Tests – what are they good for?
When it comes to 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 trouble those who get
these results. They arouse fear or caution where it
is not always needed. MRIs like this confuse the
proper treatment plan. They cost quite a bit.
Watertown Wellness Center carefully evaluates the necessity of
MRI in the Watertown chiropractic treatment plan of Watertown
back pain relief.
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 produce misleading suspicion. When
following the guidelines of the American College of Radiology, 93% of lumbar
spine MRIs were proper. Of those, only 13% found
anything that needed to be addressed. 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 misinform.
For example, MRI demonstrates that the appearance 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 Watertown Wellness Center, to compare all such
findings to patient symptoms. (1,3) Your Watertown
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 suggest
something more worrisome). (4) A review of the success
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 objective
of guidelines is less imaging, fewer false positives. Watertown Wellness Center wants what is
best for our Watertown chiropractic care patients.
COX® TECHNIC’S VIEW
Chiropractors like yours at Watertown Wellness Center review
all the symptoms, tests and images our Watertown chiropractic back
pain patients [[present on|bring with them39] their first Watertown
chiropractic visit. So many back pain patients present to
Watertown Wellness Center with MRI images already with them.
Watertown Wellness Center will study 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% reduction of back pain in the first 30 days
of care before ordering additional imaging or
testing or arranging surgical consultation. (6)
CONTACT Watertown 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 Watertown chiropractic appointment
with Watertown Wellness Center today. Let us discover together
the best path to Watertown back pain relief – with or without MRI