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December 06, 2011

Know any Baton Rouge residents or friends who have back pain and were consulted for MRI right away? Sure! Medical Spine and Sports Injury and Rehab Centers sees many patients come to the office with stacks of MRIs who still have lots of back pain. So what should you do when it's reported that MRI isn't recommended for chronic low back pain?

MRI has its place in back pain care.

Well, seek input from professionals like us at Medical Spine and Sports Injury and Rehab Centers, and decide what is best for you. Please reflect that researchers strongly suggest against surgery for chronic low back pain based only on MRI images that show degenerative changes in the spine. (1) That's where Medical Spine and Sports Injury and Rehab Centers's thorough clinical examination comes into play. It helps us determine the source of your back pain and set a treatment plan for its relief.  We can often get you pain relief for less than the cost of an MRI. An MRI alone hasn't relieved pain yet.

MRIs of asymptomatic people often show disc herniations, but their owners have no pain.Now, MRIs do make pretty pictures. MRIs can show spinal disc degeneration, but they can't tell if there is any pain associated with the degeneration. You may have just a little bit of back pain, but the MRI comes back showing lots of degeneration, making you worry unnecessarily. Don't do that! Medical Spine and Sports Injury and Rehab Centers wants to save you from that worry. We know that the use of advanced imaging is not proven to improve patient outcomes (2), so we'll consider the MRI findings. We won't base our whole treatment plan on them nor will we order an MRI unless it becomes necessary.

So, when is "necessary"? Evidence-based medicine guidelines say "necessary" is after 4 to 6 weeks of unremitting back pain that has been under care. (2) Such guidelines recommend no bed rest, no imaging for a few weeks, staying active, and spinal manipulation. (3)

Now, physicians don't always follow the guidelines. Over 25% of general practitioners order imaging and prescribe NSAIDS and opioid drugs first instead of more conventional things like analgesics or advice. (4) Interestingly, if an orthopedic surgeon orders an MRI, the patient has a 34% higher chance of having surgery than if it was ordered by a primary care physician (PCP). (5) And if the physician owns an MRI unit, more orders for MRIs are made. (5) It's no wonder that PCPs are the least likely to feel confident in dealing with musculoskeletal and neuropathic pain like lower back pain. (6) There are so many options!

Medical Spine and Sports Injury and Rehab Centers is here to help make sense of the options. Bring your MRIs if you have them already. Tell us about the drugs you've been prescribed. Let us know if exercise helps. We'll share with you the progress we've had in helping Baton Rouge back pain sufferers with our chiropractic treatment with Cox Technic protocols. Read more about the medical references for Medical Spine and Sports Injury and Rehab Centers's chiropractic, evidence-based care, then contact us, your non-surgical back pain relief.