Tests – what are they good for?
When it comes to back pain tests, of
MRIs that question must be questioned. What are MRIs good
for when the proportion
of helpful, influential MRI studies is so small?
False positive MRI results distress those who get
these results. They inspire fear or caution where it
is not always warranted. MRIs like this blur the
proper treatment plan. They cost quite a bit.
Spine & Sports Rehab Center carefully evaluates the need for
MRI in the Baton Rouge chiropractic treatment plan of Baton Rouge
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 cause 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 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 mislead.
For example, MRI shows 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 Spine & Sports Rehab Center, to correlate all such
findings to patient symptoms. (1,3) Your Baton Rouge
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 sinister). (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 goal
of guidelines is less imaging, fewer false positives. Spine & Sports Rehab Center wants what is
best for our Baton Rouge chiropractic care patients.
COX® TECHNIC’S VIEW
Chiropractors like yours at Spine & Sports Rehab Center review
all the symptoms, tests and images our Baton Rouge chiropractic back
pain patients [[present on|bring with them39] their first Baton Rouge
chiropractic visit. So many back pain patients present to
Spine & Sports Rehab Center with MRI images already with them.
Spine & Sports Rehab Center will study them but will rely 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% reduction of back pain in the first 30 days
of care before ordering more imaging or
testing or referring for surgical consultation. (6)
CONTACT Spine & Sports Rehab 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 scheme of treatment
for pain relief.
Schedule your Baton Rouge chiropractic appointment
with Spine & Sports Rehab Center today. Let us discover together
the best path to Baton Rouge back pain relief – with or without MRI