Tests – what are they good for?
In the realm of back pain tests, of
MRIs that question must be asked. What are MRIs good
for when the proportion
of helpful, influential MRI studies is so little?
False positive MRI results trouble those who receive
such results. They arouse fear or caution where it
is not always warranted. MRIs like this blur the
proper treatment plan. They cost quite a bit.
Pensacola Spinal Rehab Center carefully weighs the necessity of
MRI in the Pensacola chiropractic treatment plan of Pensacola
back pain relief.
Interpretations of MRI images by
radiologists often vary.
The true-positive finding rate was 56.4%, and the miss-rate was 43.6%. (1)
MRI imaging may produce false suspicion. When
following the guidelines of the American College of Radiology, 93% of lumbar
spine MRIs were appropriate. Of those, only 13% revealed
anything suspicious. Of the 36 MRIs that provoked
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 demonstrates that the presence of
disc degeneration in asymptomatic persons – persons with no back pain – rises
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 Pensacola Spinal Rehab Center, to compare all such
findings with patient symptoms. (1,3) Your Pensacola
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 indicate
something more worrisome). (4) A review of the success
of the Canadian Choosing Wisely recommendations for imaging nonspecific spinal
pain and symptoms reported that there is very low risk of missing
a serious cause of back pain. (5) The objective
of guidelines is less imaging, fewer false positives. Pensacola Spinal Rehab Center wants what’s
best for our Pensacola chiropractic care patients.
COX® TECHNIC’S VIEW
Chiropractors like yours at Pensacola Spinal Rehab Center review
all the symptoms, tests and images our Pensacola chiropractic back
pain patients [[present on|bring with them39] their first Pensacola
chiropractic visit. So many back pain patients present to
Pensacola Spinal Rehab Center with MRI images already in-hand.
Pensacola Spinal Rehab Center will look at 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 seek 50% decrease of back pain in the first month
of care before arranging more imaging or
testing or arranging surgical consultation. (6)
CONTACT Pensacola Spinal Rehab Center
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 Pensacola chiropractic appointment
with Pensacola Spinal Rehab Center today. Let’s discover together
the best path to Pensacola back pain relief – with or without MRI