Friday Findings: Should I Get an MRI?
<<First Name>>,

At about a rate of once per year, I am subject to a bout of central low back pain that forces me into excessive stiffness, pain, and an old man posture. Usually, it's by doing something stupid where in retrospect I probably shouldn't have been doing what I was doing. Heavy deadlifts for time? Yeah, that's happened.

I had my yearly occurrence about three weeks ago while standing up from sloppily crawling around on the ground with my toddler after having sat in front of a computer for two hours. A quick bout of activity (bear crawling is much more demanding than you may think) after prolonged sitting conjured my retrospective thought of, "dumbass -- you know better."

I was diligent with great sitting posture utilizing my McKenzie lumbar roll and performed my sustained cobra press-up (Fig 4 below, typing in this position as we speak) before I could do full and free press-ups (Fig 5 below) with repetition. By following some basic rules for acute back pain, as my stiffness decreased, my range of motion increased and subsequent pain alleviated. It took about three days to get back to normal.

So, why am I in laying in the cobra position now? Well, my "yearly" bout of back pain had struck again just two days ago, a second time in less than a month. I did it in the morning while getting dressed. Why did such a simple daily task set it off? My thought is that with all the time I have spent doing manual labor on my knees -- working on the new office -- and not being diligent about performing my back exercise/movement as maintenance, led to putting on my socks as the straw the broke the proverbial camel's back. Putting on socks for God's sake! Classic.

Ironically, I've had a few patients recently shuffle into my office with the exact same issue as moi, which stimulated me to make this the subject of this week's Finding.

Have I ever or should I get an MRI? I have not and no I should not as it would cost me a boat-load of moolah for irrelevant information that would not change the way I treat myself or how I would treat one of my patients that are in a similar unfortunate situation.

There's an 80% chance that an individual will experience back pain over the course of his or her life, let alone his or her athletic career. The dreaded disc herniations and arthritis have been associated with giving up athletic endeavors and dealing with a life of pain. It doesn't have to be like this in the vast majority of cases. In fact, there's a chance that having a disc herniation will have nothing to do with experiencing pain! An MRI may do more harm than good as these incidental findings on the picture of your back can raise your anxiety level, thus pain; ultimately, avoiding activites that you enjoy.

Let's be real, call me! Read more about this here.

Now don't get me wrong, MRI technology is unprecedented and provides invaluable information to physicians in the right cases. However, as seen in the image above, it is very unreliable associating structural abnormalities with pain. Our healthcare system is guilty of unnecessary over-imaging that continues to amass healthcare costs.

The moral of the story: seek a qualified conservative musculoskeletal specialist, such as a chiropractor or physical therapist, as soon as possible to provide a thorough evaluation and devise a plan to get you back in action as soon as possible. Acute back pain constantly hurts so there are actions you will or will not do to find any relief you can get. The issue with this is you may be making your problem worse without realizing it. Furthermore, the longer you let it go, the longer you will suffer, the longer it will take to abate and you suscept yourself to a progressively greater risk of more serious issues down the road.

What about me? I'm at about 80% need to show some more diligence in practicing what I preach before this happens (i.e. quit being a dumbass)! On the bright side, there is a calming nature to knowing your Doctor has felt and dealt with something exactly as you -- misery loves company!

Do you know someone that could find value in this information? Please, consider forwarding or sharing this email using the "share" buttons at the top and bottom of this email!

Treating patients on a daily basis, I frequently address questions regarding nutrition, lifestyle, and "how do I now stay out of pain," questions. In our technology age, there's instant access to vast quantities -- not always quality -- of information, but so little time. Friday's Findings offers access to quality information, in small, weekly doses, so you can make the little changes that make a significant impact, without having to sift through all the mumbo-jumbo. I believe you'll find value. To maintain relevancy to you, please, email me with suggestions for future topics. Thank you and make today count, because it only happens once!

- RJ Burr, D.C.
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