Chiropractic Care & X-Rays

When seeing a chiropractor for diagnosis and treatment, you may be recommended to get an X-ray scan.

There are a multitude of reasons why your chiropractor may refer you for an X-ray, and it does not necessarily mean there is a serious condition present. It is important to understand your choices as a patient regarding X-rays in chiropractic care. 

Are X-Rays Required When Attending Chiropractic Care?

X-ray imaging is a part of the diagnostic process for chiropractic care, but it is not always required for treatment. An X-ray scan exposes the body to small, safe doses of radiation that must be justified by medical need.

Under the Australian Chiropractic Board’s guidelines, chiropractors cannot recommend or perform X-rays without sufficient clinical justification - you should never be asked to undergo  regular X-ray scans as part of treatment (e.g. weekly). In most cases, a single X-ray scan is sufficient to provide chiropractors with enough information to identify spinal issues.

How Chiropractors Use X-rays

X-rays provide a clear picture of the skeletal system; chiropractors obtain X-ray scans of the spine and hips to assess spinal health and identify problems that are not visible during the initial physical examination.

X-rays are often taken before treatment is applied. After reviewing the spine's structure and alignment on imaging, chiropractors discuss their findings with patients and typically provide a diagnosis.

In addition to aiding diagnosis, chiropractors use X-rays to minimise risk for patients. X-rays can reveal small fractures that make certain manual adjustments unsuitable, allowing chiropractors to perform safer and more appropriate treatments. 

Chiropractors also use X-rays as a reference point for future comparisons, especially for long-term treatments that involve postural corrections. If you have prior X-rays of the affected area, your chiropractor will typically request that you bring them for review. 

Evidence for the Use of Chiropractic X-Ray Imaging

X-ray imaging is clinically proven to be valuable for chiropractic treatment and is approved for use by the Australian Chiropractic Board.

A 2018 review published in the Journal of Chiropractic and Manual Therapies showed evidence from multiple sources that support the use of X-ray in the diagnosis and treatment of spinal trauma, spondylosis, and spinal deformity. Similar to the Australian Chiropractic Board’s guidelines, the review also confirmed that spinal X-rays should not be routinely performed in chiropractic practice due to the risks of overexposure to radiation.

When Is X-Ray Imaging Used in Chiropractic Care?

X-ray imaging used in chiropractic care covers the cervical, thoracic and lumbar regions of the spine, and may include the hips. X-rays are only taken when chiropractors deem it necessary to take a closer look at your skeletal structure. These include: 

• Postural conditions, such as scoliosis or kyphosis, concerning the structure, alignment, and growth of the spine.
• Possible structural damage and trauma, including fractures, dislocations, or misalignments, commonly from an accident or a bad fall. These fractures
• Underlying bone conditions, such as arthritis or bone infections. X-rays can reveal characteristic changes in bones and joints to help chiropractors distinguish between types of arthritis (e.g. osteoarthritis, rheumatoid arthritis)

X-rays can only visualise skeletal issues (bones and joints) and are generally not used for muscle or tissue-related conditions. Your chiropractor will be the best judge of whether an X-ray is necessary to rule out any serious, underlying conditions. 

Things to Consider for X-Ray Chiropractic Care

Avoid Treatment Plans With“Routine” X-Ray Scans  

Experienced chiropractors do not need multiple X-ray scans on a regular basis to deliver effective treatment. Routine X-ray scans are often unnecessary, costly, and pose health risks due to frequent exposure to radiation.

If your chiropractor recommends undergoing regular X-ray scans, it is worth seeking a second opinion from another medical professional. 

Consult a Radiography-Licensed Chiropractor

Chiropractors must hold a state-specific radiography licence in order to perform X-ray imaging independently. If your chiropractor does not have the required licence, they must refer you to a radiologist for X-ray imaging instead.

Chiropractors who are licensed to perform X-rays must also have approved X-ray machines and equipment. For example, the Spinal Works Chiropractic clinic in Townsville and Cairns is licensed and approved to conduct in-clinic X-ray scans, cutting down on the time required for diagnosis and treatment.