. So many back pain patients present to
Minster Chiropractic Center with MRI images already in-hand.
Minster Chiropractic Center will study them but will rely 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 work
toward 50% decrease of back pain in the first 30 days
of care before ordering more imaging or
testing or referring for surgical consultation. (6)
CONTACT Minster Chiropractic Center
Listen to this PODCAST
with Dr. Dan Clark on the Back Doctor’s Podcast with Dr. Michael Johnson as he explains
the role of imaging for back pain in the program of treatment
for pain relief.
Schedule your Minster chiropractic appointment
with Minster Chiropractic Center today. Let us discover together
the best path to Minster back pain relief – with or without MRI