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The national average cost in 2015 of an MRI is well over $1,400, in some areas over $3,000

MRI’s are almost never useful in determining the true cause of a pain issue

Even though you are only paying a portion of your MRI cost, they are used so often that healthcare premiums are higher because of it.

Because most MRI machines are owned by the same organizations that own the practice groups, their frequent use is a steady income source for these groups by billing insurance for their full cost and this financial motivation contributes to their over-recommendation.

MRI’s can be life saving in certain situations. This post is about the overuse of MRI’s for the purposes of diagnosing and treating musculoskeletal pain and injury issues, not brain and organ related concerns.

shutterstock_90423109Almost everyone has had pain and injury problems in their life. If they aren’t experiencing one currently, they almost certainly have in the past. The truth about the huge majority of pain and injury issues is that there isn’t actually a structural problem that is the cause. It isn’t that something is torn or broken or chipped or slipped, it is simply a movement problem and/or an imbalance in what muscles are performing certain functions – and if there is a dysfunction, it can cause certain joints or areas of the body to be put under more stress than they are designed to handle, resulting in pain, but it still isn’t a structural issue that can be explained or clarified by an MRI.

A simple analogy is that if your hand hurts because someone is standing on it, there is nothing wrong with your hand, the person just needs to stop standing on it. Too many times, the typical approach with joint and back pain is to immediately assume that there is a structural problem with the “hand” an over-investigate that, instead of finding out what is standing on it and removing that stress. The pain area could be a knee or a low back or a shoulder or anything else.

A concerning process that we see and hear about all the time is that someone has a pain issue, goes to the doctor, and the first thing they do after hearing the patient explain their symptoms for three minutes is order an MRI to find out more, then often prescribe pain medicine, and then refer the patient to well intentioned but outdated and ineffective therapy/rehab. So between the MRI and pain medicine prescription, your insurance has been billed for about $2,500 on the very first day and you really aren’t an inch closer to knowing what’s actually wrong. This is a scary pattern and it really needs to be updated and changed. There are many more effective assessment methods that cost nothing that should happen way before an MRI is even considered. Some therapy is great but most is outdated and doesn’t work. We see these people after they have been through a round or two of treatment efforts that didn’t work and are almost always able to fix everything in a short period of time by using an objective movement assessment system based on the Functional Movement Screen and moving on from there.

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MRI images of a knee.

MRI’s are also not usually a helpful way to investigate back pain. Dr. Stu McGill who is arguably the top spine and back pain specialist on the planet, explains in more detail when he says, “Generally speaking most people would be better without an MRI. Some people would say that’s responsible. However, the picture of the anatomy very rarely helps. You will have some docs that will say, “well I can’t see anything on the MRI and therefore your pain is not real or I don’t understand it, it must be in your head, go away.” Or they will look at the next MRI and it will look absolutely awful and all kinds of things could be possible pain candidates, and yet the person doesn’t have much pain.”

Of course sometimes an MRI is useful for pain issues – a torn ACL in the knee, a torn Achilles tendon, etc – but most of the time these injuries can be identified without an MRI and an MRI is then used to confirm them before proceeding to further treatment. So we are not saying that MRI’s have no place in the treatment of pain and injury issues, just that they should almost never be step one, but almost always are. They should be maybe step five – and what you would find out is, the proper steps 1-4 resolve the problem over 95% of the time for less cost than a single MRI.

Call or email us with any questions and let us know if we can help. If you are not in our area we can still put you in touch with the best people in your area.

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