MRIs - The Positives and the False Positives

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 distress those who receive such results. They arouse fear or caution where it’s not always needed. MRIs like this confuse the proper treatment plan. They cost quite a bit. Atiyeh Chiropractic and Functional Neurology carefully weighs the need for MRI in the Plymouth chiropractic treatment plan of Plymouth back pain relief.


Interpretations of MRI images 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 that needed to be addressed. Of the 36 MRIs that raised 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 presence 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 suggest that these are signs of normal aging. They remind all doctors, remind chiropractors like yours at Atiyeh Chiropractic and Functional Neurology, to correlate all such findings with patient symptoms. (1,3) Your Plymouth 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 indicate something more sinister). (4) A review of the success of the Canadian Choosing Wisely recommendations for imaging nonspecific spinal pain and symptoms stated that there is very low risk of missing a serious cause of back pain. (5) The goal of guidelines is less imaging, fewer false positives.  Atiyeh Chiropractic and Functional Neurology wants what is best for our Plymouth chiropractic care patients.


Chiropractors like yours at Atiyeh Chiropractic and Functional Neurology study all the symptoms, tests and images our Plymouth chiropractic back pain patients [[present on|bring with them39] their first Plymouth chiropractic visit. So many back pain patients come to Atiyeh Chiropractic and Functional Neurology with MRI images already with them. Atiyeh Chiropractic and Functional Neurology will look at them but will depend more on clinical exam findings and link 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 month of care before ordering additional imaging or testing or referring for surgical consultation. (6)

CONTACT Atiyeh Chiropractic and Functional Neurology

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 scheme of treatment for pain relief.

Schedule your Plymouth chiropractic appointment with Atiyeh Chiropractic and Functional Neurology today. Let’s discover together the best path to Plymouth back pain relief – with or without MRI imaging!

Atiyeh Chiropractic and Functional Neurology carefully chooses when and if MRI images are needed to guide the Plymouth chiropractic treatment plan.  
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