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No MRI for Chronic Low Back Pain. Really?

Know any Burlington and Hamilton residents or friends who have back pain and were referred for MRI right away? Sure! Spinal Care Clinic sees many patients come to the office with stacks of MRIs who still have lots of back pain. So what should you do when it's reported that MRI isn't recommended for chronic low back pain?

MRI has its place in back pain care.

Well, seek input from professionals like us at Spinal Care Clinic, and decide what is best for you. Please reflect that researchers strongly recommend against surgery for chronic low back pain based only on MRI images that show degenerative changes in the spine. (1) That's where Spinal Care Clinic's thorough clinical examination comes into play. It helps us determine the source of your back pain and set a treatment plan for its relief.  We can often get you pain relief for less than the cost of an MRI. An MRI alone hasn't relieved pain yet.

MRIs of asymptomatic people often show disc herniations, but their owners have no pain.Now, MRIs do make pretty pictures. MRIs can show spinal disc degeneration, but they can't tell if there is any pain associated with the degeneration. You may have just a little bit of back pain, but the MRI comes back showing lots of degeneration, making you worry unnecessarily. Don't do that! Spinal Care Clinic wants to save you from that worry. We know that the use of advanced imaging is not proven to improve patient outcomes (2), so we'll consider the MRI findings. We won't base our whole treatment plan on them nor will we order an MRI unless it becomes necessary.

So, when is "necessary"? Evidence-based medicine guidelines say "necessary" is after 4 to 6 weeks of unremitting back pain that has been under care. (2) Such guidelines recommend no bed rest, no imaging for a few weeks, staying active, and spinal manipulation. (3)

Now, physicians don't always follow the guidelines. Over 25% of general practitioners order imaging and prescribe NSAIDS and opioid drugs first instead of more conservative things like analgesics or advice. (4) Interestingly, if an orthopedic surgeon orders an MRI, the patient has a 34% higher chance of having surgery than if it was ordered by a primary care physician (PCP). (5) And if the physician owns an MRI unit, more orders for MRIs are made. (5) It's no wonder that PCPs are the least likely to feel confident in dealing with musculoskeletal and neuropathic pain like lower back pain. (6) There are so many options!

Spinal Care Clinic is here to help make sense of the options. Bring your MRIs if you have them already. Tell us about the drugs you've been prescribed. Let us know if exercise helps. We'll share with you the achievements we've had in helping Burlington and Hamilton back pain sufferers with our chiropractic treatment with Cox Technic protocols. Read more about the medical references for Spinal Care Clinic's chiropractic, evidence-based care, then contact us, your non-surgical back pain relief.

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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."