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 constructive, influential MRI studies is so little?
False positive MRI results distress those who receive
such results. They inspire fear or caution where it
is not always warranted. MRIs like this confuse the
proper treatment plan. They spend a lot of money.
Soft Health and Healing Clinic carefully evaluates the necessity of
MRI in the Brooks chiropractic treatment plan of Brooks
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 cause misleading suspicion. When
following the guidelines of the American College of Radiology, 93% of lumbar
spine MRIs were proper. Of those, only 13% found
anything suspicious. 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 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 suggest that
these are signs of normal aging. They remind all doctors, remind chiropractors
like yours at Soft Health and Healing Clinic, to compare all such
findings to patient symptoms. (1,3) Your Brooks
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 (unless there
are “red flags” – issues that indicate
something more disturbing). (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 purpose
of guidelines is less imaging, fewer false positives. Soft Health and Healing Clinic wants what is
best for our Brooks chiropractic care patients.
COX® TECHNIC’S VIEW
Chiropractors like yours at Soft Health and Healing Clinic review
all the symptoms, tests and images our Brooks chiropractic back
pain patients [[present on|bring with them39] their first Brooks
chiropractic visit. So many back pain patients present to
Soft Health and Healing Clinic with MRI images already with them.
Soft Health and Healing Clinic 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 work
toward 50% reduction of back pain in the first month
of care before ordering additional imaging or
testing or referring for surgical consultation. (6)
CONTACT Soft Health and Healing 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 Brooks chiropractic appointment
with Soft Health and Healing Clinic today. Let us explore together
the best path to Brooks back pain relief – with or without MRI