In the NY Times article “The Pain May Be Real, But The Scan Is Deceiving“, Gina Kolata visits the idea that the problems we find with sophisticated diagnostic machinery may be the mere effects of a greater causal problem elsewhere – how profound. Those in the holistic alliance of practitioners that always look at the bigger picture employ tactical treatments that focus on the individual rather then their symptons. So many symptons end up taking us down the wrong road. The symptom treatment protocol is analogous to cutting the power to an alarm system to shut it off without ever checking if there is a burglar in the premises.

…An M.R.I. scan that showed a torn cartilage and convinced her that her only hope for relief was to have surgery to repair it. But in fact, fixing the torn cartilage that was picked up on the scan was not going to solve her problem, which, eventually, she found was caused by arthritis.

Scans — more sensitive and easily available than ever — are increasingly finding abnormalities that may not be the cause of the problem for which they are blamed. It’s an issue particularly for the millions of people who go to doctors’ offices in pain.
The scans are expensive — Medicare and its beneficiaries pay about $750 to $950 for an M.R.I. scan of a knee or back, for example. Many doctors own their own scanners, which can provide an incentive to offer scans to their patients.

Further into the article this important part comes up:

Somewhere between 20 and 25 percent of people who climb into a scanner will have a herniated disk,” Dr. Modic said. As many as 60 percent of healthy adults with no back pain, he said, have degenerative changes in their spines.

Those findings made Dr. Modic ask: Why do a scan in the first place? There are some who may benefit from surgery, but does it make sense to routinely do scans for nearly everyone with back pain? After all, one-third of herniated disks disappear on their own in six weeks, and two-thirds in six months.

Wow.