Be careful what you wish for….

These days we are inundated with information. One problem is trying to decide how much information you really need and what do you do with it once you have it?

Take for example imaging of work or sports injuries. We can see what the cause is and should be able to provide better treatment. Right? Well it’s not that clear cut.

A couple of recent studies come to mind. The first, a study on low back pain, found that patients who had been given MRI scans took the same amount of time to heal as people who had not been scanned. Straightforward and what you would expect. What was surprising was that the MRI group suffered more and had much higher disability scores during the healing period compared to the non-scanned group. Knowing the intricate details of their injuries seemed to disturb more than re-assure the MRI scanned patients. The second study looked at what injuries/problems a doctor could see as possibly being present from evaluating an MRI scan of a shoulder. A variety of injuries were observed in 40% of the participants including significant muscle tears. This study sounded straight forward as well except for one small problem. The subjects in the second study were all high level athletes with no symptoms or reported complaints and at 5 years follow-up no problems had been reported.

The moral? The human body is extremely adaptive and we get by in spite of various injuries that may really just become quiescent rather than totally disappear. Sometimes knowing more than really necessary can create anxiety that make someone’s suffering worse than it could be. We need to trust that our bodies will tell us when something is truly amiss. So, before you go to your doctor asking for a scan or x-ray for an injury you might want to think, is there anything to indicate that this is really serious enough to need imaging? It’s not always good to know everything..

It’s sometimes said that what you don’t know can hurt you but sometimes what you do know can hurt you too!! Be careful what you wish for, what you get/find out isn’t always good for you. ;’ )

Ross

http://ajs.sagepub.com/content/31/5/724.abstract

http://www.ncbi.nlm.nih.gov/pubmed/22415000

24 thoughts on “Be careful what you wish for….

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      • Hi Ross,
        I guess that is why you did not look at my MRI results when I saw you the other day.
        I was told it was important to have a scan done to rule out or confirm my injury.
        Regards.

        • Of course scans are done to ensure that there is nothing seriously wrong with a patient. As I have discussed here I try to find out what the person’s signs and symptoms are first to see if what I find corresponds to what is seen on imaging. It can be difficult not to be drawn into treating what is visible. If the problem is something else then either time may be wasted or a non symptomatic injury/degeneration may become irritable and further complicate issues.

          Regards

          Ross

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