Try conservative treatment before X-rays
Imagine that you woke up this morning with acute neck or back pain. You did not do anything in particular yesterday to deserve it, you did not have a recent trauma or accident, and you do not have any significant arthritis in your spine that you are aware of. Concerned and in pain, you visit your medical doctor and pressure him or her into prescribing an assortment of medications (muscle relaxer, anti-inflammatory, and pain killer) and to refer you for an x-ray of the affected area so he can “see” what is wrong.
This may sound like a typical plan of management for someone for acute neck or back pain – and unfortunately it is. Recent research that compared this type of treatment to manual therapy and physiotherapy showed the latter two getting significantly better results. This was particularly the case for manual therapy (which chiropractors use with almost all of their patients).
In regards to pressuring your medical doctor into requesting X-rays right away, this will often not give you any new information about your problem. If you have not experienced any recent trauma or accidents, and serious arthritic conditions can be ruled out, having an x-ray will likely not change how you should be treated. Therefore, it may be better to try conservative treatment first. Only after you undergo this treatment and do not begin to feel an improvement or if abnormal signs or symptoms begin to appear should you have an x-ray done.
There also seems to be some confusion as to what exactly it is we can clearly see on an x-ray. An X-ray really only shows bone, with some “shadows” of soft tissue or fluid. So, in regards to a low back or neck x-ray, it does not show a herniated disk, a pinched nerve, muscle spasm, typical joint inflammation/swelling, or almost anything else that is significant to a person with non-traumatic neck or back pain. As well, bones and joints do not “go out of place”, so this cannot be visualized either. Even if some of the joints in the spine are very stiff and lack their typical motion, an x-ray is just a static picture that cannot show how well or poorly a region moves.
To summarize, if you have a recent neck or back problem that is not the result of a traumatic injury, don’t simply assume that an x-ray is going to give you any new useful information. In most cases, a series of treatments from a chiropractor will result in rapid positive changes. If specific signs and symptoms are present (red flags for a different and more serious problem), or you are not responding to early conservative intervention, then an x-ray and referral may be indicated.