Tests – what are they good for?
When it comes to back pain tests, of
MRIs that question must be questioned. What are MRIs good
for when the proportion
of useful, influential MRI studies is so small?
False positive MRI results trouble those who get
such results. They inspire fear or caution where it’s not always needed. MRIs like this confuse the
proper treatment plan. They cost quite a bit.
Vancouver Spine Care Centre carefully weighs the need for
MRI in the Vancouver chiropractic treatment plan of Vancouver
back pain relief.
MRI interpretations 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 proper. Of those, only 13% uncovered
anything suspicious. Of the 36 MRIs that roused
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 misinform.
For example, MRI shows 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 Vancouver Spine Care Centre, to compare all such
findings to patient symptoms. (1,3) Your Vancouver
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 (except when “red flags” are present– issues that suggest
something more worrisome). (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 serious cause of back pain. (5) The objective
of guidelines is less imaging, fewer false positives. Vancouver Spine Care Centre wants what is
best for our Vancouver chiropractic care patients.
COX® TECHNIC’S VIEW
Chiropractors like yours at Vancouver Spine Care Centre review
all the symptoms, tests and images our Vancouver chiropractic back
pain patients [[present on|bring with them39] their first Vancouver
chiropractic visit. So many back pain patients come to
Vancouver Spine Care Centre with MRI images already in-hand.
Vancouver Spine Care Centre will study them but will rely more on clinical exam findings and correlate them to what the MRI reveals.
A rule of thumb with the Cox Technic System of Back Pain Relief is to work
toward 50% reduction of back pain in the first 30 days
of care before arranging additional imaging or
testing or arranging surgical consultation. (6)
CONTACT Vancouver Spine Care Centre
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 Vancouver chiropractic appointment
with Vancouver Spine Care Centre today. Let us discover together
the best path to Vancouver back pain relief – with or without MRI