Tests – what are they good for?
When it comes to back pain tests, of
MRIs that question must be asked. What are MRIs good
for when the percentage
of constructive, influential MRI studies is so small?
False positive MRI results trouble those who receive
these results. They inspire fear or caution where it’s not always warranted. MRIs like this confuse the
proper treatment plan. They cost quite a bit.
Moses Chiropractic carefully evaluates the need for
MRI in the West Palm Beach chiropractic treatment plan of West Palm Beach
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 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 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 mislead.
For example, MRI shows that the presence of
disc degeneration in asymptomatic persons – persons with no back pain – increases
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 Moses Chiropractic, to correlate all such
findings to patient symptoms. (1,3) Your West Palm Beach
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 suggest
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 objective
of guidelines is less imaging, fewer false positives. Moses Chiropractic wants what’s
best for our West Palm Beach chiropractic care patients.
COX® TECHNIC’S VIEW
Chiropractors like yours at Moses Chiropractic review
all the symptoms, tests and images our West Palm Beach chiropractic back
pain patients [[present on|bring with them39] their first West Palm Beach
chiropractic visit. So many back pain patients come to
Moses Chiropractic with MRI images already done.
Moses Chiropractic will study them but will depend 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% decrease of back pain in the first 30 days
of care before arranging more imaging or
testing or referring for surgical consultation. (6)
CONTACT Moses 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 scheme of treatment
for pain relief.
Schedule your West Palm Beach chiropractic appointment
with Moses Chiropractic today. Let us discover together
the best path to West Palm Beach back pain relief – with or without MRI