Research deepens questions about low back mri

mri machine

The March 25, 2013 edi­tion of JAMA Inter­nal Med­i­cine tells the sto­ry: doc­tors are still order­ing far too many low back MRI’s of ques­tion­able val­ue.

Inves­ti­ga­tors first estab­lished “expert” guide­lines that iden­ti­fied sit­u­a­tions in which MRI’s were like­ly to yield use­ful clin­i­cal infor­ma­tion.

Then they stud­ied 1,000 actu­al MRI pre­scrip­tions to see if the case records con­formed to the guide­lines.  Few­er than half of the MRI stud­ies were found to have been appro­pri­ate.

Use­less MRI’s are expen­sive and can be harm­ful, because they cause unnec­es­sary anx­i­ety and lead doc­tors to even more ques­tion­able and more dan­ger­ous diag­nos­tic pro­ce­dures.  The bot­tom line is that we’re spend­ing bil­lions of dol­lars a year on a phan­tom process of diag­no­sis.

MRI and lumbar epidural injection

In a relat­ed arti­cle, researchers stud­ied the use of MRI’s for patients who were can­di­dates for epidur­al steroid injec­tions.  These injec­tions are com­mon­ly used in the med­ical com­mu­ni­ty for peo­ple with back pain or sci­at­i­ca who don’t seem to respond to oth­er treat­ments.

In this group of patients, did the MRI help improve the out­come of the epidur­al injec­tion?

Unfor­tu­nate­ly, the answer is no.  Patients who received epidu­rals sole­ly based on their phys­i­cal signs got just as much pain relief as those whose physi­cians had a chance to review their MRI pri­or to treat­ment.

Palpation — the forgotten tool of diagnosis

What are the best ways to diag­nose low back prob­lems?  In a few cas­es, an MRI is need­ed.  But most peo­ple with back prob­lems get more ben­e­fit from a physi­cian who can lis­ten atten­tive­ly to your case his­to­ry, pal­pate your mus­cles and joints, and assess your pos­ture and func­tion­al move­ment per­for­mance.

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Deepen Your Body of Knowledge

Low back MRI and dis­cec­to­my recov­ery

Hid­den costs of MRI scans, CT scans

Epidur­al injec­tions for back pain and sci­at­i­ca

 

 

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About Aaron Bynen

Aaron is a health conscious individual living in the Pacific Northwest.

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