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 constructive, influential MRI studies is so small?
False positive MRI results trouble those who get
these results. They inspire fear or caution where it
is not always warranted. MRIs like this confuse the
proper treatment plan. They cost quite a bit.
Poulin Chiropractic of Herndon and Ashburn carefully weighs the need for
MRI in the Ashburn chiropractic treatment plan of Ashburn
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 appropriate. Of those, only 13% revealed
anything suspicious. 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 mislead.
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 Poulin Chiropractic of Herndon and Ashburn, to correlate all such
findings with patient symptoms. (1,3) Your Ashburn
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 (unless there
are “red flags” – issues that suggest
something more worrisome). (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 goal
of guidelines is less imaging, fewer false positives. Poulin Chiropractic of Herndon and Ashburn wants what is
best for our Ashburn chiropractic care patients.
COX® TECHNIC’S VIEW
Chiropractors like yours at Poulin Chiropractic of Herndon and Ashburn study
all the symptoms, tests and images our Ashburn chiropractic back
pain patients [[present on|bring with them39] their first Ashburn
chiropractic visit. So many back pain patients come to
Poulin Chiropractic of Herndon and Ashburn with MRI images already with them.
Poulin Chiropractic of Herndon and Ashburn will look at them but will rely 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 seek 50% reduction of back pain in the first 30 days
of care before arranging more imaging or
testing or referring for surgical consultation. (6)
CONTACT Poulin Chiropractic of Herndon and Ashburn
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 Ashburn chiropractic appointment
with Poulin Chiropractic of Herndon and Ashburn today. Let us discover together
the best path to Ashburn back pain relief – with or without MRI