Do you need an xray when you have back pain?

Today, I want to discuss with you when you should and shouldn't get an x-ray if you're having neck and back pain. Chiropractors get asked this question a lot and we often fall in to two camps - either we blanket x-ray everything or we only x-ray when we think it's needed.

Thirty or forty years ago, the standard was to automatically x-ray when you visited a chiropractor, physical therapist, or doctor.

However, what research has shown us over time is, x-rays and MRI's aren't necessarily going to show us what we need to see. When it comes to back pain especially, less than 5% of problems are what we would consider a red flag. Some red flags that could cause back pain are an infection in the bones, cancer that has spread to the bones, a fracture, etc.

With those, 95% of incidents will have been picked up in the original history. You as the patient will say something that triggers us, as the clinician, to recognize that your problem might not be a normal mechanical issue and it requires further investigation. Those types of incidents should be sent for an x-ray, before getting treatment, so we can be sure that you aren't dealing with something a little more serious or life-threatening.

Our opinion, or at least the way we practice, is to avoid the blanket x-ray. We will send you for an x-ray if we feel like something is out of the ordinary, potentially a red flag, or if you aren't improving in the time frame we expect. When you visit a chiropractor, you want to make sure they're setting short-term goals. That doesn't mean that you'll walk out of the doors completely healed in two weeks but if you're going for six weeks and not having any change, something more needs to be done about that.

So, if you've been to a chiropractor and they're saying that you need to get x-rays and you're not sure that is something you want, by all means go and seek a second opinion. However, if your doctor or your chiropractor are telling you that they're concerned about something, then it doesn't hurt to go and get a little peace of mind. If you ever have any questions about this topic or you want a second opinion, don't hesitate to reach out and contact us.