A new study suggests an MRI that is ordered too early is dangerous to your health.
In the practice of health care, especially with back and neck pain, ordering an MRI is sometimes necessary. Our usual protocol is to wait for 6 to 9 visits to see if and how much the patient improves. Most people improve at least 50% in that time which eliminates the requirement for an MRI. Others may have unexplained exacerbation’s, which is a red flag diagnostically, and an MRI is usually indicated.
Many times, doctors will often order an MRI as their diagnostic tool, without trying an effective rehabilitation regimen first. Considering the cost of the MRI which can be more than the rehabilitation trial, and considering even the worst cases are most likely to improve, unless the test alters the treatment approach drastically, it is not useful. It can also be harmful because of the sensitivity of the test. Even though there are findings on the MRI, it does not mean the person needs to have a surgical consult. As stated before, most people improve without it.
Sometimes people do not trust the process, however, considering the odds, if a practitioner is unhappy with your progress under their care (at least 50% improvement in 9 visits or less), they will order the tests and make the necessary specialist referrals. This has led many to spend many health care dollars on things that do not work or as this doctor has seen, horrific surgeries that creates permanent problems that could have been avoided had the patient had more faith in the rehabilitation regimen.
A new study in the Journal Spine shows that early usage of MRI can lead to over treatment medically, including procedures that are expensive and potentially harmful. Check this article out
MRI scans for low back injuries among workers may delay recovery
The use of complex diagnostic tools is on the rise among injured workers. Imaging can be great for understanding the internal structures of the body. However, when it comes to low back pain, imaging may be a costly and time consuming distraction.
A recent study evaluates the link between early imaging and disability status one year after patients suffered from acute low back injury.
The study found that early imaging of the injury signified an increased length and chance of disability in patients, but it did not affect pain intensity nor quality of life.
Lead author, Janessa M. Graves, MPH, PhD, and team with The University of Washington monitored 1226 participants in Washington State with nonspecific lower back problems with related worker’s compensation claims.
All participants were 18 years old or older and had an accepted claim between July 2002 and April 2004. The participants also missed at least four workdays due to the injury but were not hospitalized.
Sprains were diagnosed in 77.9 percent of the participants. Radiculopathy, nerve inflammation that results in pain, was seen in 22.1 percent of the participants.
Information regarding date of injury, wage replacement benefits and type of job was collected from the worker’s compensation data.
Two to three weeks after the injury and after one year, the participants were interviewed. The interview questions ranged from overall and injury-specific health status to work and personal information.
The participants completed the Roland-Morris Disability Questionnaire to determine any physical disability caused by the low back pain.
The 36-Item Short Form Health Survey (SF-36) was used to measure health-related quality of life, mental health status and predict long-term disability of participants.
Workers pain intensity was assessed at each interview using a modified version of the Graded Chronic Pain Scale.
Of the 1226 patients, 18.6 percent of the study participants received a magnetic resonance imaging (MRI) within six weeks of incurring the injury and 15.7 percent received an MRI after six weeks from when the injury took place.