Tests – what are they good for?
When it comes to back pain tests, of
MRIs that question must be questioned. What are MRIs good
for when the percentage
of useful, influential MRI studies is so small?
False positive MRI results distress those who receive
these results. They inspire fear or caution where it’s not always needed. MRIs like this blur the
proper treatment plan. They spend a lot of money.
Pflugerville Wellness Center carefully weighs the necessity of
MRI in the Pflugerville chiropractic treatment plan of Pflugerville
back pain relief.
Interpretations of MRI images by
radiologists often vary.
The true-positive finding rate was 56.4%, and the miss-rate was 43.6%. (1)
MRI imaging may produce misleading suspicion. When
following the guidelines of the American College of Radiology, 93% of lumbar
spine MRIs were proper. Of those, only 13% uncovered
anything suspicious. 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 mislead.
For example, MRI demonstrates that the appearance of
disc degeneration in asymptomatic persons – persons with no back pain – rises
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 Pflugerville Wellness Center, to compare all such
findings to patient symptoms. (1,3) Your Pflugerville
chiropractor does this!
Choosing Wisely guidelines for American chiropractors suggest30
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 sinister). (4) A review of the efficacy
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 purpose
of guidelines is less imaging, fewer false positives. Pflugerville Wellness Center wants what’s
best for our Pflugerville chiropractic care patients.
COX® TECHNIC’S VIEW
Chiropractors like yours at Pflugerville Wellness Center review
all the symptoms, tests and images our Pflugerville chiropractic back
pain patients [[present on|bring with them39] their first Pflugerville
chiropractic visit. So many back pain patients come to
Pflugerville Wellness Center with MRI images already done.
Pflugerville Wellness Center will study them but will depend 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 seek 50% decrease of back pain in the first 30 days
of care before ordering more imaging or
testing or arranging surgical consultation. (6)
CONTACT Pflugerville Wellness Center
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 program of treatment
for pain relief.
Schedule your Pflugerville chiropractic appointment
with Pflugerville Wellness Center today. Let us discover together
the best path to Pflugerville back pain relief – with or without MRI