Tests – what are they good for?
When it comes to back pain tests, of
MRIs that question must be examined. What are MRIs good
for when the proportion
of useful, influential MRI studies is so little?
False positive MRI results distress those who get
such 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.
Most Chiropractic Clinic carefully weighs the necessity of
MRI in the Murfreesboro chiropractic treatment plan of Murfreesboro
back pain relief.
MRI interpretations by
radiologists often differ.
The true-positive finding rate was 56.4%, and the miss-rate was 43.6%. (1)
MRI imaging may trigger false suspicion. When
following the guidelines of the American College of Radiology, 93% of lumbar
spine MRIs were appropriate. Of those, only 13% found
anything suspicious. Of the 36 MRIs that provoked
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 – 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 imply that
these are signs of normal aging. They remind all doctors, remind chiropractors
like yours at Most Chiropractic Clinic, to compare all such
findings to patient symptoms. (1,3) Your Murfreesboro
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 (except when “red flags” are present– issues that suggest
something more worrisome). (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 worrying cause of back pain. (5) The purpose
of guidelines is less imaging, fewer false positives. Most Chiropractic Clinic wants what’s
best for our Murfreesboro chiropractic care patients.
COX® TECHNIC’S VIEW
Chiropractors like yours at Most Chiropractic Clinic review
all the symptoms, tests and images our Murfreesboro chiropractic back
pain patients [[present on|bring with them39] their first Murfreesboro
chiropractic visit. So many back pain patients come to
Most Chiropractic Clinic with MRI images already done.
Most Chiropractic Clinic will study them but will depend 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 work
toward 50% decrease of back pain in the first month
of care before ordering more imaging or
testing or arranging surgical consultation. (6)
CONTACT Most Chiropractic Clinic
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 Murfreesboro chiropractic appointment
with Most Chiropractic Clinic today. Let us explore together
the best path to Murfreesboro back pain relief – with or without MRI