Tests – what are they good for?
In the realm of back pain tests, of
MRIs that question must be questioned. What are MRIs good
for when the proportion
of useful, influential MRI studies is so small?
False positive MRI results upset those who get
such results. They inspire fear or caution where it
is not always needed. MRIs like this blur the
proper treatment plan. They cost quite a bit.
The Novelli Wellness Center carefully evaluates the necessity of
MRI in the Buffalo, NY chiropractic treatment plan of Buffalo, NY
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 produce false suspicion. When
following the guidelines of the American College of Radiology, 93% of lumbar
spine MRIs were proper. Of those, only 13% revealed
anything that needed to be addressed. 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 mislead.
For example, MRI demonstrates that the presence 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 imply that
these are signs of normal aging. They remind all doctors, remind chiropractors
like yours at The Novelli Wellness Center, to correlate all such
findings with patient symptoms. (1,3) Your Buffalo, NY
chiropractor does this!
Choosing Wisely guidelines for American chiropractors recommend
not repeating spinal imaging and not obtaining spinal imaging for
patients with acute low back pain in the first 6 weeks of back pain (unless there
are “red flags” – issues that indicate
something more worrisome). (4) A review of the success
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 goal
of guidelines is less imaging, fewer false positives. The Novelli Wellness Center wants what is
best for our Buffalo, NY chiropractic care patients.
COX® TECHNIC’S VIEW
Chiropractors like yours at The Novelli Wellness Center review
all the symptoms, tests and images our Buffalo, NY chiropractic back
pain patients [[present on|bring with them39] their first Buffalo, NY
chiropractic visit. So many back pain patients present to
The Novelli Wellness Center with MRI images already in-hand.
The Novelli Wellness Center will look at 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 seek 50% reduction of back pain in the first month
of care before ordering more imaging or
testing or referring for surgical consultation. (6)
CONTACT The Novelli Wellness Center
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 Buffalo, NY chiropractic appointment
with The Novelli Wellness Center today. Let us discover together
the best path to Buffalo, NY back pain relief – with or without MRI