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 trouble those who receive
such results. They arouse fear or caution where it
is not always needed. MRIs like this confuse the
proper treatment plan. They cost quite a bit.
Hutter Chiropractic Office carefully weighs the need for
MRI in the Groton chiropractic treatment plan of Groton
back pain relief.
Interpretations of MRI images 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 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 mislead.
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 Hutter Chiropractic Office, to compare all such
findings with patient symptoms. (1,3) Your Groton
chiropractor does this!
Choosing Wisely guidelines for American chiropractors recommend
not repeating spinal imaging and not obtaining spinal imaging for
patients with acute low back pain in the first 6 weeks of back pain (unless there
are “red flags” – issues that indicate
something more disturbing). (4) A review of the effectiveness
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 objective
of guidelines is less imaging, fewer false positives. Hutter Chiropractic Office wants what’s
best for our Groton chiropractic care patients.
COX® TECHNIC’S VIEW
Chiropractors like yours at Hutter Chiropractic Office study
all the symptoms, tests and images our Groton chiropractic back
pain patients [[present on|bring with them39] their first Groton
chiropractic visit. So many back pain patients come to
Hutter Chiropractic Office with MRI images already in-hand.
Hutter Chiropractic Office will look at them but will depend more
on clinical exam findings and correlate them to what the MRI shows.
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 month
of care before ordering additional imaging or
testing or referring for surgical consultation. (6)
CONTACT Hutter Chiropractic Office
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 Groton chiropractic appointment
with Hutter Chiropractic Office today. Let us discover together
the best path to Groton back pain relief – with or without MRI