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 percentage
of useful, influential MRI studies is so little?
False positive MRI results distress those who get
such results. They arouse fear or caution where it
is not always needed. MRIs like this confuse the
proper treatment plan. They cost quite a bit.
Chiropractic Care carefully evaluates the necessity of
MRI in the Chicago chiropractic treatment plan of Chicago
back pain relief.
Interpretations of MRI images by
radiologists often differ.
The true-positive finding rate was 56.4%, and the miss-rate was 43.6%. (1)
MRI imaging may produce misleading suspicion. When
following the guidelines of the American College of Radiology, 93% of lumbar
spine MRIs were proper. Of those, only 13% revealed
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 demonstrates that the presence 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 indicate that
these are signs of normal aging. They remind all doctors, remind chiropractors
like yours at Chiropractic Care, to link all such
findings with patient symptoms. (1,3) Your Chicago
chiropractor does this!
Choosing Wisely guidelines for American chiropractors recommend
not repeating spinal imaging and not getting 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 suggest
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 purpose
of guidelines is less imaging, fewer false positives. Chiropractic Care wants what’s
best for our Chicago chiropractic care patients.
COX® TECHNIC’S VIEW
Chiropractors like yours at Chiropractic Care study
all the symptoms, tests and images our Chicago chiropractic back
pain patients [[present on|bring with them39] their first Chicago
chiropractic visit. So many back pain patients present to
Chiropractic Care with MRI images already done.
Chiropractic Care will look at them but will depend more
on clinical exam findings and correlate them to what the MRI shows.
A rule of thumb with the Cox Technic System of Back Pain Relief is to seek 50% decrease of back pain in the first 30 days
of care before ordering additional imaging or
testing or arranging surgical consultation. (6)
CONTACT Chiropractic Care
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 scheme of treatment
for pain relief.
Schedule your Chicago chiropractic appointment
with Chiropractic Care today. Let’s discover together
the best path to Chicago back pain relief – with or without MRI