By Alexander Germanis
In the mid-1990’s, computer graphics technology had reached a level of affordability and popularity where nearly every special effects house tried employing them in their films. The problem was the effects were, for the most part, misused and not in any way believable. Companies were often using this new computer-generated imagery simply because it was there. As a result, many films suffered due to a focus on this technology rather than focusing on when or how to use it the right way.
Dr. Ramsin Benyamin, founder of Millennium Pain Center in Bloomington, sees the same mentality currently creeping into the healthcare industry. “One of the problems we have in medicine,” he states, “is we don’t focus enough on diagnosis, even though we have better tools to diagnose medical problems.”
Putting technology like magnetic resonance imaging (MRI), fluoroscopy, and computerized tomography (CT) to work is something, Dr. Benyamin insists, that should be done to confirm a diagnosis rather than being the first and single step in attempting to make one.
In other words, knowing when to use the technology can make all the difference in whether a proper diagnosis is even made in the first place.
The doctor illustrated such an occurrence in the previous article of this series. A patient suffering from excruciating neck pain had been initially — and incorrectly — diagnosed with a sprained neck after no more examination than an x-ray scan. When the pain did not dissipate, the patient came to see Dr. Benyamin.
After a proper physical examination, the patient was tentatively diagnosed with a disc herniation — a diagnosis that was then confirmed by the use of an MRI scan.
The doctor explains there are problems with relying too much on technology. The case of that patient is a prime example. “The pain that radiates down the arm into the fingers is not a problem you can detect by x-ray,” he states. “First, examine the patient to see if they have any neurological deficits, meaning, are the reflexes okay, is the sensation okay, do they have weakness of the muscle? These are all signs that will alert us to a nerve that is compressed. And the only way you can see that is by doing an MRI.”
However, Dr. Benyamin cites caution about relying on MRI technology as well. “What’s the problem with MRIs?” he asks. “It’s a snapshot of your back performed in the most comfortable position. Most people don’t have back pain when they’re lying down; and how do we do the MRI? When you’re lying down.”
Although, he adds, there are MRI’s that can be done sitting and standing. The doctor does not necessarily advocate those either. “We need to put a limit on the value of the MRI. Just because the MRI doesn’t show it, doesn’t mean there is not a problem. And it’s the other way around —just because the MRI shows something it does not mean that is the problem.”
Dr. Benyamin says a better start is to stop — stop using scanning technology right at the outset. “Instead,” he suggests, “take a good history, listen to the patient, examine the patient, and then see if the MRI, CT, or whatever correlates with the patient examination.”
Again, the doctor stresses the “whens” of using technology. The best tools for diagnosis, he always feels, are the doctor’s eyes, ears, and expertise.
To learn about how scanning technology can be properly employed in the diagnosis process, read “Simple Steps for Proper Diagnoses: Part 4” in next month’s Healthy Cells Magazine.
For more information or to schedule an appointment, contact Millennium Pain Center at millenniumpaincenter.com or 309-662-4321 The office is located at 1015 S. Mercer Ave. in Bloomington. The practice provides the most advanced and comprehensive pain management for a wide variety of conditions, including a new treatment for knee osteoarthritis. Doctors Benyamin and Vallejo have been identified among 70 of the Best Pain Physicians in America.