Why I Need X-rays and Traditional Chiropractors Don’t
By Dr. Jason Slagel | January 24th, 2023
Most chiropractors take x-rays on new patients, and the reality is that most chiropractors do not need to take them. The majority of the time, traditional chiropractors take x-rays on new patients for three reasons.
1. Sell Care- This is usually one of the main reasons traditional chiropractors take x-rays on new patients. Once the chiropractor takes x-rays, they can show the patient the x-rays and convince them to start care in their office. Most patients are willing to acknowledge that they have a spinal problem, which is why they sought help at a chiropractor’s office in the first place, so the only question left is whether it is the chiropractor that can help them. X-rays help the chiropractor sell their care to that person because they can point to specific problems that are able to be seen on the x-ray and present themselves as the solution. This is a poor reason to take x-rays on people and does not justify taking them.
2. Bill Insurance- 99% of the time this is the case when a traditional chiropractor takes x-rays on a new patient. Insurance companies require very little justification for taking x-rays on patients, so it’s easy for traditional chiropractors to get paid a good amount by insurance companies for x-rays. Most insurance companies simply just pay the money without any hassle or question, so most traditional chiropractors see it as an easy quick way to make a chunk of extra money, and the patient doesn’t care because typically insurance covers all x-rays. This is an extremely poor reason for taking x-rays on people.
3. Check for Pathology- This is the most legitimate reason for a traditional chiropractor to take x-rays on a new patient, although it is still not a great reason. If the chiropractor suspects there may be a fracture, for example, then they don’t want to twist/crack/pop that area and make it much worse. However, if a traditional chiropractor suspects something like a fracture, then the better course of action is to send the patient to an emergency care center where they can do something about a fracture. Just like if the chiropractor suspects that the patient has skin cancer, the chiropractor doesn’t order the biopsy, instead the better course of action is to send the patient to someone who can not only test but treat the skin cancer as well. So, if a traditional chiropractor does not suspect a pathology, then there is no justification for x-rays, but if the chiropractor does suspect a pathology, then the patient ought to be sent to the provider who can help with that suspected pathology.
One important point to consider is that traditional chiropractors do what are called “Mobilizations.” This means that they feel for joints that are stuck and twist/crack/pop them to make them move more. This is very similar to Physical Therapists who do Mobilizations (but don’t take rays of their patients beforehand, by the way, because they understand that it doesn’t change positioning). There is nothing wrong with Mobilizations, and they help a lot of people. However, this approach does not “Reposition” or “Align” anything. It just makes the joints move more in whatever position they are in. So for someone whose spine is in a normal position, this approach works great, but for someone whose spine is shifted out of position, this approach only provides temporary relief since those joints will just lock back up again because they are still in the wrong position.
X-rays measure the spine’s Positioning. They are a snapshot of how the bones in the patient’s spine are Positioned or Aligned. They do not show Motion, so it is inappropriate for a traditional chiropractor to say that they use the x-rays to help them know how to Mobilize the joints in the spine. It makes no sense. This is also why traditional chiropractors almost never take x-rays after they Mobilize someone’s spine, because they know it will look exactly the same as before, so there’s no point. But it looks exactly that same as before because they don’t fix what an x ray shows. They Mobilize while the x-rays show Positioning.
What I correct in my office is spinal Positioning. Can you see where I’m going with this? I need to take x-rays in order to measure the spine’s positioning so that I can calculate the exact angle to correct the problem. I correct the problem without any twisting/cracking/popping since my goal is not Mobilizing. The correction that I do feels like I’m taking your pulse. Very gentle. After I correct the positioning, I take the exact same x rays again after the first correction to make sure the spine is repositioned within the normal limits.
Since I heavily depend on x-ray measurement to correct my patients’ spines back to the normal positioning, it is essential that my x-ray machine is calibrated to be accurate for positional measurements. I flew in an expert from California to calibrate my x-ray machine to be accurate down to 1/100 th of a degree. This is extremely precise. My x-ray unit is one of 7 in the state of Florida to be calibrated in this way. This is just another way I go above and beyond for my patients to make sure they get better.
If you are interested in an evaluation to see if you have a spinal positioning problem, please call our office at (954) 842-2677. We would love to help!