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 proportion
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’s not always needed. MRIs like this confuse the
proper treatment plan. They spend a lot of money.
Tarrytown Chiropractic carefully evaluates the need for
MRI in the Tarrytown chiropractic treatment plan of Tarrytown
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 misleading suspicion. When
following the guidelines of the American College of Radiology, 93% of lumbar
spine MRIs were appropriate. 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 mislead.
For example, MRI shows 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 Tarrytown Chiropractic, to correlate all such
findings with patient symptoms. (1,3) Your Tarrytown
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 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 goal
of guidelines is less imaging, fewer false positives. Tarrytown Chiropractic wants what’s
best for our Tarrytown chiropractic care patients.
COX® TECHNIC’S VIEW
Chiropractors like yours at Tarrytown Chiropractic review
all the symptoms, tests and images our Tarrytown chiropractic back
pain patients [[present on|bring with them39] their first Tarrytown
chiropractic visit. So many back pain patients come to
Tarrytown Chiropractic with MRI images already in-hand.
Tarrytown Chiropractic 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 work
toward 50% decrease of back pain in the first month
of care before arranging more imaging or
testing or arranging surgical consultation. (6)
CONTACT Tarrytown Chiropractic
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 scheme of treatment
for pain relief.
Schedule your Tarrytown chiropractic appointment
with Tarrytown Chiropractic today. Let us explore together
the best path to Tarrytown back pain relief – with or without MRI