Tests – what are they good for?
In the realm of 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 trouble those who get
such results. They inspire fear or caution where it’s not always warranted. MRIs like this blur the
proper treatment plan. They cost quite a bit.
The Chiropractic TRUhealthDR carefully weighs the necessity of
MRI in the Colorado Springs chiropractic treatment plan of Colorado Springs
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% revealed
anything that needed to be addressed. 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 demonstrates that the appearance 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 imply that
these are signs of normal aging. They remind all doctors, remind chiropractors
like yours at The Chiropractic TRUhealthDR, to compare all such
findings with patient symptoms. (1,3) Your Colorado Springs
chiropractor does this!
Choosing Wisely guidelines for American chiropractors recommend
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 sinister). (4) A review of the success
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. The Chiropractic TRUhealthDR wants what’s
best for our Colorado Springs chiropractic care patients.
COX® TECHNIC’S VIEW
Chiropractors like yours at The Chiropractic TRUhealthDR review
all the symptoms, tests and images our Colorado Springs chiropractic back
pain patients [[present on|bring with them39] their first Colorado Springs
chiropractic visit. So many back pain patients present to
The Chiropractic TRUhealthDR with MRI images already with them.
The Chiropractic TRUhealthDR will look at them but will rely more on clinical exam findings and link 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 30 days
of care before arranging additional imaging or
testing or referring for surgical consultation. (6)
CONTACT The Chiropractic TRUhealthDR
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 Colorado Springs chiropractic appointment
with The Chiropractic TRUhealthDR today. Let us discover together
the best path to Colorado Springs back pain relief – with or without MRI