Wednesday, August 27, 2008

If You Have Back Pain... Do You Really Need An X-ray?

Most chiropractic patients have x-rays taken of their lumbar spine. Since x-rays do carry a very small risk of tissue damage, this risk needs to be outweighed by benefits. So, how are x-rays used in our clinic?

First, x-rays can tell us about medical conditions that may require referral to another health care provider such as a spine tumor or an infection. Fortunately, these diseases are very rare, but they do need to be considered in every patient, especially those who may have certain "red flags" such as back pain at night or rest, or if there is also a fever. In addition, certain severe traumas (like a fall) can produce fractures. In an older adult with osteoporosis, or someone taking steroid medications over years, even a minor trauma event can be enough to cause a break, because the bone is in a weakened condition.

After these very rare conditions are ruled out, your x-rays can provide important information about your anatomy and physical posture. For example, curvatures of the lumbar spine, such as scoliosis, are virtually undetectable without an x-ray. If we know how your spine is deviated, this information can help direct the adjustment more specifically. Sometimes leg lengths are uneven and a person may require an orthotic (arch support) or heel lift to level the foundation for your spine. About one in ten patients will have an unequal leg length of a centimeter or more.

In terms of the bone anatomy, x-rays can show the planes and angles of the disks between bones and whether any degeneration is present. If the degeneration is advanced, then a natural bone fusion may be present. It should be obvious that if the spinal anatomy does not allow movement or if the joints are literally fused movement is impossible, then adjustments are not appropriate.

X-rays can also show us how one area of the spine mechanically compensates for a deviated area below. Sometimes, pain may be present at compensatory areas but without knowledge of the cause of this deviation, care may be less optimum. Just as the lumbar spine may compensate for a pelvic problem, so to can a neck condition be caused by abnormal postural lower down the spine. The x-rays can show us how case management needs to be altered to reflect your individual needs.

In any case, x-rays are important to reach an accurate diagnosis, which is the first step on the road to recovery and regaining your vitality and quality of life.

If you'd like to schedule a complimentary consultation to discuss your health concerns just call us at 860-633-8756 to make an appointment.


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