Chiropractic CE

X-Ray in the Chiropractic Practice

            There is a lot of talk amongst healthcare providers as to whether x-rays should be involved in the chiropractic profession. While there are some concerns that patients and research studies have regarding the use of x-rays regularly in a chiropractic visit, the risks are minimal at best. Additionally, there is now digital x-ray available which diminishes the concerns that the medical community conveys regarding its use in a chiropractic office.

Benefits of X-Rays in Chiropractic

            Diagnostic testing is one of the biggest elements in chiropractic care. Chiropractic providers use a multitude of tools to determine the conditions of the patient, but the x-ray is definitely one of the most widely used in chiropractic. The x-ray allows us to see what is happening inside the body more closely to better understand the patient’s condition and it’s severity.

X-Rays are important for diagnostic analysis because:

  • It allows for providers to pinpoint the problem location.

  • It allows providers to view any spinal misalignment as well as any other related injuries to diagnose accurately.

  • It allows the provider to more accurately determine and decide the intensity of care needed as well as the frequency of treatment needed to obtain optimal recovery.

  • It can help the provider find any fractures, bone spurs, scar tissue, spinal lesions, or tumors that can worsen with adjustments or over time.

  • They are a visual representation of progress made with chiropractic treatment
Another main reason that x-rays are a beneficial part of the chiropractic office is that we are able to determine not only the spinal health of the patient, but also if there are any abnormalities. This is especially important after any traumatic injury to the body such as one after a car accident. With this information, we can determine if there are any complications that need to be addressed before pursuing chiropractic treatment is carried out for the main problem. Essentially, there are some medical procedures or care that shouldn’t be pursued if there is any type of growth present, and the x-ray can provide chiropractors with that information. A patient’s health can be protected while simultaneously producing better treatment results simply by having the x-ray as a diagnostic tool available to chiropractors. While x-rays may not be necessary for every patient, they can be helpful for a multitude of patients.

Patient cases when an x-ray would possibly be needed:

  • There is spinal instability suspected

  • There is a risk of/has osteoporosis

  • There is chronic pain in the patient that is not getting better with treatment

  • There is a significant injury that the patient has

  • There is cancerous growth suspected

  • The patient is over 65
In general, the x-ray helps both the patient and chiropractic provider to make informed treatment decisions, helps to show spinal history and potential issues, allow the provider to take measurements for curvature or deviation from an ideal spine, streamline the treatment approach by taking out the guess work, and quick diagnosis with the help of the x-ray.

Cons of X-Ray & Digital X-Ray Alternative

            There is some debate amongst both the western medicine community and even within the chiropractic community regarding the need for an x-ray as the standard of care with an initial chiropractic evaluation. The argument by those that don’t support using x-ray is that most musculoskeletal conditions that are treated in a chiropractic office cannot be visualized on an x-ray. The additional argument by those that are unsupportive of the x-ray in the chiropractic office is that an x-ray exposes patients to radiation, and if it is not necessary, it is best to avoid it. However, in most chiropractic offices, x-rays are usually saved for more severe conditions such as osteoporosis, spinal stenosis, or scoliosis.
However, the argument of exposure to more radiation is moot, as there are digital x-rays that are now available to chiropractic providers for use in the office as the next step forward in technology. The process of using digital x-ray is capturing an x-ray image using a sensor and rendering the image on a computer. The lack of radiation is not the only benefit of implementing digital x-ray. All-digital x-rays allow for a higher degree of accuracy when diagnosing a patient’s condition utilizing the expertise of the chiropractor as well as technological techniques to analyze the digital image.

The benefits of digital x-ray:

  • Less radiation to patients

  • Instant image availability

  • Achieve specialized image results using a computer program allowing for a faster and more accurate diagnosis

  • Digital images can be magnified in ways a traditional x-ray cannot

  • Images can be stored in a computer and are easily transferrable to other providers should the patient seek additional care

  • Less time consuming from start to finish
While digital x-ray systems may have a higher initial investment from the chiropractor, they are less expensive in the long-run to maintain especially without the need for film, file storage, or development chemicals.

X-Rays & Chiropractic

            All in all, the use of x-rays within the chiropractic office are useful, but should only be used when it is medically necessary. According to a study in 2018, X-Ray Imaging is Essential for Contemporary Chiropractic Manual Therapy Spinal Rehabilitation: Radiography Increases Benefits and Reduces Risks, it states that x-ray imaging is necessary to deliver acceptable patient care, and concerns with risk of cancer are “baseless” based on current radiobiology and scientific evidence. It also goes on to say that the “chiropractic spinal x-ray is more than 100 times below the dose threshold for radiogenic leukemia”. Additionally, with chiropractors across the country upgrading to digital x-rays, the safety and necessity of x-rays for chiropractic providers is further proven.