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 constructive, influential MRI studies is so minor? False positive MRI results upset those who receive these results. They arouse fear or caution where it’s not always warranted. MRIs like this confuse the proper treatment plan. They cost quite a bit. New Hampshire Spine and Sport carefully weighs the necessity of MRI in the Southern New Hampshire chiropractic treatment plan of Southern New Hampshire 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 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 mislead. For example, MRI shows that the appearance 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 New Hampshire Spine and Sport, to compare all such findings to patient symptoms. (1,3) Your Southern New Hampshire chiropractor does this!
Choosing Wisely guidelines for American chiropractors suggest30 not repeating spinal imaging and not getting 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 worrying cause of back pain. (5) The goal of guidelines is less imaging, fewer false positives. New Hampshire Spine and Sport wants what’s best for our Southern New Hampshire chiropractic care patients.
COX® TECHNIC’S VIEW
Chiropractors like yours at New Hampshire Spine and Sport study all the symptoms, tests and images our Southern New Hampshire chiropractic back pain patients [[present on|bring with them39] their first Southern New Hampshire chiropractic visit. So many back pain patients present to New Hampshire Spine and Sport with MRI images already done. New Hampshire Spine and Sport will study them but will rely more on clinical exam findings and correlate them to what the MRI reveals. A rule of thumb with the Cox Technic System of Back Pain Relief is to work toward 50% reduction of back pain in the first 30 days of care before arranging additional imaging or testing or arranging surgical consultation. (6)
CONTACT New Hampshire Spine and Sport
Listen to this PODCAST with Dr. Dan Clark on the Back Doctor’s Podcast with Dr. Michael Johnson as he describes imaging for back pain in the scheme of treatment for pain relief.
Schedule your Southern New Hampshire chiropractic appointment with New Hampshire Spine and Sport today. Let’s discover together the best path to Southern New Hampshire back pain relief – with or without MRI imaging!