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 constructive, influential MRI studies is so minor?
False positive MRI results upset those who receive
such results. They arouse fear or caution where it’s not always warranted. MRIs like this confuse the
proper treatment plan. They cost quite a bit.
Dr. Le's Chiropractic & Wellness, L.L.C. carefully evaluates the necessity of
MRI in the Auburn chiropractic treatment plan of Auburn
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 cause 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 that needed to be addressed. 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 shows 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 suggest that
these are signs of normal aging. They remind all doctors, remind chiropractors
like yours at Dr. Le's Chiropractic & Wellness, L.L.C., to compare all such
findings to patient symptoms. (1,3) Your Auburn
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 indicate
something more worrisome). (4) A review of the efficacy
of the Canadian Choosing Wisely recommendations for imaging nonspecific spinal
pain and symptoms reported that there is very low risk of missing
a worrying cause of back pain. (5) The purpose
of guidelines is less imaging, fewer false positives. Dr. Le's Chiropractic & Wellness, L.L.C. wants what is
best for our Auburn chiropractic care patients.
COX® TECHNIC’S VIEW
Chiropractors like yours at Dr. Le's Chiropractic & Wellness, L.L.C. study
all the symptoms, tests and images our Auburn chiropractic back
pain patients [[present on|bring with them39] their first Auburn
chiropractic visit. So many back pain patients come to
Dr. Le's Chiropractic & Wellness, L.L.C. with MRI images already with them.
Dr. Le's Chiropractic & Wellness, L.L.C. 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% reduction of back pain in the first 30 days
of care before arranging additional imaging or
testing or arranging surgical consultation. (6)
CONTACT Dr. Le's Chiropractic & Wellness, L.L.C.
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 Auburn chiropractic appointment
with Dr. Le's Chiropractic & Wellness, L.L.C. today. Let us discover together
the best path to Auburn back pain relief – with or without MRI