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 percentage
of useful, influential MRI studies is so small?
False positive MRI results distress those who receive
such results. They inspire fear or caution where it
is not always needed. MRIs like this blur the
proper treatment plan. They cost quite a bit.
Malverne Health & Wellness carefully evaluates the need for
MRI in the Malverne chiropractic treatment plan of Malverne
back pain relief.
MEDICINE’S VIEW
MRI interpretations by
radiologists often differ.
The true-positive finding rate was 56.4%, and the miss-rate was 43.6%. (1)
MRI imaging may cause misleading suspicion. When
following the guidelines of the American College of Radiology, 93% of lumbar
spine MRIs were proper. Of those, only 13% revealed
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 presence 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 suggest that
these are signs of normal aging. They remind all doctors, remind chiropractors
like yours at Malverne Health & Wellness, to link all such
findings with patient symptoms. (1,3) Your Malverne
chiropractor does this!
CHIROPRACTIC’S VIEW
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 (unless there
are “red flags” – issues that suggest
something more worrisome). (4) A review of the effectiveness
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. Malverne Health & Wellness wants what is
best for our Malverne chiropractic care patients.
COX® TECHNIC’S VIEW
Chiropractors like yours at Malverne Health & Wellness review
all the symptoms, tests and images our Malverne chiropractic back
pain patients [[present on|bring with them39] their first Malverne
chiropractic visit. So many back pain patients present to
Malverne Health & Wellness with MRI images already with them.
Malverne Health & Wellness will look at them but will rely 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 seek 50% reduction of back pain in the first 30 days
of care before ordering additional imaging or
testing or referring for surgical consultation. (6)
CONTACT Malverne Health & Wellness
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 Malverne chiropractic appointment
with Malverne Health & Wellness today. Let us discover together
the best path to Malverne back pain relief – with or without MRI
imaging!