MRIs - The Positives and the False Positives

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 helpful, influential MRI studies is so minor? False positive MRI results trouble those who get such results. They arouse fear or caution where it is not always warranted. MRIs like this confuse the proper treatment plan. They spend a lot of money. The practice of Dr. Tim Schneider carefully evaluates the need for MRI in the Ottawa chiropractic treatment plan of Ottawa 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 misleading suspicion. When following the guidelines of the American College of Radiology, 93% of lumbar spine MRIs were appropriate. Of those, only 13% found anything suspicious. Of the 36 MRIs that raised 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 presence 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 imply that these are signs of normal aging. They remind all doctors, remind chiropractors like yours at The practice of Dr. Tim Schneider, to compare all such findings to patient symptoms. (1,3) Your Ottawa 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 efficacy of the Canadian Choosing Wisely recommendations for imaging nonspecific spinal pain and symptoms stated 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.  The practice of Dr. Tim Schneider wants what’s best for our Ottawa chiropractic care patients.


Chiropractors like yours at The practice of Dr. Tim Schneider review all the symptoms, tests and images our Ottawa chiropractic back pain patients [[present on|bring with them39] their first Ottawa chiropractic visit. So many back pain patients present to The practice of Dr. Tim Schneider with MRI images already with them. The practice of Dr. Tim Schneider will study 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 seek 50% decrease of back pain in the first 30 days of care before ordering additional imaging or testing or arranging surgical consultation. (6)

CONTACT The practice of Dr. Tim Schneider

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 program of treatment for pain relief.

Schedule your Ottawa chiropractic appointment with The practice of Dr. Tim Schneider today. Let’s explore together the best path to Ottawa back pain relief – with or without MRI imaging!

The practice of Dr. Tim Schneider carefully decides when and if MRI images are needed to guide the Ottawa chiropractic treatment plan.  
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