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 little?
False positive MRI results distress those who receive
such 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.
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.
COX® TECHNIC’S VIEW
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 30 days
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 explore together
the best path to Plymouth back pain relief – with or without MRI