Tests – what are they good for?
In the realm of back pain tests, of
MRIs that question must be examined. What are MRIs good
for when the proportion
of helpful, influential MRI studies is so small?
False positive MRI results upset those who get
these 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.
Spengel Chiropractic carefully evaluates the necessity of
MRI in the McHenry chiropractic treatment plan of McHenry
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 cause misleading suspicion. When
following the guidelines of the American College of Radiology, 93% of lumbar
spine MRIs were proper. Of those, only 13% uncovered
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 misinform.
For example, MRI demonstrates that the appearance 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 Spengel Chiropractic, to correlate all such
findings with patient symptoms. (1,3) Your McHenry
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 serious cause of back pain. (5) The objective
of guidelines is less imaging, fewer false positives. Spengel Chiropractic wants what’s
best for our McHenry chiropractic care patients.
COX® TECHNIC’S VIEW
Chiropractors like yours at Spengel Chiropractic study
all the symptoms, tests and images our McHenry chiropractic back
pain patients [[present on|bring with them39] their first McHenry
chiropractic visit. So many back pain patients come to
Spengel Chiropractic with MRI images already in-hand.
Spengel Chiropractic will look at 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 seek 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 Spengel Chiropractic
Listen to this PODCAST
with Dr. Dan Clark on the Back Doctor’s Podcast with Dr. Michael Johnson as he describes imaging for back pain in the scheme of treatment
for pain relief.
Schedule your McHenry chiropractic appointment
with Spengel Chiropractic today. Let us discover together
the best path to McHenry back pain relief – with or without MRI