Tests – what are they good for?
In the realm of back pain tests, of
MRIs that question must be examined. What are MRIs good
for when the percentage
of constructive, influential MRI studies is so minor?
False positive MRI results distress those who get
such results. They inspire fear or caution where it’s not always warranted. MRIs like this confuse the
proper treatment plan. They spend a lot of money.
Hollstrom & Associates Inc carefully weighs the necessity of
MRI in the Largo chiropractic treatment plan of Largo
back pain relief.
MRI interpretations by
radiologists often differ.
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 proper. Of those, only 13% found
anything suspicious. 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 – 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 Hollstrom & Associates Inc, to correlate all such
findings with patient symptoms. (1,3) Your Largo
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 (except when “red flags” are present– issues that suggest
something more disturbing). (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 worrying cause of back pain. (5) The objective
of guidelines is less imaging, fewer false positives. Hollstrom & Associates Inc wants what’s
best for our Largo chiropractic care patients.
COX® TECHNIC’S VIEW
Chiropractors like yours at Hollstrom & Associates Inc review
all the symptoms, tests and images our Largo chiropractic back
pain patients [[present on|bring with them39] their first Largo
chiropractic visit. So many back pain patients come to
Hollstrom & Associates Inc with MRI images already in-hand.
Hollstrom & Associates Inc will look at them but will rely 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 work
toward 50% decrease of back pain in the first month
of care before ordering more imaging or
testing or arranging surgical consultation. (6)
CONTACT Hollstrom & Associates Inc
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 Largo chiropractic appointment
with Hollstrom & Associates Inc today. Let us discover together
the best path to Largo back pain relief – with or without MRI