Tests – what are they good for?
In the realm of back pain tests, of
MRIs that question must be questioned. What are MRIs good
for when the percentage
of useful, influential MRI studies is so small?
False positive MRI results upset those who get
these results. They inspire fear or caution where it
is not always needed. MRIs like this blur the
proper treatment plan. They cost quite a bit.
Gormish Chiropractic & Rehabilitation carefully evaluates the necessity of
MRI in the Carrolltown chiropractic treatment plan of Carrolltown
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 produce misleading suspicion. When
following the guidelines of the American College of Radiology, 93% of lumbar
spine MRIs were proper. 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 misinform.
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 Gormish Chiropractic & Rehabilitation, to compare all such
findings with patient symptoms. (1,3) Your Carrolltown
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 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. Gormish Chiropractic & Rehabilitation wants what is
best for our Carrolltown chiropractic care patients.
COX® TECHNIC’S VIEW
Chiropractors like yours at Gormish Chiropractic & Rehabilitation review
all the symptoms, tests and images our Carrolltown chiropractic back
pain patients [[present on|bring with them39] their first Carrolltown
chiropractic visit. So many back pain patients present to
Gormish Chiropractic & Rehabilitation with MRI images already done.
Gormish Chiropractic & 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 30 days
of care before ordering more imaging or
testing or arranging surgical consultation. (6)
CONTACT Gormish Chiropractic & 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 scheme of treatment
for pain relief.
Schedule your Carrolltown chiropractic appointment
with Gormish Chiropractic & Rehabilitation today. Let us discover together
the best path to Carrolltown back pain relief – with or without MRI