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 minor?
False positive MRI results distress those who get
such results. They arouse fear or caution where it
is not always needed. MRIs like this blur the
proper treatment plan. They spend a lot of money.
Johnson Chiropractic carefully weighs the need for
MRI in the Richmond chiropractic treatment plan of Richmond
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 produce false 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 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 shows that the appearance 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 Johnson Chiropractic, to compare all such
findings with patient symptoms. (1,3) Your Richmond
chiropractor does this!
Choosing Wisely guidelines for American chiropractors recommend
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 disturbing). (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 worrying cause of back pain. (5) The purpose
of guidelines is less imaging, fewer false positives. Johnson Chiropractic wants what’s
best for our Richmond chiropractic care patients.
COX® TECHNIC’S VIEW
Chiropractors like yours at Johnson Chiropractic review
all the symptoms, tests and images our Richmond chiropractic back
pain patients [[present on|bring with them39] their first Richmond
chiropractic visit. So many back pain patients come to
Johnson Chiropractic with MRI images already done.
Johnson Chiropractic will look at them but will rely 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 work
toward 50% decrease of back pain in the first month
of care before ordering additional imaging or
testing or arranging surgical consultation. (6)
CONTACT Johnson 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 program of treatment
for pain relief.
Schedule your Richmond chiropractic appointment
with Johnson Chiropractic today. Let’s discover together
the best path to Richmond back pain relief – with or without MRI