As a chiropractic physician most of my low back pain patients are surprised by my answer when they ask “Should I get an MRI?” My answer is mostly no. Why? Because more times than none I have figured out the joints involved and how they are dysfunctional. I have figured out which muscles are tight and weak and which muscles are tight and overworked. I have the treatment plan, and unless my treatment plan isn’t working like I expected, then there is no reason to get an expensive MRI to show me what may be causing your pain. Again, why? Because my treatment isn’t going to change unless something severe is going on, in which I would send the patient for an MRI anyway.
MRI’s in particular have been used more and more over the last few years by Medical Doctors. Now studies are finding that they have not improved patient care and have possible made patient care and symptoms worse.
How? It’s like taking one of those magnifying mirrors to your face. You can see every blemish, bump and line. But, just because you see it doesn’t mean it is a problem. The same is true for an MRI. Showing a patient every “abnormality”, as well as the doctor seeing the little abnormalities here and there can lead to blind surgery of an area you are not 100% is the area of concern.
Consider this study done by SD Boden in 1990. In this study 67 patients that HAD NEVER had low back pain had MRI’s of the lower back. The findings were astonishing!
• Ages 20-29 – 35% had degenerative disc disease
• Under the age of 60 – 20% had confirmed disc herniations
• Over the age of 60 – 37% had confirmed disc herniations and 21% spinal stenosis
Boden, SD. “Abnormal magnetic resonance scans of the lumbar spine in asymptomatic subjects: A prospective investigation.” 1990.
Well, a change in guidelines by the American College of Physicians, due to various studies that have come out in recent times, states that X-rays, CT scans, and MRIs for patients with acute low back pain is not recommended for all patients. In fact, it has been recommended that MRI’s and other imaging may be appropriate for only those who may be suffering from cancer, infections, and nerve damage. And as I state to my patients these are the more serious or severe disorders that would trigger me to send them for an MRI. Furthermore, they also suggest that patients not receive imaging studies unless the initial treatment has been exhausted (not meaning the patients tried treatment for a week and decided it wasn’t working, but instead the patient was fully compliant and completed the prescribed treatment plan) and there have been no improvements.
Conclusion: There is a time and a place for all methods and treatments of care that help improve patient health and well being. It appears that the method of using diagnostic imaging should only be done when a more serious injury or disease is suspected and when other treatment options have been exhausted with no results.
Dr Tonya Ingalls, D.C.
Categories : Fitness News