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 percentage
of constructive, influential MRI studies is so small?
False positive MRI results upset those who receive
these results. They arouse fear or caution where it
is not always needed. MRIs like this blur the
proper treatment plan. They cost quite a bit.
Executive Chiropractic of Iowa carefully weighs the need for
MRI in the West Des Moines chiropractic treatment plan of West Des Moines
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 false 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 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 demonstrates that the appearance 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 indicate that
these are signs of normal aging. They remind all doctors, remind chiropractors
like yours at Executive Chiropractic of Iowa, to correlate all such
findings to patient symptoms. (1,3) Your West Des Moines
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 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 serious cause of back pain. (5) The objective
of guidelines is less imaging, fewer false positives. Executive Chiropractic of Iowa wants what’s
best for our West Des Moines chiropractic care patients.
COX® TECHNIC’S VIEW
Chiropractors like yours at Executive Chiropractic of Iowa review
all the symptoms, tests and images our West Des Moines chiropractic back
pain patients [[present on|bring with them39] their first West Des Moines
chiropractic visit. So many back pain patients come to
Executive Chiropractic of Iowa with MRI images already with them.
Executive Chiropractic of Iowa will study them but will rely more on clinical exam findings and link them to what the MRI shows.
A rule of thumb with the Cox Technic System of Back Pain Relief is to seek 50% decrease of back pain in the first month
of care before ordering additional imaging or
testing or referring for surgical consultation. (6)
CONTACT Executive Chiropractic of Iowa
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 West Des Moines chiropractic appointment
with Executive Chiropractic of Iowa today. Let’s explore together
the best path to West Des Moines back pain relief – with or without MRI