I want to start by saying that this article is for people who need help determining if imaging is appropriate for their ORTHOPEDIC condition.
If you are battling a condition regarding any other system in the body (Circulatory, Digestive, Endocrine, etc.) please see a medical specialist in the respective field.
Medical Decisions Can Be Stressful
In today’s society, most people are faced with a decision, at least once in their lifetime, about whether or not they need imaging to treat their orthopedic injury.
We also live in a world where surgeons are gaining a strong reputation for being ‘quick to cut.’ And often, getting an MRI is the first step a surgeon might take to convince you of getting surgery.
In fact, this is now becoming the topic of many popular publications. Please see the following:
- New York Times: "Why 'Useless' Surgery Is Still Popular"
- British Journal of Sports Medicine: "The Sexy Scalpel: Unnecessary Shoulder Surgery On The Rise"
If surgery is not on the table, should we bother getting imaging first? Or should we instead use our resources to get the best, most qualified, physical therapist to help manage our injury conservatively? The choice is entirely yours.
On A Personal Note:
A few years ago, my father underwent a surgery to remove a small tumor from his spinal cord. His Neurosurgeon came to update us after the surgery. He told my family that this particular type of tumor is likely to be cancerous as its location, type and size all match a specific condition.
I asked, “is there a chance this type of cancer may have spread (metastasized) from another place in his body.” I asked if it would be worth getting imaging to determine this.
He responded, “your father doesn’t have symptoms indicating this would be the case. But bad things tend to occur when you go searching the body for conditions that may not even be worth treating. The option to get imaging will always be there in the future should he start to show symptoms.”
As a Physical Therapist, I knew exactly what he meant. He was referring to something commonly seen in the medical world.
Did you know that a large part of the U.S. population has no pain, yet a moderate to severe classification of arthritis in their knees? Also, roughly 60% of 50 year olds (with no pain) have bulging discs when imaged?
It is important to know what this means.
Don't give your MRI too much power.
Just because an MRI revealed that you might have an issue, it does not mean that it needs to be surgically corrected to get rid of your pain.
In fact, what's shown on the image may not even be contributing to your pain.
With the growing rate in which medical imaging is prescribed, I’m sure you can imagine how often I am asked about its necessity. This can be tricky and should ultimately be determined on a case by case basis. However, here are some general guidelines to follow to see if you would benefit from having imaging.
Imaging May Be Beneficial If:
- You've experienced direct trauma
- Ex. Car accident, falling down stairs, head-on sports collision
- You've been experiencing pain for multiple years
- You did not receive pain relief with prior Physical Therapy
- This only counts if your therapist was thorough and spent adequate 1:1 time with you
- If you did not get this level of attention, feel free to contact us and we can guide you in the right direction
- Your pain is consistently high and now affects your everyday living
- You had positive results with special testing from a licensed healthcare provider
- These positive tests can indicate whether or not you've torn or broken something that needs immediate surgical repair
Pros To Receiving Imaging
- Ease of mind
- Simply knowing if there is any structural damage
- Can help you decide if you might benefit from surgery
- If you are looking to avoid surgery, it might help your therapist better direct your treatment
Cons To Receiving Imaging
- Results will not account for pain caused by faulty biomechanics
- Given that most imaging is simply a still image of your body, it will not take into account if you're having pain from poor movement
- Mostly all imaging, aside from X-Rays, can cost hundreds to thousands of dollars and do not provide a guarantee of answers
- Exposure to radiation
- Can delay the start of treatment
- It can take weeks to get an appointment with your orthopedist, another 1-2 weeks to schedule your MRI, and another week to receive the results. By the time this process is over, if you are not planning on scheduling a surgery, you could have waited close to 5 weeks to start physical therapy for conservative management.
As always, if you are unsure if getting medical imaging is right for you, you may certainly schedule a FREE 30 Minute Discovery Consultation with our Doctor of Physical Therapy.
The therapist can take a look at your injury, perform a thorough screening and advise appropriately based on the results. If you need to see an orthopedist or sports medicine doctor, we can then refer you to the best in the area. We will make sure to reach out, on our end, so that your appointment takes place as soon as possible.
Feel free to leave your comments, questions and concerns below in the comments section. We'd love to hear from you!