Foundation Responds to ACA’s X-Ray “Recommendations”

Foundation for Vertebral Subluxation
Foundation Responds to ACA’s X-Ray “Recommendations”

Urges Evidence Informed Approach in Contrast to ACA’s Unsupported Opinions

The Foundation for Vertebral Subluxation issued a Policy Statement in response to the American Chiropractic Association’s (ACA) just released recommendations not to take spinal x-rays in acute low back pain patients unless there are so called Red Flags and to never take repeat x-rays to monitor progress. 

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The Foundation’s Policy Statement reads: 

The Foundation for Vertebral Subluxation encourages an evidence-informed approach to the use of radiography in the assessment of vertebral subluxation. 

Doctors of chiropractic are responsible for determining the safety and appropriateness of chiropractic care. This responsibility includes the detection and characterization of vertebral subluxations, congenital and developmental anomalies which may affect the selection of chiropractic techniques, and conditions which may contraindicate certain chiropractic adjusting methods.  

Furthermore, radiography may disclose conditions requiring referral to another type of health care provider.

The Foundation is in the process of developing the most current guidelines and best practices for vertebral subluxation in chiropractic practice and imaging is one of the topics currently under review. According to the Foundation the evidence overwhelmingly supports the policy statement.

The ACA released a list of five tests it states are commonly ordered but not always necessary in chiropractic care including the two regarding imaging that are directly at odds with what is considered to be a standard of care within chiropractic.

Teaming up with ABIM Foundation and Consumer Reports, the ACA’s President David Herd DC referred to these as “unneeded or overused services” and that following these recommendations would yield the “best possible care”.

Such recommendations are nothing new for the ACA which endorsed and supported the infamous Mercy Guidelines back in the early 90’s. Mercy was an insurance claim cutter’s cookbook and was widely discredited throughout the profession.

Beyond insurance cutters, Mercy was (and still is) used against subluxation chiropractors in malpractice cases and regulatory board actions. These recommendations by the ACA are expected to be utilized in a similar fashion and they have the added endorsement of ABIM and Consumer Reports.

Both members and non-members of the ACA expressed outrage at the x-ray recommendations on social media and more fallout is expected. The ACA has been distancing itself from traditional, conservative chiropractic for some time now as it seeks scope expansion, including drugs, across the country in an effort to position chiropractic as the practice of primary care. The outrage is not expected to stop the ACA’s efforts.         

Contact Information: 

Matthew McCoy DC, MPH

Foundation for Vertebral Subluxation


Foundation for Vertebral Subluxation