Why do chiropractors order so many X rays?

[HuckleB]

http://scientopia.org/blogs/whitecoatunderground/2010/08/10/why-do-chiropractors-order-so-many-x-rays/

"People often visit primary care physicians and chiropractors for low back pain (LBP). It is a very common problem, and one that usually resolves on its own. Research has repeatedly shown that X rays are rarely useful in the evaluation and treatment of simple back pain. Outside of certain “red flags” (fever, history of cancer, weight loss, and a few others), there is rarely any reason to get an X ray of someone’s spine when they come to see the doctor for low back pain.

Both anecdotal and quantitative studies have shown that chiropractors are very likely to order spine X rays. Given the inutility of these studies, and the radiation exposure, what reason could there be (aside from financial incentive) for chiropractors to order X rays?

...

X rays can be very effective at diagnosing traumatic bone and joint injuries such fractures and dislocations. These films can be very tricky to interpret, and nearly all doctors have their films over-read by a radiologist. Given that chiropractic is not useful in the treatment of an acute fracture or dislocation, and that chiropractors are not qualified to read these films, this seems a poor excuse for ordering films.

...

X rays are a significant intervention. Anytime ionizing radiation is applied to a human being, there better be a good reason for it. If there is no evidence that the X ray will help in a meaningful way with diagnosis or treatment, then no X ray should be done. There is no clear reason any chiropractor should ever order an X ray."

-----------------------------------------------------------


This does seem like a question that really ought to be asked and investigated further.

:hi:

[arcane1]

1. The answer is in parentheses in your 2nd paragraph (nt)

[mzteris]

2. not all of them always do...

I and my children and my ex have been to five different chiros in two states and three cities over the past 20 years.

I've had x-rays taken once - after a car accident. The ex had his done once. My daughter once after she fell off her back and hurt her hip (bruised near the growth plate). My other two sons, never.

[Jim__]

18. That's my experience too.

I've been to a number of different chiropractors for lower back pain and I've never had one take an x-ray. I have been to both medical doctors and chiropractors and found that, outside of temporary relief from pain through heavy doses of drugs, medical doctors are essentially useless for back pain, chiropractors quite effective.

[louis-t]

3. I would imagine it is to keep from doing more harm

than good. Define "so many". Was this article written by an MD? Or by a group that works on behalf of MDs? This is a biased article from what I've seen of it. My only experience with chiro was positive. Corrected a painful cervical problem that had lingered for years.

[HuckleB]

4. How would it keep from doing more harm?

That is one of the big questions on the table.

Anecdotes and ad hominem attacks against the author don't change that.

[louis-t]

9. A chiropractor will not attempt to correct a problem if there is damage

to the spine.

[HuckleB]

11. So you say.

And how would he know there is damage to the spine?

Please read the article before responding.

Thank you.

[NickB79]

17. My coworker's partially herniated disk was completely herniated by his chiro

His lower back pain was actually worsened by his chiropractor's adjustments. After 2 surgeries and physical therapy he is finally back to functionality.

[Peregrine]

6. The journal commentary the blogger used

was by an MD. Oooo he must be lying. But wait, he is in the Department of Complementary Medicine (AKA the Woo factory). Which means he is pretty open to the woo that is chiropractic and homeopathy and reiki, and other bunk. Unlike most complementary medicine commentaries, this one actually cites resources.

[mike r]

5. A set of lumbar X-rays = Six months of natural background radiation

http://www.independent.co.uk/life-style/health-and-families/health-news/a-question-of-health-how-many-xrays-is-it-safe-to-have-are-bacteriacontaining-drinks-good-for-you-745353.html

[whistler162]

7. I know my Chiro didn't ask for X-Ray's until the problem

in my lower back and legs didn't improve, as it had in the past, after 2 or so weeks. Turns out I have arthritis in at least my lower back and right hip, and likely my left hip.

[Dappleganger]

8. The only things x-rays showed for me

was arthritis in the neck, nothing else. Of course multiple mri's w/contrast over time showed bulging discs, herniated/non-existent discs, stenosis, bone spurs, etc. All of that was in my neck and lower back. Now, x-rays just confirm how much metal is in my neck, LOL.

[postulater]

10. You might find the answer to your question here.

Practicing Chiropractors’ Committee
on Radiology Protocols (PCCRP)
For Biomechanical Assessment
Of Spinal Subluxation
In Chiropractic Clinical Practice

http://www.chiropractic.org/files/PCCRP_Guideline_4-2009.pdf

It's the official X-ray guideline for the International Chiropractic Association.

[HuckleB]

12. That's nice.

Unfortunately, it doesn't answer the question why a chiropractor would ever use and X-ray.

[postulater]

13. You asked a question.

I provided a good source of background that explains in some detail the rationale behind the use of spinal xrays in chiropractic practice.

It appears that you are more interested in maintaining your argumentative stance than in considering the possibility that a different viewpoint could serve as the basis for a helpful therapeutic approach.

Back to Ignore with you.

[HuckleB]

14. I see no justification in response to the question.

That's simply stating the reality.

You can call that argumentative if you want, but if you're going to do so, then you are asking people to refrain from stating the facts of the situation in order to "refrain" from being argumentative, and that makes no sense at all. (Remember, the "guideline" is about the use of a very serious diagnostic tool to diagnose or assist in the treatment of something that has never been shown to exist.)

[sounderforum]

15. Why do chiropractors order so many X rays?

X rays can be very effective at diagnosing traumatic bone and
joint injuries such fractures and dislocations.  These films
can be very tricky to interpret, and nearly all doctors have
their films over-read by a radiologist.  Given that
chiropractic is not useful in the treatment of an acute
fracture or dislocation, and that chiropractors are not
qualified to read these films, this seems a poor excuse for
ordering films.

X rays are not very sensitive or specific for the diagnosis of
other important bone diseases such as osteoporosis, and can be
very tricky when cancer is a consideration, as some bony
cancer lesions show up on X rays and some do not.  X rays done
and interpreted by a chiropractor or any other unqualified
individual can lead to a false sense of security.
X rays are a significant intervention. Anytime ionizing
radiation is applied to a human being, there better be a good
reason for it.  If there is no evidence that the X ray will
help in a meaningful way with diagnosis or treatment, then no
X ray should be done.  There is no clear reason any
chiropractor should ever order an X ray.

Medical Equipment url: http://www.medwow.com/
Used Hospital Equipment url:
http://www.medwow.com/used-hospital-equipment.htm

[Dorian Gray]

16. I agree with this

I also think that if a chiropractor wants to use X-rays, it's a red flag that they are completely unethical.

I've been to three chiros in the past. One only once. He cracked my back, gave me exercises to do and suggested a new pillow and new sleeping position. He didn't want to see me again, and I liked him. (He's the only one I would consider going back to.)

The other two tried to sell me on multiple sessions and packages of 60. Only one of those two, however, tried to X-ray me. I told him I wasn't interested and left.

No way.