We go to school for eight years. We spend countless didactic hours in lecture halls learning about musculoskeletal and pathological disorders and how to diagnose and treat them. We even learn how to read MRIs in the most basic sense and then the second we graduate with our “doctorate” we walk out the door and go right to the same quackery bullshit that got us our reputation over the past 127 years. If someone needs an MRI then order the damn MRI has long been my philosophy
Yes, chiropractors can refer for MRI and should order MRI’s when clinically necessary.
When should my doctor order an MRI?
Doctors and chiropractors, or if you consider your chiropractor a doctor, should utilize MRIs appropriately just as they do all other diagnostic tools when assessing injury or suspected pathology. Typically, a thorough physical examination coupled with less intensive diagnostic imaging or scans are utilized before an MRI is ordered; however in some cases MRI may be the first option especially when considering soft tissue involvement. The truth of the matter is MRIs are expensive and should only be ordered when they are necessary for making clinical decisions. They are expensive for the cash paying patient as well as for insurance companies and you will find they are sometimes difficult to get approved so be patient with your doctor if they are ordering one.
Can chiropractors order mri for Medicare patients?
No, Medicare and Medicaid patients are the exceptions when it comes to chiropractors ordering MRIs. Much of this is due to outdated laws and bureaucracy surrounding government funded health entities. It must be understood that Medicare and Medicaid are not insurance coverage but actual government entities that provide access to health care with much more stringent laws and reduced access to care. They are the lowest reimbursing agencies when it comes to health care costs which often deters health care providers from contracting with them. Usually, a few times a year I find myself frustrated that I cannot order an MRI for one of these patients, but a simple referral back to their PCP and discussion with the provider usually works and the images can be obtained in a round about way.
Can chiropractor make sciatica pain worse?
There is one very large chiropractic franchise in the United States, which for legal purposes I wont name, that publishes the lack of use for imaging including MRI for patients with low back pain. These quack shops often staffed by underpaid new graduates are a fantastic source of hopeful patients in my office. I inevitably encounter at least 5 new patients a month that visited these $29 chiropractors who hurt them. I blame both the business model and the “doctor” when these patients are injured. This unnecessary negligence is the foundation for this entire blog. If a physical exam including neurologic and orthopedic testing reveal a possible soft tissue component for sciatic pain then MRI should always be considered during patient care especially if the patient is unresponsive to conservative care after a short period of time (typically 4 weeks). If these quacks don’t stop hurting patients due to their blatant incompetence, then patients will continue to suffer. THE ONLY REASON THESE ENTITIES DO NOT UTILIZE IMAGING IS DUE TO COST AND TIME. THEY WOULD RATHER BE A FACTORY RUNNING PATIENTS THROUGH THE DOOR THAN ACTUALLY DIAGNOSE AND PROPERLY TREAT FOR THEIR OWN FINANCIAL GAIN.
Can my chiropractor order MRI?
Yes, and they should order MRI when clinically necessary. If your pain or symptoms are not improving after 4 weeks of chiropractic care then ask your doctor about advanced imaging like MRI or a referral. If they want you to continue with your “care plan” then run out the door and call me. I will get you to a practical chiropractor or maybe recommend a different medical provider.