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 constructive, influential MRI studies is so minor?
False positive MRI results distress those who get
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.
Carter Chiropractic & Acupuncture carefully weighs the need for
MRI in the Peoria chiropractic treatment plan of Peoria
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 trigger false 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 caused
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 imply that
these are signs of normal aging. They remind all doctors, remind chiropractors
like yours at Carter Chiropractic & Acupuncture, to correlate all such
findings to patient symptoms. (1,3) Your Peoria
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 (except when “red flags” are present– issues that indicate
something more worrisome). (4) A review of the efficacy
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. Carter Chiropractic & Acupuncture wants what is
best for our Peoria chiropractic care patients.
COX® TECHNIC’S VIEW
Chiropractors like yours at Carter Chiropractic & Acupuncture review
all the symptoms, tests and images our Peoria chiropractic back
pain patients [[present on|bring with them39] their first Peoria
chiropractic visit. So many back pain patients present to
Carter Chiropractic & Acupuncture with MRI images already done.
Carter Chiropractic & Acupuncture will study them but will depend more
on clinical exam findings and correlate them to what the MRI shows.
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 more imaging or
testing or referring for surgical consultation. (6)
CONTACT Carter Chiropractic & Acupuncture
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 Peoria chiropractic appointment
with Carter Chiropractic & Acupuncture today. Let’s explore together
the best path to Peoria back pain relief – with or without MRI