Tests – what are they good for?
When it comes to back pain tests, of
MRIs that question must be examined. 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.
Manchester Chiropractic & Sports Injuries carefully weighs the necessity of
MRI in the Manchester chiropractic treatment plan of Manchester
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 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 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 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 indicate that
these are signs of normal aging. They remind all doctors, remind chiropractors
like yours at Manchester Chiropractic & Sports Injuries, to link all such
findings to patient symptoms. (1,3) Your Manchester
chiropractor does this!
Choosing Wisely guidelines for American chiropractors suggest30
not repeating spinal imaging and not getting spinal imaging for
patients with acute low back pain in the first 6 weeks of back pain (unless there
are “red flags” – issues that indicate
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 serious cause of back pain. (5) The goal
of guidelines is less imaging, fewer false positives. Manchester Chiropractic & Sports Injuries wants what’s
best for our Manchester chiropractic care patients.
COX® TECHNIC’S VIEW
Chiropractors like yours at Manchester Chiropractic & Sports Injuries review
all the symptoms, tests and images our Manchester chiropractic back
pain patients [[present on|bring with them39] their first Manchester
chiropractic visit. So many back pain patients come to
Manchester Chiropractic & Sports Injuries with MRI images already done.
Manchester Chiropractic & Sports Injuries will study 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 month
of care before ordering additional imaging or
testing or arranging surgical consultation. (6)
CONTACT Manchester Chiropractic & Sports Injuries
Listen to this PODCAST
with Dr. Dan Clark on the Back Doctor’s Podcast with Dr. Michael Johnson as he describes imaging for back pain in the program of treatment
for pain relief.
Schedule your Manchester chiropractic appointment
with Manchester Chiropractic & Sports Injuries today. Let’s explore together
the best path to Manchester back pain relief – with or without MRI