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.
COX® TECHNIC’S VIEW
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