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Member
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Join Date: Jan 2009
Location: Paradise
Posts: 855
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Member
Join Date: Jan 2009
Location: Paradise
Posts: 855
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Quote:
Originally Posted by Leesa
Hey Dubious -- I'm sorry -- I didn't know you were a Chiropractor at one time. I just knew that you knew alot about spines.  Now I'm embarrassed! LOL But all I had to go by was what 3 Neurosurgeons told me, plus the fact that I got my sternum broken.  Now I'll grant you that I got ahold of a rotten Chiro that broke my sternum, and all he offered me was a free visit as compensation. LOL What a guy.  I should have pursued it, but I didn't.
Anyway -- will you grant me this? That too many people go to Chiropractors BEFORE they know what is wrong with them? Don't you think they should find out first thru MRI what is wrong before being manipulated, etc.?? Cause many Chiros WILL manipulate without benefit of MRI films. Your thoughts? |
No worries. My thoughts?
Since you asked, no not everyone needs an MRI. What I will say is that while I would have loved to have had an MRI on everyone (and everyone always wanted one) it would not be beneficial as most cases of back pain do not involve emergent problems, disc injuries or neurologic compromise, so there would be an extra $1500 expense (which ordered at the wrong time would not be reimbursed) that doesn't change the course of care at the end of the day. And then there are false positives of course which cost the patient needless money and scares the hell out of them to boot.
As I have maintained before, a skilled physician, whether it be an orthopedist, neurologist, neurosurgeon, chiropractic orthopedist or neurologist, a well thought out history needs to be taken, a thoughtfull examination performed, probably x-rays (bone integrity issues are important for chiropractors and there is a list of reasons for when to acquire such) and if there are no red flags, then a short course of care implemented. This is not an all-inclusive list, by the way. There are excptions to everything and I was always supportive of co-management with medical speciaist whom I worked with.
Reasons for early MRI and/or medical referral would involve suspected infection, tumor, bone weakening disease, metabolic disease, significant neurological compromise (which should have some suspicion from a good history and exam) for which any or all of these may represent a reason not to manipulate a given patient and scoot them along to some one else. Another reason would be a patient who has embarked on a short course of care (2-4 weeks) and either not improved or worsened. There are always exceptions to the above but this is instructive for most cases.
Finally, studies have been done on the education, training and clinical decision making of chiropactors, and in reviewing the few that I have read, as far as diagnostic accumen is concerned a general chiropractor is about as good as or slightly better than a GP when it comes to understanding musculoskeletal conditions. And a chiropractic specialist (board certified orthopedist, neurologist, radiologist) are almost as proficient as and in some cases equal to thier medical specialist counterparts.
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