The marriage of medicine and technology has been a fruitful one. We now have many beneficial technological tools to aid us in diagnosing and understanding diseases. Unfortunately, too much dependence on technology alone can lead to misdiagnosis and mismanagement. An example of this is the over-reliance on Magnetic Resonance Imaging, (MRI), to make final surgical recommendations in patients with back pain.

This point was clearly made in a study published in the New England Journal of Medicine in 1994. Surprisingly, the study revealed that of 98 people who had no back pain and normal function, over half had a disc bulge, and about a third had a frank disc protrusion! The article concluded that before surgery could be recommended based on MRI findings, a thorough physical exam should be performed. Unless that exam reveals significant nerve damage, surgery should not be pursued. The vast majority of patients with low back pain, even with disc protrusion evident on MRI, can be successfully treated with exercise, Osteopathic manipulation, acupuncture, or prolotherapy.