Have you or a loved one ever had an X-Ray, MRI, or CT Scan? A high majority of the population has had some form of diagnostic imaging in their life. Whether it be for a broken bone, torn ligament, or severe back pain, diagnostic imaging has played a role in our healthcare in some form or another...
BUT, did you know that imaging does not correlate with PAIN or DISABILITY?
There are MULTIPLE studies showing that diagnostic imaging such as radiographs (X-Ray) or MRIs do not correlate with one's pain or injury. For example, someone can have sharp, shooting low back pain that radiates to their feet, but have a clean lumbar spine MRI. In addition, someone can have what appears to be a "bad" MRI and be completely asymptomatic. This doesn't just apply to spinal pain.
Additional studies have shown a similar correlation with:
- Rotator Cuff Tears
- Meniscus Tears
- Sub-acromial Pain Syndrome
- Ankle Sprains
Then why do most Orthopedists or General Practitioners refer to imaging? Well...because they get paid for it. They do not get paid for doing manual therapy, rehab, or using modalities.
At Strength & Spine Chiropractic, imaging is only immediately ordered when the clinician believes there to be underlying pathology or a serious issue (RED FLAG) such as a fracture, tumor, infection, or cancer. This does not mean patients are NEVER referred for X-rays or MRIs, however, a trial of care should always be rendered before considering imaging.
Here are two examples of patients. Can you guess which one was referred for IMMEDIATE imaging?
Patient 1: Acute, severe low back pain (10/10 pain) with sharp radiation and tingling into the right foot and severely limited range of motion. The patient was in so much pain, they almost fainted. There were no red flags present.
Patient 2: Acute, severe neck pain (8/10 pain) with complete numbness and weakness of their right arm. The patient could not feel or move their arm in any capacity.
Which patient do you think was sent for immediate imaging?
If you guessed patient #2, you are correct. They were referred to the ER for immediate imaging and action and ended up having surgery.
Patient #1 responded favorably and his pain was reduced by 50% with significant lumbar range of motion regained following the care.
The point is, if patient #1 had been sent for an MRI, they most likely would have found some form of an intervertebral disc issue (very common). However, the patient responded favorably to care as it was deemed safe by the doctor to treat. This potentially saved the patients hundreds to thousands of dollars for an unnecessary MRI.
If you are concerned about getting imaging for an injury, it is important to discuss this with your provider to work as a team to decide if imaging is appropriate.
Hopefully you all enjoyed the first #WiserWednesday ! I look forward to providing you all with these bi-weekly informational blogs.
Dr. Cameron Gholampour DC, CSCS
International Certified Sports Chiropractor
Strength & Spine Chiropractic