MRIs - The Positives and the False Positives

Tests – what are they good for?

In the realm of back pain tests, of MRIs that question must be questioned. What are MRIs good for when the proportion of helpful, influential MRI studies is so minor? False positive MRI results distress those who receive these results. They inspire fear or caution where it’s not always warranted. MRIs like this confuse the proper treatment plan. They cost quite a bit. Paramus Medical & Sports Rehabilitation Center carefully weighs the necessity of MRI in the Paramus chiropractic treatment plan of Paramus back pain relief.


MRI interpretations by radiologists often vary.  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 – 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 indicate that these are signs of normal aging. They remind all doctors, remind chiropractors like yours at Paramus Medical & Sports Rehabilitation Center, to link all such findings with patient symptoms. (1,3) Your Paramus 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 suggest something more sinister). (4) A review of the effectiveness 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 goal of guidelines is less imaging, fewer false positives.  Paramus Medical & Sports Rehabilitation Center wants what’s best for our Paramus chiropractic care patients.


Chiropractors like yours at Paramus Medical & Sports Rehabilitation Center study all the symptoms, tests and images our Paramus chiropractic back pain patients [[present on|bring with them39] their first Paramus chiropractic visit. So many back pain patients come to Paramus Medical & Sports Rehabilitation Center with MRI images already done. Paramus Medical & Sports Rehabilitation Center will look at 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 seek 50% reduction of back pain in the first 30 days of care before arranging more imaging or testing or referring for surgical consultation. (6)

CONTACT Paramus Medical & Sports Rehabilitation 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 program of treatment for pain relief.

Schedule your Paramus chiropractic appointment with Paramus Medical & Sports Rehabilitation Center today. Let’s discover together the best path to Paramus back pain relief – with or without MRI imaging!

Paramus Medical & Sports Rehabilitation Center carefully decides when and if MRI images are needed to guide the Paramus chiropractic treatment plan.  
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"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."