Tests – what are they good for?
When it comes to back pain tests, of
MRIs that question must be examined. What are MRIs good
for when the percentage
of constructive, influential MRI studies is so little?
False positive MRI results upset those who receive
such 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.
Layden Chiropractic carefully weighs the necessity of
MRI in the Plainville chiropractic treatment plan of Plainville
back pain relief.
Interpretations of MRI images by
radiologists often vary.
The true-positive finding rate was 56.4%, and the miss-rate was 43.6%. (1)
MRI imaging may trigger misleading suspicion. When
following the guidelines of the American College of Radiology, 93% of lumbar
spine MRIs were appropriate. Of those, only 13% revealed
anything suspicious. Of the 36 MRIs that caused
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 demonstrates that the presence of
disc degeneration in asymptomatic persons – persons with no back pain – grows
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 Layden Chiropractic, to compare all such
findings to patient symptoms. (1,3) Your Plainville
chiropractor does this!
Choosing Wisely guidelines for American chiropractors suggest30
not repeating spinal imaging and not getting spinal imaging for
patients with acute low back pain in the first 6 weeks of back pain (unless there
are “red flags” – issues that indicate
something more disturbing). (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 objective
of guidelines is less imaging, fewer false positives. Layden Chiropractic wants what’s
best for our Plainville chiropractic care patients.
COX® TECHNIC’S VIEW
Chiropractors like yours at Layden Chiropractic study
all the symptoms, tests and images our Plainville chiropractic back
pain patients [[present on|bring with them39] their first Plainville
chiropractic visit. So many back pain patients come to
Layden Chiropractic with MRI images already in-hand.
Layden Chiropractic will study them but will depend more
on clinical exam findings and link them to what the MRI reveals.
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 arranging more imaging or
testing or arranging surgical consultation. (6)
CONTACT Layden Chiropractic
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 Plainville chiropractic appointment
with Layden Chiropractic today. Let’s discover together
the best path to Plainville back pain relief – with or without MRI