Do I Need An MRI Scan For My Low Back Pain?

Yesterday, the Ottawa Citizen ran an article documenting wait times for MRI scans in Eastern Ontario (http://www.ottawacitizen.com/health/With+delays+worst+province+eastern+Ontario+tries+clear/7251302/story.html).

Despite the addition of three new scanners for the region since 2009, wait times have actually increased. Is this reflective of a greater need, or simply an increased usage?

Recently, the Ontario Chiropractic Association undertook a joint program with the Ministry of Health and Long Term Care in order to ease the diagnostic process for low back pain. The program worked as a chiropractor performed an assessment on patients referred by their family physician. Following the assessment, the chiropractor communicated with both the patient and the family physician. Reccomendations were made regarding care and further investigation in order to help the physician work with the patient to achieve better outcomes.

The goal of this program was to reduce the number of radiographs (x-rays) and special imaging scans (MRI’s, CT’s, etc) that did not effect the patients outcome or aid in their diagnosis. This would reduce the overall number of referrals for scans, and therefore reduce wait times. After all, the best way to stop a boat from sinking is to plug the whole, not to add more bail buckets!

The Windsor Star gave a great report on the whole project: http://blogs.windsorstar.com/2012/06/12/pilot-project-shows-fewer-mris-referrals-to-surgeons-for-patients-with-low-back-pain-when-family-doctors-have-chiropractor-on-their-team/

So, do YOU need an MRI scan for your low back pain? While each person is different, you probably don’t require special scans.

Why?

Most spinal pain is not caused by a specific pathology (tumour, infection, fracture, etc) but rather by excess stress and strain (dysfunction) of the joints and muscles leading to inflammation. Special scans are helpful to rule out serious pathology or to aid in surgical decision making. Unless this is the objective, the test results have no bearing on your conservative treatment plan (chiropractic, massage, acupuncutre, physical therapy, etc.) or on the outcome of that treatment.

The question of whether you require a scan for your lower back pain is one that your chiropractor is equipped to answer. After a thorough assessment your chiropractor will be able to discuss with you the most likely cause of your lower back pain, what to expect over the coming weeks, whether extra tests will be helpful for your case and what your treatment options include.

So, ask a chiropractor. They know back pain best.