One of the drivers of our high healthcare costs are the new technologies that are available to physicians and hospitals. I often see patients after they already had an MRI, but no useful information was found. Or people are getting treated and getting better, but get the MRI anyway because it was already scheduled. (Not all the new technology increases costs as many – particularly those related to surgery can drive down costs dramatically as what was one done in-patient for a week is now an outpatient procedure). However some technology such as MRIs for back pain are sometimes being used non-judiciously and likely driving up costs.
In 2001 a study was done that looked at MRI for back pain and the authors concluded: “Many MR imaging findings have a high prevalence in subjects without low back pain. These findings are therefore of limited diagnostic use. “
A new study was just released that was a follow up to the 2001 study. They used the same data, but looked at 3 year followup in patients that received a second MRI. They applied some stricter standards hoping to see more positive results, however the study still showed the most MRIs for back pain are not clinically useful.
Therefore before getting an MRI for back pain consider other beneficial therapies. Since I am an acupuncturist I say try acupuncture as even Medicare now covers acupuncture for low back pain. In addition other treatments such osteopathic, cranial sacral, chiropractic, massage or PT are likely more cost effective approaches than just getting an MRI.
References
Jarvik JJ1, Hollingworth W, Heagerty P, Haynor DR, Deyo RA. The Longitudinal Assessment of Imaging and Disability of the Back (LAIDBack) Study: baseline data. Spine (Phila Pa 1976). 2001 May 15;26(10):1158-66. PMID: 11413431. [PubMed] [Read by QxMD]
Prospective cohort study of randomly selected Veterans Affairs (VA) outpatients. […]
Baker LC1, Atlas SW, Afendulis CC. Expanded use of imaging technology and the challenge of measuring value. Health Aff (Millwood). 2008 Nov-Dec;27(6):1467-78. PMID: 18997202. [PubMed] [Read by QxMD]
The availability of computed tomography (CT) and magnetic resonance imaging (MRI) scanning has grown rapidly, but the value of increased availability is not clear. We document the relationship between CT and MRI availability and use, and we consider potentially important sources of benefits. We discuss key questions that need to be addressed if value is to be well understood. In an example we study, expanded imaging may be valuable because it pro […]