Tests – what are they good for?
When it comes to back pain tests, of
MRIs that question must be asked. What are MRIs good
for when the proportion
of constructive, influential MRI studies is so little?
False positive MRI results distress those who get
such results. They arouse fear or caution where it’s not always needed. MRIs like this confuse the
proper treatment plan. They spend a lot of money.
Satterwhite Chiropractic carefully weighs the necessity of
MRI in the Oxford chiropractic treatment plan of Oxford
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 trigger false suspicion. When
following the guidelines of the American College of Radiology, 93% of lumbar
spine MRIs were appropriate. Of those, only 13% uncovered
anything that needed to be addressed. Of the 36 MRIs that roused
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 indicate that
these are signs of normal aging. They remind all doctors, remind chiropractors
like yours at Satterwhite Chiropractic, to compare all such
findings to patient symptoms. (1,3) Your Oxford
chiropractor does this!
Choosing Wisely guidelines for American chiropractors suggest30
not repeating spinal imaging and not obtaining 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 suggest
something more disturbing). (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 worrying cause of back pain. (5) The objective
of guidelines is less imaging, fewer false positives. Satterwhite Chiropractic wants what’s
best for our Oxford chiropractic care patients.
COX® TECHNIC’S VIEW
Chiropractors like yours at Satterwhite Chiropractic review
all the symptoms, tests and images our Oxford chiropractic back
pain patients [[present on|bring with them39] their first Oxford
chiropractic visit. So many back pain patients present to
Satterwhite Chiropractic with MRI images already done.
Satterwhite Chiropractic will study them but will depend 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 work
toward 50% decrease of back pain in the first month
of care before ordering additional imaging or
testing or referring for surgical consultation. (6)
CONTACT Satterwhite 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 Oxford chiropractic appointment
with Satterwhite Chiropractic today. Let’s explore together
the best path to Oxford back pain relief – with or without MRI