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Commonly Asked Question Series – (1) X-Rays

My last chiropractor took x-rays to know where to treat, how do you know where to treat without them?

There are many different approaches to chiropractic treatment. Some chiropractors feel that everyone should have radiographic imaging (x-rays) completed prior to treatment, so that they can measure certain lines or angles and see how your spine is “aligned.” However, current research does not support this practice in patients without trauma.

As part of their education, chiropractors learn how to complete a physical assessment of each body area to rule in and rule out various conditions. While some things cannot be diagnosed, such as the amount of degeneration or the severity of a muscle or tendon tear without imaging, there are different physical tests in addition to history questions that can indicate these conditions. If the specific diagnosis will change the course of treatment, or if an underlying issue needs to be ruled out, then your chiropractor will refer you for diagnostic imaging.

If there are no red flags in your history which would warrant imaging, the chiropractors at MiltonBackDoc will complete a comprehensive assessment during your initial assessment. This may include:

  • Range of motion to assess joint quality, ligamentous tension, and muscular tension
  • Neurological assessment to determine if any nerves are compromised
  • Orthopaedic tests to determine which structures are primarily affected and to rule out other conditions
  • Functional motor testing to assessment muscular imbalances
  • Joint/motion palpation to find local restrictions/dysfunction
  • Soft tissue palpation to identify trigger points, muscular tension, and strains
  • Observation to identify any bruising, rashes, or abnormal postures or movements

There are still some instances where imaging might be required first. These may include, but are not limited to, the following:

  • Trauma where a fracture is suspected
  • Presence or suspected presence of underlying conditions such as inflammatory arthritis which could affect the treatment plan or a patient's response to treatment
  • Suspected muscle or tendon tear which may require modification of the treatment plan
  • The medical history or physical assessment leads to the suspicion of a more serious condition
  • The patient has no response to treatment

In these cases, the chiropractors at MiltonBackDoc may be able to refer you directly for radiographic imaging or we can refer you back to your Family Physician to discuss diagnostic imaging options.

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