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.
COX® TECHNIC’S VIEW
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