New Research on Importance of X-rays in Chiropractic Practice

A recent review of the scientific literature reveals that x-rays play an important role in determining safety and efficacy in the management of spinal problems cared for by chiropractors. The research, reported in the Annals of Vertebral Subluxation Research, includes a review of the literature, standards of care, best practices and practice guidelines and the role of radiography in the types of spinal problems managed by chiropractors.

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“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.” Stated Christopher Kent DC, JD, a Professor and Director of Evidence Informed Curriculum and Practice at Sherman College of Chiropractic in Spartanburg, SC. 

On the surface it seems reasonable that if a health care provider is going to put forces into the spine to try and correct something then they may need to see inside the body to determine exactly what’s wrong. Just as importantly they need to make sure there isn’t something there that shouldn’t be there like cancer, an infection, or a broken bone for example. 

Unfortunately, x-rays cost money and since may times those x-rays are supposed to be paid for by insurance companies they go out of their way to find ways not to pay for them. Insurance companies and the consultants they hire go to great lengths to publish opinion pieces and influence the standard of care in ways that improve their bottom line. 

Making matters worse is that some trade organizations in chiropractic go along with such dangerous recommendations that put the public at risk for injury when chiropractors do not take x-rays.   

Recently, the American Chiropractic Association (ACA), which represents a minority of the chiropractic profession, published guidelines that say x-rays are often not necessary prior to chiropractic care and that follow-up x-rays looking for improvement in spinal structure are not necessary.  

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The ACA group is closely aligned with an insurance based model of short term treatment of back pain and some other types of musculoskeletal pain. The ACA believes chiropractors are primary care providers, as are medical doctors. The ACA supports a “state’s right” policy, where state laws would permit chiropractors to prescribe drugs for pain and other problems. 

“It makes perfect sense when you think about it” stated Kent. “If all you are going to do is give the patient a drug or some type of electrical stimulation to suppress their symptoms, then that doctor may not see the need for an x-ray.” Kent continued “These guidelines basically tell patients to ‘roll the dice’ and hope they don’t have something serious or life threatening.” 

According to the most up to date best practices - health care providers should be practicing a patient centered approach and acting in ways that minimize risk and enhance health outcomes for the patient instead of making decisions that benefit the insurance company and put the patient at risk.          

Contact Information:

Matthew McCoy DC, MPH
Annals of Vertebral Subluxation Research
http://www.vertebralsubluxationresearch.com
drmatthewmccoy@gmail.com