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MRIs - The Positives and the False Positives

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 blur 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.

MEDICINE’S VIEW

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!

CHIROPRACTIC’S VIEW

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 imaging!

 
Soft Health and Healing Clinic carefully decides when and if MRI images are needed to guide the Brooks chiropractic treatment plan.  
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