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 percentage of useful, influential MRI studies is so minor? False positive MRI results trouble those who receive these results. They inspire fear or caution where it is not always needed. MRIs like this confuse the proper treatment plan. They spend a lot of money. Capitol Spine & Rehabilitation carefully weighs the need for MRI in the Baton Rouge chiropractic treatment plan of Baton Rouge back pain relief.


MRI interpretations by radiologists often vary.  The true-positive finding rate was 56.4%, and the miss-rate was 43.6%. (1) MRI imaging may trigger false 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 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 indicate that these are signs of normal aging. They remind all doctors, remind chiropractors like yours at Capitol Spine & Rehabilitation, to correlate all such findings with patient symptoms. (1,3) Your Baton Rouge 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 indicate something more sinister). (4) A review of the effectiveness of the Canadian Choosing Wisely recommendations for imaging nonspecific spinal pain and symptoms stated 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.  Capitol Spine & Rehabilitation wants what’s best for our Baton Rouge chiropractic care patients.


Chiropractors like yours at Capitol Spine & Rehabilitation review all the symptoms, tests and images our Baton Rouge chiropractic back pain patients [[present on|bring with them39] their first Baton Rouge chiropractic visit. So many back pain patients present to Capitol Spine & Rehabilitation with MRI images already in-hand. Capitol Spine & Rehabilitation 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 more imaging or testing or referring for surgical consultation. (6)

CONTACT Capitol Spine & Rehabilitation

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 Baton Rouge chiropractic appointment with Capitol Spine & Rehabilitation today. Let’s discover together the best path to Baton Rouge back pain relief – with or without MRI imaging!

Capitol Spine & Rehabilitation carefully decides when and if MRI images are needed to guide the Baton Rouge chiropractic treatment plan.  
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"This information and website content is not intended to diagnose, guarantee results, or recommend specific treatment or activity. It is designed to educate and inform only. Please consult your physician for a thorough examination leading to a diagnosis and well-planned treatment strategy. See more details on the DISCLAIMER page. Content is reviewed by Dr. James M. Cox I."