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New MRI imaging promises more accurate diagnosis of back pain

A research article published in JOR Spine investigating a new MRI scanning technique may hold promise for more accurately diagnosing and treating back pain.

The study compared scans performed on rabbits using the new technique, which were then compared to the actual disc in a post-mortem examination. The actual disc matched the scan 97 per cent of the time, which is up from 70 per cent with current MRI scanning techniques.

Lead author of the study Dr Kyle Sheldrick, from UNSW Medicine's St. George & Sutherland Clinical School, said the results are promising and may enable doctors and radiologists to more accurately pinpoint the cause and location of a patient's back pain.
"Back pain affects about one in six Australians, but in 95% of cases, doctors (including me and my co-authors) can't find any cause.

"This not only makes it very hard to treat individual patients but also makes it very hard to find new cures for back pain.

"Experts think degeneration of the spinal discs is a cause of back pain, but current tests for disc degeneration don't work very well.

"Patients with discs that look healthy on MRI often have severe back pain, and patients with discs that look very degenerate on T2 MRI often have no back pain, so better technology is needed," Dr Sheldrick said.

The Australian Physiotherapy Association (APA) refutes that the new MRI technique will support better diagnosis and treatment due to the complex nature of back pain.

APA National Chair of Pain group, Dianne Wilson said that difficulties diagnosing and treating back pain do not result from inadequate imaging technology, but rather because of the complexity of pain and the poor correlation between pain and tissue damage.

"Chronic back pain is a massive problem, but it is far too simplistic to suggest that it can be rectified and treated by an MRI scan, no matter how high quality it is.

"The difficulty faced by people with persistent pain and practitioners alike is that the internal state of the disc is not indicative at all of the level of back pain being felt.

"Research has shown that scan results do not reliably measure back pain at all.

"Many people will be delighted to hear the results of this study because they are looking for a quick and simple fix for their back pain, but the reality is back pain, and indeed chronic pain generally, is a multi-factorial problem that requires a coordinated approach overseen by trusted health practitioners including GP's, physiotherapists and psychologists.

"Contemporary pain science has made great inroads into understanding chronic pain in recent years, but there are no quick fixes, and new scanning technologies are not the silver bullet people in pain are looking for.

"A crucial aspect of treating chronic pain is to identify people's beliefs about their pain in their own context and educate them about the body's ability to adapt and heal given the right environment.

"This is best achieved in a multi-disciplinary team where focused exercise and education is delivered by qualified health practitioners such as physios," said Ms Dianne Wilson.

Professor Lorimer Moseley, a pain scientist, agrees: "These advances in imaging come along reasonably regularly in back pain and the clinical response is usually to image more people looking for this or that pathology, invariably such 'pathology' is found, and it negatively impacts patient journeys.

"So, it is one thing to be able to better 'photograph' the state of our tissues but another thing altogether to link that photo to symptoms.

"We have a massive industry in musculoskeletal pain built on treating scans, usually with expensive, risky treatments, the effects of which are often explainable by psychological pathways as easily as they are by the claimed pathways.

"I think the wider back pain field would need a lot of convincing to consider that this new analysis protocol will offer any clinical benefit," said Professor Moseley.

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Haley Williams

Haley Williams has a Bachelor of Communication in Journalism and over a decade of experience in the media, marketing and communications industries.

She is a widely published journalist with a particular interest in writing magazine features on parenting, health, fitness, nutrition and education.

Before becoming a freelance journalist, Haley worked as a writer for NeoLife (a worldwide nutrition company), News Limited and APN News & Media.

Haley also has extensive experience as an SEO Content Writer and Digital Marketing Strategist.