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 percentage
of helpful, influential MRI studies is so minor?
False positive MRI results upset those who receive
these results. They arouse fear or caution where it’s not always needed. MRIs like this blur the
proper treatment plan. They spend a lot of money.
Wilson Family Chiropractic carefully evaluates the need for
MRI in the Millville chiropractic treatment plan of Millville
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 misleading 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 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 – grows
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 Wilson Family Chiropractic, to link all such
findings with patient symptoms. (1,3) Your Millville
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 suggest
something more worrisome). (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 serious cause of back pain. (5) The purpose
of guidelines is less imaging, fewer false positives. Wilson Family Chiropractic wants what is
best for our Millville chiropractic care patients.
COX® TECHNIC’S VIEW
Chiropractors like yours at Wilson Family Chiropractic study
all the symptoms, tests and images our Millville chiropractic back
pain patients [[present on|bring with them39] their first Millville
chiropractic visit. So many back pain patients come to
Wilson Family Chiropractic with MRI images already with them.
Wilson Family Chiropractic will look at them but will rely 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 work
toward 50% decrease of back pain in the first 30 days
of care before ordering additional imaging or
testing or referring for surgical consultation. (6)
CONTACT Wilson Family Chiropractic
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 Millville chiropractic appointment
with Wilson Family Chiropractic today. Let’s explore together
the best path to Millville back pain relief – with or without MRI