Tests – what are they good for?
In the realm of back pain tests, of
MRIs that question must be asked. What are MRIs good
for when the percentage
of helpful, influential MRI studies is so minor?
False positive MRI results trouble those who receive
these results. They inspire fear or caution where it
is not always needed. MRIs like this blur the
proper treatment plan. They cost quite a bit.
Spinal Care Clinic carefully weighs the need for
MRI in the Burlington and Hamilton chiropractic treatment plan of Burlington and Hamilton
back pain relief.
Interpretations of MRI images by
radiologists often differ.
The true-positive finding rate was 56.4%, and the miss-rate was 43.6%. (1)
MRI imaging may trigger 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 raised
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 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 Spinal Care Clinic, to link all such
findings with patient symptoms. (1,3) Your Burlington and Hamilton
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 (except when “red flags” are present– issues that indicate
something more disturbing). (4) A review of the success
of the Canadian Choosing Wisely recommendations for imaging nonspecific spinal
pain and symptoms stated that there is very low risk of missing
a worrying cause of back pain. (5) The purpose
of guidelines is less imaging, fewer false positives. Spinal Care Clinic wants what’s
best for our Burlington and Hamilton chiropractic care patients.
COX® TECHNIC’S VIEW
Chiropractors like yours at Spinal Care Clinic review
all the symptoms, tests and images our Burlington and Hamilton chiropractic back
pain patients [[present on|bring with them39] their first Burlington and Hamilton
chiropractic visit. So many back pain patients present to
Spinal Care Clinic with MRI images already done.
Spinal Care Clinic 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 arranging surgical consultation. (6)
CONTACT Spinal Care 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 Burlington and Hamilton chiropractic appointment
with Spinal Care Clinic today. Let us explore together
the best path to Burlington and Hamilton back pain relief – with or without MRI