I have patients who when they come into the office for an evaluation, they tell me, “Look at my MRI and you’ll see, you’ll know what’s wrong” or I’ve spoken to some patients who they tell me, “I’m going to wait to get my MRI done before I start physical therapy.” What I’m going to say is I don’t really believe in MRI or I don’t wait for the MRI or don’t rely on the MRI to determine what’s wrong with the patient or what’s causing their dysfunction or their pain. And I’m going to tell you why I don’t believe in MRI for back pain.
Top Reasons Why I Don’t Believe in MRI for Back Pain
#1 Because after the scan, a person has to look at those scans. It’s possible that person can miss something and then that can lead to something not showing the MRI. So that’s one thing.
#2 Another reason is on the other end of the spectrum, MRIs are very sensitive, but they are not very specific, meaning they are prone to creating false positives. Let’s say, for example, you put a group of healthy people make them undergo an MRI.
Actually, I came across this article before, it was in the New York Times a couple of years ago and they interviewed Dr. Andrews, who’s one of the experts in sports medicine. Dr. Andrews conducted his own kind of his own study there. He had 31 athletes, healthy, no symptoms, no pain. They underwent an MRI to see what the results will be, and to his surprise, actually all of them showed that there is something wrong in the shoulder. In this case they did an MRI of the shoulder. He saw that 90% of them showed something wrong in the shoulder. But remember these are healthy people, healthy athletes and none of them had pain. None of them had any symptoms or any dysfunction, any difficulties. So that led him to conclude that MRIs are not really very reliable in that sense.
So in my case, what I would say there is I rely on my clinical skills, on my clinical findings, on the history that I take with the patients and correlate that to the clinical findings that I see when I do my exams. I have them do the movements that they’re having difficulty with, have them describe those moments, show me the movements and describe patterns of the pain. I rely on that more rather than MRIs to determine what’s causing the patient’s dysfunction, what’s causing the their pain.
Because I believe that there are imbalances in the body that are causing people to have pain and to have problem moving, and these imbalances are the root cause of everything. I look at the person as a whole, looking at the different parts of the body and how they relate to each other when the patient is moving.
These imbalances are what we call fault lines, and these fault lines leads to weakness, leads to stiffness, and eventually leads to pain and inflammation. And that’s what’s causing the patient to have difficulty moving, a difficulty walking, reaching up, all those things. So I make it a point to see what the internal imbalance is in the body and determine how do I correct those imbalances. That’s how I create and formulate my treatment plan. I address those imbalances. That is how I will restore the patient’s function.
Treatment for Back Pain
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