Chiropractor Questions Chiropractic Adjustment

Do chiropractors typically take x-rays?

Recently I visited a chiropractor and he took x-rays to rule out any possible pre-existing conditions as the source for my pain. I thought this was a good gesture and I had never experienced this at a chiropractor beforehand. Is this common?

70 Answers

Yes. X-rays are taken to properly diagnose a patients condition and to rule out pre-existing conditions. Most importantly, to discover the subluxation complexes (mal-alignments) present to obtain accurate bio-mechanical and structural information, necessary to formulate the treatment plan for the patient's condition. In addition, any pathology present will be revealed by x ray analysis. X-ays are a key diagnostic tool for determining structural improvements after correction has been completed.
Some chiropractic techniques require X-rays. Many chiropractors utilize X-rays to aid in their locating, analyzing, and correcting spinal misalignments, a.k.a. subluxations. And many others like myself do not X-ray, but I do refer out for X-ray if somebody had trauma.
Yes it is very common. Frankly, I would not understand the reasoning behind not taking x-rays on the first visit. There are several things films will reveal: congenital malformations, disc degeneration, vertebral spur formation, blocked vertebra (two bones that fused together naturally), chiari formation which can have very serious consequences if the doctor is unaware that it is there during treatment, missing vertebral parts such as agenesis of the odontoid (tooth like projection of the 2nd cervical vertebra) and of course underlying pathologies.
Many chiropractors x-ray every patient, it is very common. I would advise avoiding those who use the x-ray to determine treatment, but if he/she took them to rule out more sinister conditions that is perfectly reasonable.
This is the best case scenario. If you're going to work on a car, you want to know what's under the hood. The doctor that takes x-rays will be most precise, efficient, and will get better results. This is critical, especially with the spine (very complex).
Yes, and I wouldn't be treated by one that didn't!
I agree. I have never adjusted a patient Without the use of X-rays. I have always owned my own machine too. I know several Chiro's that don't take X-rays because they do not want the expense. You only have one spine. Take care of it and I am glad you found someone who cared about your health to rule things in/out.
Very. You wouldn't want a chiropractor to guess which way a bone is out of position.
This is a great question. Many chiropractors have X-ray equipment in their office, so it can be an excellent way to get more details about the health of your spine. In many cases, chiropractors are having to refer out for your X-rays to be taken, so they may wait until there is a more serious concern to recommend that you have them done. Don't forget chiropractors are all a bit different just as there are different specialists within the medical community. Either way, it is quite common to have initial X-rays. In fact, if your doctor is recommending an X-ray, it may have to do with the doctor's philosophy on spinal correction or maybe even the specific techniques that they specialize in. You might consider asking them their opinion on how often you should get an updated X-ray to understand more.
Yes, this is common practice in a lot of practitioners' offices. While we can gather a lot of information from our examinations, we can see the wear and tear on the X-rays and X-rays assist in this.

In Health,
Dr. Jodie Schultz
Yes it is common and a good practice for ruling out any type of fractures or dislocations or any other type of bone lesions as well as to view the structures
X-rays are not required but seeing is know and not seeing is guessing. Sounds like you’re in good hands.
Yes. It is often done to determine structural changes and to help deliver more thorough and accurate care.
Yes. It is common practice for reason mentioned above and assist in making proper diagnosis.
Lots of Chiropractic doctors take x-rays to evaluate the integrity of the bony spine and signs of soft tissue abnormalities. With the advancement of imaging techniques, x-ray is utilized less often for evaluating serious medical conditions as it is limited with respect to observation of anything other than bone. Insurance coverage and insurance network participation is also denied if a Chiropractor takes x-rays, therefore, some doctors do not take x-rays because they would be denied access to patient referrals.

I utilize x-rays in my practice and am of the opinion that they are a vital factor for guiding and dispensing the treatment method I use as well as evaluating and educating the patient about themselves.
Some insurance company guidelines recommend waiting 28 days after starting chiropractic care to do x-rays unless there are red flags that would warrant x-rays earlier.
Not sure of the statistics. But I can tell you that for acute low back pain in adults, x-rays are RARELY necessary.
The decision whether to or to not take x-rays is all dependent upon the practitioner. Some chiropractors take x-rays on every patient regardless of the issue and some don't take any. Most of the time x-rays are taken to rule out conditions such as what your chiropractor did. I personally decide whether I'm taking x-rays or not based on the case and history of the patient. Technique can also play a factor when deciding on whether to take x-rays or not. The more aggressive the technique the more likely x-rays will be taken. Therefore it just depends on the chiropractor when it comes to taking x-rays. I hope this helps!
Some do and some don’t. In our office we take X-rays because we want to be as specific as possible when it comes to our patients’ spinal correction.
It is a common practice, but not all Chiropractors have x-ray units. It is not a good idea to x-ray all patients that come in to a clinic, but if they had a trauma or have significant pain that is not going away or are over 50 then x-rays are a good idea.
Some but not all Chiropractors take X-rays. From the doctors standpoint it's a great educational tool to help patients understand what's going on internally. In some cases if a patient has undergone a severe trauma it's used to help rule out broken bones or other more serious conditions which may need to be addressed prior to chiropractic treatments.
Not all the time.
It really does depend on the patient's injury. Sometimes X-Rays are
required. Just like a dentist, taking a set of X-Rays allows us to see
anything under the gums or muscles that may be contributing further for a
patient's problem. Also allowing us to see any underlying problems before
it manifests into an injury. It is very common practice to have an initial
set of X-Rays taken if you are new to a doctor's practice.
Yes. It is a good idea to be sure that we are not adjusting on any
abnormality. Some Chiropractors do not take x-rays but I feel it is good to
be safe...

Christopher A. Bowers, D.C., C.C.E.P
Chiropractic Clinic Of Iowa
214 Blairs Ferry Rd NE
Cedar Rapids, Iowa 52402
Phone: (319) 378-1515
Fax: (319) 378-9292
Cell: (319) 651-2165
It is not uncommon for a chiropractor to take X-rays. Oregon for example has treatment standards, we are not recommended to take X-rays unless trauma and suspected fracture, instead it recommends treating for a few weeks before requesting X-rays. There are over 300 published techniques in chiropractic. Several take X-rays almost every visit, or during a new phase in care. Some even X-ray before and after adjustments. We now are trying to reduce excess X-ray exposure to patients. The newer digital X-ray machines use less time to take an image, and this results in less radiation exposure. We are happy your chiropractor made a judgement call when evaluating you. It is not uncommon for patients to ask for an X-ray before starting care, but ultimately it is up to the doctor to make that decision.

In Health,

Michael LoGiudice, DC
Many chiropractors typically take x-rays to rule out any possible pathology
or to create more of a clear understanding of what the issue may be.
Sometimes there are things going on that the doctor is unable to feel with
his or her hands on examination. Some chiropractors routinely take x-rays
if they are working on spinal curvature correction.
Yes, it is a common practice. Knowledge is power, guessing is assumption. We not only rule out pre-exsisting problems and pathology but we look at posture and spinal alignment on the x-ray.
Yes, it's very common. I never touch a patient without an X-ray. I need to know if the patient has arthritis and narrowing of disc spaces that is causing the pain. For accident cases, you want to rule out a fracture as well.
My belief is that all chiropractors, given good reason, should take xrays
for no other reason than knowing and understanding the underlying
structure. About 95% of my patients will require films before any treatment
is performed. The other 5% fall into the too young to justify or muscular
condition which is expected to resolve with care. Some of my chronic pain
cases will get xrays so I can know how much wear and tear
(arthritis/degeneration) has developed of the years, others with acute
traumatic injuries will receive films also.
It is common for chiropractors to take x-rays. I do not order x-rays for everyone, but based on extensive history of complaint, or nature of an injury, and examination findings, an x-ray may be relevant or not. Usually, will take an x-ray for common ground if I know I would like other imaging to be done.
X-rays (radiographs) are taken to rule out bone abnormalities and pathologies especially in high risk populations, for examples those over a certain age with certain conditions such as osteoporosis or in individuals who where injured in a trauma lie a tumble down a flight of stairs. The use of x-rays have changed in the chiropractic profession over the last hundred years as we have developed our clinical expertise as doctors and learned more about the pros and cons of radiation as well as the limitations of radiographs. If a chiropractor takes an x-ray on the first visit it should be to rule out a condition that would change the course of care and not every patient needs an x-ray before starting a course of treatment.
Yes it is very common with manual therapies such as adjustments because
they move the bones in your spine, and if any of them have congenital
abnormalities (birth defects that are considered normal) then it may alter
the course of treatment. So, I use x rays to help determine the safety of
treatment when patients have any history of congenital abnormalities or if
they have severe pain patterns and/or neurological conditions such as
sciatica. Usually if the doctor does not take x rays on the first visit
they may wait and see how the patient responds to care before determining
the need of more advanced imaging such as x rays. The only exception to
this rule is trauma like a motor vehicle accident or fall and x rays are
almost always used to rule out any type of fracture, dislocation or other
serious damage that would require immediate medical attention.

*Yours in Health,*

*Dr. Weston Zenner, D.C.*
Indian Creek Natural Medicine
10464 Metcalf Ave
Overland Park, KS 66212
Many chiropractors take X-rays for various reasons including ruling out pathology. A good exam should be done to correlate any findings. Every chiropractor is different in their approach. Our office typically does orthopedic exams which helps us determine if X-rays or MRI is needed which we would refer out for. But as you said, it was a good gesture.
Yes an No. X-rays are not always neccesary but it really depends on the doctor and his standard of operating procedures. Having x-rays done prior to adjusting is a good idea in many cases. First, he can rule out anything potentially harmful from cancer or congenital anamolies that could injure the patient. Secondly, x-rays can show the patient how their spine has developed with increased curvature to misaligned vertebra contributing to your discomfort. It's really a very good educational tool for you to know why your having issues in the first place. Hope this helps.
Depends, If the diagnosis is questionable or there are 'red flags' ie.. trauma, pain that wakes you up every night.......They should always be taken. If the exam is inconclusive and the history of pain is vague then again more testing should be routine. I believe in trusting your gut. We have caught many things on xray that warranted referral first.
We are well trained in the physics and
positioning for x-Ray procedures.
Also we are extremely qualified in the interpretation
of the film.
When I look to refer people to a doctor that is one of my criteria. They
must take films to see what the problem is and how bad it is. This is the
resoonsible thing to do. I will not put my hands in anyone without proper
films first as that would be guessing and therefore subpar care.
There is a lot to learn about your body from xrays and they are the key to
unlocking the best healing potential out of wach patient.
I am glad you found a doctor that is not willing to guess with your health.
Good for you...

Dr Robert Arnone
St Charles, MO
Yes most Chiropractors should take or at least evaluate previously taken xrays before beginning treatment. It will let the Chiropractor have a better idea of the condition of your spine.
Yes, most Chiropractors take x-rays but there are a some that don't take x-rays before adjusting. My opinion it that x-rays should be taken first simply because it's possible that a patient has an underlying condition they don't know about especially if they have had some type of trauma.
Yes this is a reasonable thing to do.
Each chiropractor determines whether xrays are necessary based on the
individual patient's presenting complaint and a thorough health history.
In most situations, xrays are performed in the office. If an office
doesn't have in house xray machine, then a patient is referred to a
radiology clinic.
X-rays are not always needed to begin treatment; a chiropractor will decide if x-rays are needed based on history and physical examination.  X-rays expose patients to radiation so they should be used as a tool to rule out serious expected pathology like fractures, tumors, or severe degenerative changes and not simply to check for expected minor postural or joint misalignments; most chiropractors can feel with their hands restricted/abnormal joint motion and see with their eyes postural imbalances.
Hello and thank you for the question.Every chiropractor practices different. However, with that being said there are times where a practitioner may think xray are needed, not only to help with a diagnosis but to also rule out any conditions.  
Yours in health,Dr. Chris

It is quite typical.
It is common for a Chiropractor to take x-rays prior to making recommendations for treatment or adjusting fixated joints. In my opinion, it is a good practice to do appropriate radiologic and laboratory tests to ascertain if and what treatment or recommendations are most appropriate for each patient.

Dr. Juanee Surprise, DC. NMD, DCBCN, BCIM, IMD
Yes it is, a majority of chiropractors do take X-rays not only to rule out pre-existing condition but also to access the curvature and alignment of the spine. After a couple of months of treatment they might take more X-rays as a re-examination to show the improvement in alignment. However, some doctors don't have the room for an X-ray machine so they will send you out for one. In addition other doctors might not take X-rays based on your history. If your injury occurred due to trauma, then most likely an X-ray will be taken, but if there is no trauma some doctors will choose not to take an X-ray.
This used to be a common thing as chiropractors would use it to determine spinal listing and any other existing conditions. Now it's not done for a number of reasons. 1) xray exposure ( even though today's X-rays are much less than previously). 2) cost most facilities don't have it in their budget to maintain and provide X-rays. 3) insurance often will not pay for a "screening" through X-ray. 4) often most other people have previous imaging.
Absolutely! Most chiropractors do take xrays, not only to rule pre-existing
conditions, but also to see the health of your spine, alignment if your
vertebra and other possible complications to your adjustment.
Actually, taking xrays is the standard in taking care of people. In some chiropractic techniques, it is essential to discover the "architecture" of the bone structures that cause subluxation, and critically important to use those images to develop a correction strategy which resolves that subluxation. One of the other important reasons, as you have discovered, is to rule out pathology that might be causing symptoms. Bone infections, bone cancers are among those conditions that would require an alternative approach. Dr. Philip R. Schalow  Upper Cervical Care Center-Rockford a division of 1st Step Chiropractic, S.C. 4519 Highcrest Rd Rockford, IL 61107 815-398-4500
Hi there!
Some chiropractors do, some don't. Personally I choose not to x-ray everybody on intake because an x-ray will usually not change the treatment protocol, and I do everything I can to avoid radiation exposure for myself and patients. If there is a history of cancer, osteoporosis, or an injury which may have caused a fracture or some type of damage to the spine, or the patient is not responding to treatment as expected, then x-rays are indicated and I send patients off site to get them. I take a very detailed health history and do very gentle chiropractic adjustments, usually with an activator which has no history of injuring the spines of patients. Some chiropractors are more "rack and crack" docs who rush you in and out with a heavy handed adjustment and probably are wise to X-ray. Some do it to show the patient scoliosis or other problems in curvatures of the spine in order to show the patient why they need chiropractic care. The problem with using it to identify curvatures or educate their patient is that x-rays don't show everything. Also curvature can be changed dramatically depending on how a person stands during the x-ray. A disc herniation which is a very common problem seen in practice is not seen on x-ray, you must get an MRI for that. Also, osteophytes or arthritic changes may or may not affect the outcome of treatment. In my experience, function does not always follow structure, meaning that you can have a pretty "ugly" arthritic spine on x-ray and still have full range of motion and be pain-free, or you can have a very "clean" looking spine and be unable to move.. If X-rays did not subject the patient to radiation I would say it's ok to do them without cause if the patient wants to pay for them, but for me the risk of subjecting a patient to radiation outweighs the risk of missing a pre-existing condition. I hope that helps!
I take X-rays when clinically indicated. I don't do them on every patient.
Hi there,

Great question. Yes, it is very common. It is best to determine if you are a chiropractic patient. Also, to determine if we need to refer you out to a specialist or co-treat with your PCP. Usually with children and preganant women I will not do xrays, unless it's the cervical or upper thoracic region. For MVA (motor vehicle accidents) then its an x ray for that patient. No way around it.
It is very common for a chiropractor to take x-rays before treatment to rule in/rule out any condition that may complicate your condition(s) unless your visit is purely wellness/preventative. There are chiropractors that take x-ray only for trauma related cases.
This is a practice that is not backed by research. The ACA (American Chiropractic Association) has brought forth new, evidence-based guidelines that only recommend the taking of x-rays for the presence of red flags (infection of the bone, fracture, etc.). If there were no indications for an x-ray then taking one as a normal procedure is not recommended and does not go with the standard of care. The taking of x-rays is not a normal thing done at a chiropractic office unless there is an indication (as discussed above) to do so.
Yes, we take x-rays of every patient. I have come across fractures and tumors that patients were not aware of. If we would have treated those patients without x-rays we would have caused more harm.
Yes--most chiropractors take X-rays to be absolutely sure of what is going on
So chiropractors do take x-rays and some do not, it all depends on how they like to practice. Some might treat a few times and then request to have x-rays taken. If x-rays have already been taken they usually wont have you get more.
An x-ray is a diagnostic tool and as such is generally used, like any other
diagnostic tool, when clinically indicated. Most routine x-rays that are
taken in the absence of clinical signs and symptoms will be negative and
yield little additional evidence or information that might impact clinical
decision making. Routine x-rays by Chiropractors, in the absence of solid
clinical indications, are much less common than they were two or three
decades ago. Generally, in the absence of trauma, chronicity or severe
symptoms an adequate history and examination will allow an experienced
doctor to arrive at a diagnosis and formulate an appropriate treatment
plan. Should the patient fail to respond to the treatment as expected, an
x-ray would then be appropriate for further investigation. The use of
x-ray as a routine screening tool exposes the patient to doses of ionizing
radiation that are unnecessary and potentially harmful, and adds to the
cost of care. Not having any more information about your own reasons for
visiting the Chiropractor I can not comment on the efficacy of the x-rays
taken or the doctors reasoning for doing so. Something noted in your
health history or current clinical symptoms might have prompted the DC to
obtain the x-rays to aid in the diagnosis or formulate a treatment plan. I
hope you are getting the help you need.


J.L.Harris DC, FACO
You shouldn't see a chiropractor who doesn't Xray. It's super important to see your spine
Yes it is common to take x-rays and very important because so much more information can be revealed from an x-ray that cannot be established from exam alone.

Yes, it is quite common, and is good practice.
X-rays are one of many diagnostic tools we use to assist in a diagnosis,
The answer to that questions really depends on the philosophy, regarding X-rays, that the treating doctor holds. Of course, if trauma is involved, all docs would require X-rays before a chiropractic treatment. With more routine symptoms or conditions, philosophy plays more of a role and will vary by chiropractor. For example, in my office, I routinely take X-rays and do a complete physical exam on new patients before treating them, to rule out any reason NOT to adjust them. I.e. Occult fracture, bone disease, joint infection etc. I believe that X-rays are not only informative for the doctor, but also educational for the patient. The saying, " a picture is worth a thousand words" applies well in this case and helps them stick to treatment plans. I am always seeking to educate my patients and provide them with the knowledge that they need to advocate for their health. On the other side of the coin, some doctors feel that exposing their patients to X-rays is not worth the information that they would gain, on top of their regular physical exam. The best course for you, as a patient, is to decide what you feel most comfortable with, and seek out a chiropractor that most closely matches your needs. I hope this helps.
It varies, typically if they are indicated clinically a chiropractor will take X-rays or order them from an outside source if they don't have an X-ray machine. Some take X-rays of all patients ( with perhaps the exception of small children or babies), but if insurance is being filed there are specific circumstances in which they will
pay for an X-ray. The criteria has changed drastically in the past few years, mainly as a means to save money in my opinion. X-rays are very inexpensive in light of the information they give....a picture is worth a thousand words!! I feel
I can serve my patients more efficiently when I see their X-ray. Many findings are not palpable, and I wouldn't know without the X-ray. I do what is best for my patients, which isn't always what insurance covers, but most people choose to pay for these beneficial services out of their pocket if necessary!
Traditionally chiropractors took X-rays for every patient prior to beginning treatment, many chiropractors still follow this model today. However, current medical guidelines for conservative treatment suggest that 4-6 weeks of conservative care should be commenced prior to ordering imaging, and if there is not improvement, then imaging should be considered. Many insurance companies are now penalizing chiropractors for taking X-rays on all their patients. Most chiropractic schools today are teaching doctors to evaluate the patient carefully for risk and only order X-rays if there are "red flags" present. X-rays do come with a risk and exposing all patients to them is typically unnecessary. Chiropractic treatments fall under the category of conservative care, the treatments are safe and gentle. Having an X-ray rarely changes the treatment given or the effectiveness of it. For this reason, many chiropractors, myself included, don't X-ray all their patients anymore.
Depending on the type of pain and that doctors suspicion after his exam I would say yes it is common.
Many chiropractors do take X-rays on initial visits. This also depends on age and sex. Females over 45 or post menopausal are more prone to osteopenia and osteoporosis, so it is not just for diagnostic purposes, but also patient safety. Other factors could be previous history of accidents or injuries and possible degenerative changes.
X-rays are a fairly common practice, but not always necessary (my own opinion). Some that perform X-rays will have X-ray units in their office. I personally do not do X-rays in my clinic, but have sent patients offsite so that we could rule out any contraindications to treatment (accidents, past injuries, etc would be a good reason for X-ray review).
X-rays should always be taken to rule out any pathologies and to also get a clear picture of the patients state of health. I personally wouldn't want to be treated without X-rays. X-rays are a great tool to help determine what might be causing the issue and guide us on how to best correct it.

Dr. Neil K. Pai, D.C., F.A.S.A.
At our office we take X-rays on a regular basis. It is in my professional opinion that chiropractors should rule out any and all contraindications before adjusting a patient. Sometimes certain contraindications to manipulation are asymptomatic so getting xrayed by your chiropractor before treatment is in your best interest. Hope this helps.