Tests – what are they good for?
When it comes to back pain tests, of
MRIs that question must be examined. What are MRIs good
for when the percentage
of helpful, influential MRI studies is so minor?
False positive MRI results distress those who receive
these results. They arouse fear or caution where it’s not always needed. MRIs like this blur the
proper treatment plan. They spend a lot of money.
Yorkville Chiropractic and Wellness Centre carefully evaluates the need for
MRI in the Toronto chiropractic treatment plan of Toronto
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 appropriate. Of those, only 13% revealed
anything that needed to be addressed. Of the 36 MRIs that provoked
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 shows 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 indicate that
these are signs of normal aging. They remind all doctors, remind chiropractors
like yours at Yorkville Chiropractic and Wellness Centre, to correlate all such
findings to patient symptoms. (1,3) Your Toronto
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 worrisome). (4) A review of the effectiveness
of the Canadian Choosing Wisely recommendations for imaging nonspecific spinal
pain and symptoms reported 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. Yorkville Chiropractic and Wellness Centre wants what’s
best for our Toronto chiropractic care patients.
COX® TECHNIC’S VIEW
Chiropractors like yours at Yorkville Chiropractic and Wellness Centre study
all the symptoms, tests and images our Toronto chiropractic back
pain patients [[present on|bring with them39] their first Toronto
chiropractic visit. So many back pain patients come to
Yorkville Chiropractic and Wellness Centre with MRI images already done.
Yorkville Chiropractic and Wellness Centre will study 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 30 days
of care before arranging more imaging or
testing or referring for surgical consultation. (6)
CONTACT Yorkville Chiropractic and Wellness Centre
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 Toronto chiropractic appointment
with Yorkville Chiropractic and Wellness Centre today. Let us discover together
the best path to Toronto back pain relief – with or without MRI