Ask a Physical Therapist: Do I need an MRI?

In the heart of a busy hospital, teeming with diverse locations and services, a doctor, deep in discussion with a dedicated nurse, scrutinizes the magnetic resonance imaging results they’ve just received from the radiologist. With the emblem of medicine, the hospital’s logo, engraved on his coat, the doctor’s eyes masterfully work as a scanner, darting back and forth over the report, meticulously analyzing the detailed image of the structures of a person’s body, taking care to examine every order and page. This imaging test, a detailed procedure involving powerful magnets, reveals a wealth of information.

Meanwhile, a few feet away, another nurse amidst essential medical products and medications, is assisting a patient, cautiously guiding them into the cavernous opening of an MRI machine. Being aware of the possibility of the patient’s claustrophobia and any potential risks of infection, she assures them, “Don’t worry. There is enough space for movement.

Just beyond them, an array of MRI machines hums with an almost tranquil rhythm, each machine a powerhouse of diagnostic capability, harnessing the power of magnets and radiation to delve deep into the human body, providing a unique perspective on health and disease. These machines, utilizing tomography to render cross-section images, under the careful watch of doctors and radiologists, can identify potential injuries within the body’s delicate network of tissues, ligaments, and nerves, even before the patient feels significant pain or experiences a symptom as serious as a heart attack.

One of the most common questions I receive from my patients suffering from low back or neck pain is whether or not they should get an MRI. This question is underpinned by the fear of the unknown, even as they hold their head high showing courage. It’s a fair question — it’s no fun to deal with the pain that doesn’t seem to go away or that shoots down a leg or arm.

So, it makes sense why folks would want to have this type of imaging procedure, performed by the magnetic resonance imaging machines available, taking place. MRIs will show what is wrong, and the doctors, armed with the powerful weapon of medicine and a wide range of medications, can use this detailed information to potentially address the identified issue, right?

Not necessarily.

What is an MRI?

MRIs are powerful diagnostic tools. They provide excellent pictures of your anatomy and detect severe diseases like tumors, cysts, and potential infections in the brain, spinal cord, and other body tissues.

You may be saying to yourself, sounds like the perfect test to tell me what is wrong, right?

Not always! The issue is that the MRI is so powerful, that it detects every imperfection of the tissues, broadcasting them as vividly as a theater spotlight.

The problem here is that the MRI may not pinpoint the specific source of your pain.

For example, just because your MRI finds you have a bulging disc doesn’t mean it is the cause of your lower back pain!

Don’t believe me? Look what the research shows: A study by Nakashima et al. in 2015 looked at the MRI findings of over 1200 individuals with NO neck or radiating arm pain. Of these volunteers, a shocking 87.6% had a bulging disk! Therefore, the order of the results on the page may not always indicate the source of your pain. Several other MRI studies performed on healthy, pain-free individuals’ lower backs showed between 60-80% had bulging discs on their MRI. This amount of bulging discs makes it clear that many people possess these conditions, despite no apparent discomfort.

If so many people without low back discomfort possess these pathological conditions on MRI, can we confidently conclude that these findings are the actual cause of their symptoms? Before jumping to conclusions, it’s wise to consider the full context and not make definitive assumptions based merely on an Instagram post or a limited amount of data.

Studies prove MRIs are not always the answer

Making assumptions based solely on MRI findings often leads to over-treatment with a variety of products and medications, and even possible surgery, both of which come with their own risk and potential complications. Additionally, the more testing and treatment a patient undergoes, the more likely fear and anxiety become associated with persistent or chronic low back pain. These overwhelming feelings can be exacerbated by the immediate access to information we have today, leading to self-diagnosis and unnecessary concern.

Don’t get me wrong, MRIs are excellent medical tools, and, when used judiciously by experienced doctors and radiologists, they offer a powerful diagnostic advantage. However, they may not be the best option for pinpointing the exact cause of one’s lower back or neck pain, especially when factoring in the amount of false positives that can arise.

Quite often, MRI procedures can be very expensive and could potentially lead to unwarranted surgery, even causing, in some unfortunate cases, injury to muscle tissue. This risk, coupled with the potential for causing or exacerbating an infection, further underscores the need for careful thought before proceeding with this diagnostic procedure. For this reason, access to a second opinion can be crucial.

Therefore, it is essential to recommend due diligence in seeking medical care if someone suspects they might be experiencing unusual symptoms. Nevertheless, this diligence does not exclude the possibility of infections or unexpected reactions to drugs that one might encounter in healthcare settings. This underlines the importance of using the vast amount of health information available today responsibly, from clinical studies to Instagram health posts.

Do I need an MRI?

This is a valid question that many patients understandably ask. Healthcare services often suggest a variety of tests to reach a conclusive diagnosis. These tests could involve different objects, for instance, MRI machines or ultrasound probes. Advanced tools like MRI machines can help detect details down to formations as small as pins within the body’s spaces – an impressive amount of precision that lends credibility to this indispensable tool.

If you find yourself having to undergo an MRI scan, then you might be wondering just what to expect when you go for your appointment. An MRI scan generally takes about 30-60 minutes and involves the use of a powerful magnetic field and radio waves – a process known as ionizing radiation, to generate detailed images of your anatomy. Unless you need an MRI with contrast, which involves the injection of a special dye to create clearer images of your tissue and organs. The use of contrast dye can result in side effects in some patients, common ones being a mild reaction like a rash or an itchy sensation. These can take a bit longer. With such a level of access to medical imaging technology, your medical team will guide you through the process.

An MRI with contrast is used when the scan needs to be more detailed to look at a problem area. For example, these types of MRI scans can highlight areas of inflammation or injuries. On this site, you can find relevant content to help understand why they are sometimes directly injected into a joint to provide a more detailed picture of the cause of pain and other symptoms a patient is experiencing.

Remember, the amount of information available through platforms like this one and even on Instagram can be a valuable resource, but should never substitute professional advice.

The cost of MRI scans can be a point of contention for many individuals like us. According to Bankrate, the average MRI scan cost will range from $400 to $3,500. This vast range can be a significant determining factor for patients deciding the best course of action to determine what is causing their pain. This is where the advice of skilled surgeons could prove invaluable. Patients may be able to work with their insurance, but based on the plan they have, they may face having to pay a significant portion out-of-pocket or have it applied toward their deductible. MRIs are eligible for use with a flexible spending account (FSA) or a health savings account (HSA), making it more affordable for some patients, but they may choose a different treatment plan for others, especially in cases where the skin or superficial tissues are involved.

It is essential to understand that sometimes, MRI scans, with the assistance and expertise of radiologists, surgeons, and physicians involved, are necessary to help diagnose an underlying medical issue. However, there is a variety of diagnostic methods beyond just MRIs when it comes to your chronic pain diagnosis. It is crucial to discuss all available options, including devices that don’t use a magnetic field, with your doctor and your insurance company. Note that each method comes with its own set of risks, and your doctor can best explain these to you.

How long does an MRI take?

Differentiating between different kinds of scans, procedures, and devices can get confusing, not to mention frustrating for many of us. Our team, consisting of trained surgeons, is here to break down and explain the difference between MRI and CT scans for you, especially in cases involving skin and superficial tissues.

Both MRI and CT scans are used to capture images of the inside of a patient’s body, but the method and equipment, such as the scanning table and metal parts included, are different in each. Along with the brain and internal organs, they are used to capture detailed information about the skin and other parts of the body such as bones.

Difference between MRI and CT scans

MRI scans are generally used for gathering images of a patient’s joints, brain, wrists, ankles, breasts, heart, blood vessels, and skin. On the other hand, CT scans, functioning via an X-ray, are a preferable option for learning more about a patient’s bone structure, internal organs, and blood vessels. Many times, CT scans are recommended for diagnosing stroke, cancer, and problems with blood flow.

The equipment used is also different — an MRI uses radio waves while CT scans use X-rays, each affecting the skin in different ways.

Physical therapists are trained to focus on improving a patient’s pain and function and figuring out if the problem is genuinely a musculoskeletal issue or something more serious needing immediate attention. Additionally, they know how to read a variety of reports from diagnostic tools, from X-rays to MRIs, thus adding to the range of care services rendered. For example, if you have had a fall, a traumatic accident, noticing progressive weakness, bowel or bladder problems, or skin pain that does not improve over time, then an MRI is warranted. The location and severity of your condition, your age, as well as the number of previous cases like yours the surgeon has handled, may all play a part in the decision for an MRI. This type of exam can provide crucial MRI images that help diagnose your condition more accurately.A growing concern, particularly within the menu of available services in hospitals, is the compatibility of medical implants such as pacemakers with the MRI system. This issue has been especially prevalent among children and adults, especially following trauma incidents.

However, it’s essential to acknowledge that up to 80% of people who suffer from back pain at some part of their life experience is mechanical. Mechanical back pain stems from placing abnormal stress and strain on the muscles of the vertebral column. A condition that medical providers often highlight, can be exacerbated by age, lifestyle factors, and the quality of one’s posture. It usually arises from bad habits such as poor posture, poorly designed seating, and incorrect bending and lifting motions. This way, mechanical back pain comes and goes and at times can spike, becoming very unruly.

MRI scans, a common item on the diagnostic menu in hospitals, are often used in a series to observe the progress of these conditions.

An MRI uses a unique piece of equipment enclosed in a tube-like shape around the patient and sometimes requires said patient to lie still for an extended period on the diagnostic table. In some cases, due to the location of the body being examined, patients may suffer from anxiety or panic attack. However, the good news is that there is an array of options and ways patented by healthcare providers so that patients can undergo an MRI without panic, making the service more accessible and less nerve-wracking.

Is there such a thing as an open MRI?

Open MRIs provide a different way, being “open” in that the shape allows a patient to see more and have more of their body out of the machine than a traditional MRI. The latter uses a cylindrical shape, but the open MRI does NOT surround the body. Given their design, for many patients – including those visiting hospitals with certain implants or devices – open MRIs might be a better solution, improving the quality of the experience.

Suppose you have to have a traditional MRI for a variety of reasons. In that case, from the service to the surgeon’s recommendations offered in hospitals, there are ways to manage your anxiety. Some methods include asking any questions you might have before the scan begins, covering your eyes (or using an eye mask), listening to music, and asking for a blanket to keep you warm (if possible, based on the type of scan being done).

Don’t want to undergo an MRI?

Here’s the good news: One of the most effective treatments listed on the healthcare providers’ menu for mechanical neck or back pain is specialist physical therapy. At Move Empower Concierge Physical Therapy, our spine specialists are trained to examine both MRI images and physical symptoms to evaluate and treat spine pathologies. Our hands-on manual therapy techniques quickly and effectively restore your mobility and function to get you back to the activities you love to do.

Are you suffering from lower back or neck pain and have been urged by healthcare providers to get an MRI?

Curious if specialist physical therapy, a proven remedy even in cases involving trauma, could help you decipher medical reports and better understand the condition you’re dealing with? If so, reach out to the number for Move Empower today at 512-659-5615 to speak to a physical therapist!