Low Back Pain and MRI’s: Is what you see what you get? (Cue Dr. Strangelove)
I know that people who are currently in pain usually aren’t thinking about long term costs, but bear with me I’m going to make an economic argument about why you should get PT first for your low back pain and save THOUSANDS of dollars.
A lot of people have low back pain every year. Every year somewhere between 22%-65% of the population will have a bout of low back pain, and 84% of people will experience a period of back pain in their lifetime. So if you have not had back pain, it is likely that you will have a bout at some time in your life. The point being, back pain is very normal and a very common occurrence that most people experience.
The prognosis for recovery from low back pain is generally positive with many patients having a resolution of pain within the first 3 months after the start of their symptoms. Unfortunately, research shows many people continue to have pain that persists for out to a year. For those people, very commonly they ask if they need an MRI or an x-ray. The short answer is not usually. For most people with low back pain more imaging is not necessary. In many cases further imaging will not add any valuable information, and may lead you down a path to more costly and less effective care.
How could it be possible that getting an MRI or x-ray could end up costing MORE money? Well to start an MRI can cost anywhere from $1000 to $3000 in the Twin Cities (http://www.startribune.com/how-much-is-that-mri-depends/210709351/). Add to that fact that there are a lot of really common findings on x-ray’s and MRI’s that do not necessarily cause pain. Many people who are completely asymptomatic still will have findings of degenerative disk issues, or disk herniations, etc, that DO NOT predict future back pain. As you can see in the table below, once you have reached the age of 30 more than half the population shows signs of disk degeneration on MRI without any symptoms of pain or stiffness. Disk degeneration is not unique, every one of the listed conditions is increasingly common as we age, without necessarily causing any pain.
Knowing these findings are very common (and quite often do not cause pain) is $1000 – $3000 for an MRI helping you get better care, or leading you to the WRONG care that is MORE COSTLY? It is very common for people who have findings on MRI, to get injections for pain relief. With the average cost for an injection in Minnesota around $1500 – $2000 (http://www.mnhospitals.org/data-reporting/minnesota-hospital-price-check/hospital-report). But if the findings on the MRI or x-ray are not truly the source of your pain, there is a good chance that an injection may not help your symptoms. So you’ve spent somewhere around $2500 – $5000 for the MRI and injection alone, that does not include any costs associated with the visit to your physician, or other tests, medications, or care provided. Generally speaking, most people coming in for therapy will use somewhere between 6 to 10 visits. Using that as our guide the average person coming for therapy will spend between $950 – $1650 for a complete course of therapy that will help you feel better and have a personalized a program to get you back to the activities that are important. All for $1500 – $3300 LESS than getting expensive MRI’s or injections. Couple that with the fact that patients that got early, active physical therapy spent 60% less over two years than those that did not. These people also used less prescription medications, had fewer injections, and were less likely to have back surgery.
So if you want to avoid surgery, have less back pain, and SAVE MONEY ($1500-$3300), early and active physical therapy is a better option than heading for that MRI.
Remember #GetPT1st !