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Overcoming the Dangers of False Positives

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Among the commonly misinterpreted irregularities that generally are not the true cause of a patient’s pain and diminished function are rotator cuff tears and defects, spinal stenosis, meniscal tears and defects, bone spurs, muscle tears, bone-on-bone conditions, bulging discs and disc herniations, and degenerative disc or joint disease.

Few clinicians—let alone patients who are experiencing pain or reduced mobility—realize that the vast majority of healthy adults who are fully functioning and 100% pain-free have such physiological irregularities. That is, if a healthy adult were subjected to an advanced orthopedic diagnostic test, chances are the 100% symptom-free individual would be told of a “concerning finding.” If a clinician is either unaware of the widespread existence of (generally irrelevant) physiological irregularities in asymptomatic individuals, then a patient may be queued up for prescription opioids and muscle relaxants, pain injections, and/or surgeries that are medically unnecessary or contraindicated. This challenge is exacerbated if a healthcare provider has financial motives for suggesting a causal relationship between physiological irregularities (i.e., alleged abnormalities and anomalies) where no causal relationship exists.

This is worth repeating.

Asymptomatic individuals—individuals who are not experiencing any musculoskeletal pain, loss of function, or disabilities whatsoever—would more likely than not to be told that “concerning findings” on their advanced diagnostic tests are worrisome abnormalities and anomalies that “qualify” them for (unnecessary or even contraindicated) prescriptions for opioids or muscle relaxants, pain injections, and/or surgeries.

Integrated Mechanical Care (IMC) offers a reliable assessment process for musculoskeletal disorders (MSD) and does not assume that apparent musculoskeletal irregularities are the direct cause of a patient’s pain or mobility challenges.

With IMC’s approach, advanced musculoskeletal specialists use decision-tree logic (i.e., clinical problem-solving algorithms focused on each patient’s step-by-step response to systematic bio-psychosocial testing) to characterize and categorize MSD conditions, determining which are mechanically, structurally, or chemically dominant.

  • Mechanically dominant conditions (which represent 90% or more of MSD cases) typically lend themselves to self-care or conservative care.
  • Structurally dominant conditions typically require escalation to surgical consults.
  • Chemically dominant conditions typically self-resolve with time (e.g., sprains) or may require pain injections or prescription medications.

IMC’s reliable Response-Based Assessment™ process is the best starting point for the evaluation of orthopedic challenges. This personalized, algorithm-driven process helps to ensure that patients receive care that is both timely and medically appropriate for their true underlying diagnoses.

The better the match between clinical diagnoses and clinical interventions, the better the outcomes.