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’s 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.
COX® TECHNIC’S VIEW
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