Do I Need An X-ray For My Pain?

Sun Prairie's sports chiropractor addresses the necessity of X-rays and when they are medically necessary for care.


What is an X-ray?

X-rays are a type of radiation called electromagnetic waves. X-ray imaging creates pictures of the inside of your body, mostly consisting of bone and some soft tissue structures. It will show structural alignment/spacing of joints and in some cases pathologies.


How is it taken?


It depends on the area that needs to be X-rayed and the positioning changes, but overall, the patient remains in a static posture and is not allowed to move during the process. Some practitioners will take multiple views in different positions to see how the joints look in those positions.



What do the X-ray findings mean?


There are a lot of findings that can appear on an X-ray that have little to no effect on your overall health. Common findings are osteophytes, degenerative disc disease, decreased joint space, osteoarthritis, etc. In the past these findings were considered concerning, but research has shown they are as common as getting gray hair.


If you were to X-ray 200 people in the same age group (100 of those healthy, and the other 100 with symptoms/pain), you would see very similar findings. The X-ray results will show the findings, but it does not determine if those findings are the source of the pain/dysfunction.


X-ray findings can be compared to looking at a picture of a speaker and trying to determine if it is playing music. You can see the picture is a speaker and you know it has the capabilities to play music, but you have no idea if it is playing a song or not; the same goes for X-rays. Therefore, a functional, movement-based examination, is more beneficial in determining the true cause of pain/symptoms.



What are X-rays meant for?


Following the "Choosing Wisely" recommendation set by the American College of Radiation, X-rays should be used after following a concerted effort of conservative care that has shown little to no progress, concerns for fractures/breaks, and pathology. Doctors are trained to have a diagnosis before ordering any type of imaging, thus limiting the over exposure to radiation.

A small portion professionals in the chiropractic field use X-rays to find "subluxations." Subluxations are not found via X-rays, but rather through movement and palpation of the spine. X-rays taken by chiropractors may find structural malalignments, but those findings are dependent on the positioning of the patient during the X-ray and are therefore unreliable in determining a functional care plan. That is why it is important to find yourself an evidenced based chiropractor that does a physical examination to determine the type of care you need based off of your functional capabilities.





Conclusion:


If a doctor has ordered an X-ray and there is no history of trauma or concern for serious pathology, it's important to ask why; this is especially important if it is before a trial of conservative care to resolve your musculoskeletal issues. Common reasons a doctor may request an X-ray are "we don't guess with your health" or "we want to see what we are working with." This can have negative effects on patient outcomes and be detrimental to their long term recovery. Doctors should follow the guidelines set for ethical care and utilization of X-rays that is followed the American Medical Association (AMA) and the American Chiropractic Association (ACA). X-rays should not be utilized for musculoskeletal pain until a trial of conservative management care is completed or a physical exam indicates so.



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As always, please remember that while online information is a great place to start it does not replace a thorough examination and care under the supervision of a trained healthcare professional. Our Sun Prairie chiropractor Dr. Logan Georgeson is a trained healthcare professional and can try to answer all of your questions. If you’re in pain, looking for answers, and feel like you have tried everything, or want help getting started, contact us, we would love to help! If you have questions about chiropractic care, give us a call! We are here to help you move well and encourage you to move often so you can achieve freedom from pain!

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