With healthcare costs skyrocketing and most insurance policies transitioning to a high deductible, the pain of an injury can extend into our wallets. Following an injury, it is important to determine the fastest, most effective, and most cost-effective medical plan. Many patients think getting an MRI is needed to set them on the path to recovery, but is this true?
As physical therapists, we are frequently asked, “Should I get an MRI before being here?” Believe it or not, the common answer is no. Most orthopedic clinicians (MD’s, PT’s, DO’s) use an MRI to confirm a diagnosis after an examination. In the future, you’ll likely see less MRI utilization as the expensive test rarely influences your course of conservative treatment. In fact, the addition of an MRI, especially too early on in treatment, increases medical costs while having minimal to no effect on your treatment program or results(1).
An injury can be debilitating and frightening. Your first thoughts should focus on treatment as quickly as possible. Postponing treatment until your imaging has been completed has been shown to slow down your healing process (2). In fact, one study found that patients with low back pain who were treated with physical therapy within two weeks of their injury were 30 % less likely to get advanced imaging, 28% less likely to require a referral to another doctor, had 10% fewer injections, were 7% less likely to be on opioids, and were 5% less likely to require spinal surgery (3)!
“Don’t you need to know what’s going on?” patients exclaim. Take a look at the quick video below, where I cover how physical therapists and other medical professionals are trained in determining if your injury will require further imaging.
Video
References
1. Webster, Barbara S., et al. “Iatrogenic consequences of early magnetic resonance imaging in acute, work-related, disabling low back pain.” Spine 38.22 (2013): 1939-1946.
2. Vroomen, Patrick CAJ, M. C. T. F. M. De Krom, and J. A. Knottnerus. “Predicting the outcome of sciatica at short-term follow-up.” British Journal of General Practice 52.475 (2002): 119-123.
3. Fritz J, Childs J, Wainner R, Flynn T. Primary Care Referral of Patients With Low Back Pain to Physical Therapy. SPINE (2012): 1-8.
