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MRIs - The Positives and the False Positives

Tests – what are they good for?

When it comes to back pain tests, of MRIs that question must be questioned. What are MRIs good for when the percentage of constructive, influential MRI studies is so little? False positive MRI results upset those who get such results. They inspire fear or caution where it’s not always warranted. MRIs like this confuse the proper treatment plan. They spend a lot of money. McMurray Chiropractic Solutions carefully evaluates the necessity of MRI in the San Jose chiropractic treatment plan of San Jose back pain relief.


Interpretations of MRI images by radiologists often differ.  The true-positive finding rate was 56.4%, and the miss-rate was 43.6%. (1) MRI imaging may trigger misleading suspicion. When following the guidelines of the American College of Radiology, 93% of lumbar spine MRIs were appropriate. Of those, only 13% revealed anything suspicious. Of the 36 MRIs that provoked 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 presence of disc degeneration in asymptomatic persons – persons with no back pain – grows 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 indicate that these are signs of normal aging. They remind all doctors, remind chiropractors like yours at McMurray Chiropractic Solutions, to correlate all such findings to patient symptoms. (1,3) Your San Jose chiropractor does this!


Choosing Wisely guidelines for American chiropractors suggest30 not repeating spinal imaging and not obtaining spinal imaging for patients with acute low back pain in the first 6 weeks of back pain (except when “red flags” are present– issues that indicate something more worrisome). (4) A review of the effectiveness 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 objective of guidelines is less imaging, fewer false positives. McMurray Chiropractic Solutions wants what is best for our San Jose chiropractic care patients.


Chiropractors like yours at McMurray Chiropractic Solutions study all the symptoms, tests and images our San Jose chiropractic back pain patients bring with them39] their first [[targetlocation chiropractic visit. So many back pain patients come to McMurray Chiropractic Solutions with MRI images already in-hand. McMurray Chiropractic Solutions will study them but will rely more on clinical exam findings and link them to what the MRI shows. A rule of thumb with the Cox Technic System of Back Pain Relief is to seek 50% reduction of back pain in the first month of care before arranging additional imaging or testing or arranging surgical consultation. (6)

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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 San Jose chiropractic appointment with McMurray Chiropractic Solutions today. Let us discover together the best path to San Jose back pain relief – with or without MRI imaging!

Chiropractic Solutions carefully chooses when and if MRI images are needed to guide the San Jose chiropractic treatment plan.  
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"This information and website content is not intended to diagnose, guarantee results, or recommend specific treatment or activity. It is designed to educate and inform only. Please consult your physician for a thorough examination leading to a diagnosis and well-planned treatment strategy. See more details on the DISCLAIMER page. Content is reviewed by Dr. James M. Cox I."