One of the most important elements of chiropractic care is diagnostics. Chiropractors rely on a variety of diagnostic techniques in order to fully understand what is happening in a patient’s musculoskeletal system. A chiropractor needs to know how a given treatment intervention could bring about positive results in a patient.
One of the most heavily relied on diagnostic techniques in chiropractic care is the X-ray. An X-ray is thought by some to be antiquated, with many other imaging processes being developed since the X-ray. However, X-rays provide doctors with a deeper understanding of a patient’s pain or discomfort.
The Importance of X-rays in Diagnosis by Chiropractor
These imaging processes are all essential in the use of surgery and invasive procedures to get that far inside the body. An X-ray can show a chiropractor exactly what is happening in the body when it comes to alignment and structure. This makes an X-ray very valuable as chiropractic care uses spinal manipulation and other techniques that involve movement of skeletal components with the hands or with the use of an instrument.
It’s worth noting that X-rays are not used universally in chiropractic care. In a majority of patients, the chiropractor is able to determine what is occurring in the musculoskeletal system — without the need for imaging technology.
In short, X-rays are considered by many in this field to be a key component of the chiropractic practice. However, X-rays are not indispensable in chiropractic care.
Reputation of X-rays in the Medical Community
The International Chiropractors Association (ICA), states that “radiography is a scientifically proven, clinically valid and an appropriate method to evaluate multiple aspects of human spinal anatomy, identify vertebral subluxations, altered spinal biomechanics, postural misalignments, pathology and in providing information and safeguards in rendering chiropractic care in clinical practice.”
Despite the claims of the ICA, there are chiropractors who question whether X-rays are necessary or even ethical. These concerns come from a campaign of the medical community known as Choosing Wisely — a program created by the American Board of Internal Medicine (ABIM) in 1989.
As X-rays are a routine part of chiropractic care, the ICA issued a response to the idea of choosing wisely. “ICA recognizes radiographic studies are the standard of practice in chiropractic care,” and that encourages chiropractors to “raise their voices and be heard.”
How Safe Are X-rays?
Many patients might wonder about the safety of X-rays. The Food and Drug Administration (FDA) estimates that radiation exposure from a digital x-ray of the spine is less that you would receive flying in plane from Los Angeles to New York. What’s more, the FDA recommends people not refuse an X-ray, because the risk of not having an X-ray when you might need one is far greater than the small risk of exposure to radiation. The FDA’s statement continues, “when a doctor determines the need for an X-ray, it is for your safety, benefit and diagnosis.”
Although X-ray equipment does vary with the manufacturer, there is no difference between a chiropractic X-ray and another type of X-ray. An important factor to consider when getting an X-ray is the part of the body that is being X-rayed. Different body tissues absorb the radiation in various ways.
The amount of radiation emitted from an X-ray can be measured. The average person is exposed to about 3.0 millisieverts or mSV, of radiation per year. This exposure results from naturally occurring radioactive materials or cosmic rays. The FDA states that 0.1 millisieverts from a chest X-ray equals 10 days of typical background radiation exposure.
X-rays of the arms and legs, or extremities, have a lower effective dosage than chest X-rays. Lower torso X-rays, however, have a higher effective dosage. What this means is the effective dosage is determined from the actual body part that is X-rayed, not the intensity or duration of the X-ray.
The Limitations of X-rays
X-rays use electromagnetic radiation that penetrates soft tissue and does not capture it on film. As a result, an X-ray will typically not show any abnormalities involving ligaments —including herniated discs, bulging discs, sciatica, pinched nerves or disorders affecting the spinal cord.
When Are X-rays Necessary?
There are chiropractors who use X-rays as standard procedure either as a precaution to rule out pathology — such as a possible tumor or fracture, and/or to aid in determining where to adjust the spine.
X-rays are recommended for the following types of medical situations:
- If the patient has sustained a significant traumatic injury, as a bone may be broken or a joint may be dislocated
- If an infection may be causing the patient’s pain
- If any significant disease is suspected, such as cancer or a possible tumor
- If any type of joint disease is suspected, such as arthritis causing joint pain
- If the patient is over age 50 and has experienced any type of trauma (even a minor one)
- For most patients over 65 years of age
- Anyone diagnosed with or who may be at risk for osteoporosis.
The X-ray could be important to identify or rule out a possible vertebral fracture from osteoporosis
- Any suspected spinal instability
- If a patient has had long-standing pain that has not responded to or resolved with previous health care treatment
As a general guideline, an X-ray is indicated if it is likely to inform the type of treatment recommended for a patient; In any of the above cases, an X-ray would likely provide critical information that will direct treatment protocols and/or referral options for the patient;
An X-ray is not necessary for the following medical situations:
- To identify problems with soft tissues (muscles, tendons, or ligaments) or within the spinal disc itself; X-rays are only effective in identifying pathology with bones and joints, not with soft tissues;
- Purely for exploratory purposes; Most practitioners will likely determine the cause of a patient’s pain before ordering the X-ray or other diagnostic test and will use the test to confirm their findings;
- If there is a possibility that the patient could be pregnant;
The bottom line is that when used appropriately, X-rays can identify and/or rule out specific pathology and help guide appropriate treatment.
If you are in need of a chiropractor in the Tri-Cities area, we suggest you contact NewEdge Wellness Center, located in Kennewick, at (509) 737-9355. Schedule your appointment today with NewEdge Wellness.