Tests – what are they good for?
In the realm of back pain tests, of
MRIs that question must be examined. What are MRIs good
for when the percentage
of useful, influential MRI studies is so little?
False positive MRI results trouble those who get
such results. They inspire fear or caution where it’s not always warranted. MRIs like this confuse the
proper treatment plan. They spend a lot of money.
Manahawkin Chiropractic Center carefully weighs the necessity of
MRI in the Manahawkin chiropractic treatment plan of Manahawkin
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 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 presence 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 Manahawkin Chiropractic Center, to link all such
findings with patient symptoms. (1,3) Your Manahawkin
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 sinister). (4) A review of the efficacy
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. Manahawkin Chiropractic Center wants what is
best for our Manahawkin chiropractic care patients.
COX® TECHNIC’S VIEW
Chiropractors like yours at Manahawkin Chiropractic Center study
all the symptoms, tests and images our Manahawkin chiropractic back
pain patients [[present on|bring with them39] their first Manahawkin
chiropractic visit. So many back pain patients come to
Manahawkin Chiropractic Center with MRI images already done.
Manahawkin Chiropractic Center will look at 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 work
toward 50% decrease of back pain in the first 30 days
of care before ordering additional imaging or
testing or arranging surgical consultation. (6)
CONTACT Manahawkin 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 scheme of treatment
for pain relief.
Schedule your Manahawkin chiropractic appointment
with Manahawkin Chiropractic Center today. Let’s discover together
the best path to Manahawkin back pain relief – with or without MRI