Tests – what are they good for?
When it comes to back pain tests, of
MRIs that question must be asked. What are MRIs good
for when the percentage
of useful, influential MRI studies is so small?
False positive MRI results upset those who get
these results. They inspire fear or caution where it
is not always needed. MRIs like this confuse the
proper treatment plan. They spend a lot of money.
Back And Neck Care Center carefully evaluates the need for
MRI in the Severna Park chiropractic treatment plan of Severna Park
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 false suspicion. When
following the guidelines of the American College of Radiology, 93% of lumbar
spine MRIs were proper. Of those, only 13% found
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 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 suggest that
these are signs of normal aging. They remind all doctors, remind chiropractors
like yours at Back And Neck Care Center, to correlate all such
findings to patient symptoms. (1,3) Your Severna Park
chiropractor does this!
Choosing Wisely guidelines for American chiropractors suggest30
not repeating spinal imaging and not getting 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 disturbing). (4) A review of the effectiveness
of the Canadian Choosing Wisely recommendations for imaging nonspecific spinal
pain and symptoms stated 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. Back And Neck Care Center wants what is
best for our Severna Park chiropractic care patients.
COX® TECHNIC’S VIEW
Chiropractors like yours at Back And Neck Care Center study
all the symptoms, tests and images our Severna Park chiropractic back
pain patients [[present on|bring with them39] their first Severna Park
chiropractic visit. So many back pain patients present to
Back And Neck Care Center with MRI images already with them.
Back And Neck Care Center will study 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 ordering additional imaging or
testing or arranging surgical consultation. (6)
CONTACT Back And Neck Care 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 program of treatment
for pain relief.
Schedule your Severna Park chiropractic appointment
with Back And Neck Care Center today. Let us discover together
the best path to Severna Park back pain relief – with or without MRI
"This information and website content is not intended to diagnose, guarantee results, or recommend specific treatment or activity. It is designed to educate and inform only. Please consult your physician for a thorough examination leading to a diagnosis and well-planned treatment strategy. See more details on the DISCLAIMER
page. Content is reviewed by Dr. James M. Cox I