Here is a great article written by Michael O’Doherty who is a Doctor of Chiropractic at Chiropractic Moves in Paddington, Brisbane and he explores the answer to a very common question regarding back pain. Technology has provided some great advancements with diagnosis but how much is really needed? This article provides some great insight into what needs to be considered with all types of diagnosis and how important it is in finding a successful outcome to your injury.
Occasionally a complex question, the answer to this is often a resounding NO. Though many people believe images can reveal the cause of their pain this is very often the opposite of what is true! Most cases of low back pain will resolve easily in a 4-6 week period. It might seem like it’s taking forever when it’s happening to you, especially if you are having difficulty moving about or trying to work, there is no mystery to it. Your back pain will likely go away, X-ray or not.
The vast majority of back pain cases can and should be diagnosed through a proper patient history and examination. Your doctor will ask you about the pain, how it started, does it move around, what makes it better and what makes it worse. With a few more questions along these lines and a brief physical examination your back pain can be easily categorised so that your doctor can quickly judge whether or not imaging is required.
Picture by James Heilman, MD (Own work) [CC BY-SA 4.0 (http://creativecommons.org/licenses/by-sa/4.0)], via Wikimedia Commons
What are X-rays Good For?
In the realm of back pain they can tell us a few things like whether or not you have another disease accompanying your back pain. Most of these problems, like Scheuermann’s disease or a large scoliosis, are usually detected in childhood. An X-ray could also be useful to detect the presence of a fracture, which would normally only occur with an impact like a fall from height or car accident. Your doctor might ask for X-rays if something like this had come up in your history.
What are the downsides to an X-ray?
We must remember that the radiation from X-rays can cause cancer, it’s not a big risk, but we have to balance it against the information we could gain. X-rays can often be an undue source of worry. There are a lot of strange looking, though entirely normal, variations in the anatomy of the human body that we can see on an X-ray. These are very prone to completely wrong interpretations by people, who will then stress out about a finding that is totally unremarkable!
Is there anything better than an X-ray?
Other kinds of spinal imaging include CT and MRI scans, CT is even better than X-ray for spotting bony problems and is often ordered when bony problems are suspected. CT scans do come with an increased radiation dose even compared to X-ray so we must again balance this risk against any information we might hope to gain.
MRI is the best, though most expensive, choice for looking at soft tissues like the spinal cord and nerves. An MRI is often ordered if your doctor suspects these structures are being impinged. Unless you have some kind of metallic implant within your body, which could be torn out of you by the powerful magnets in the MRI machine, this kind of imaging has no known risks.
What if I’m still worried?
Follow up with your treating practitioner, if your back pain is getting worse or nothing is changing maybe another test like an X-ray or an MRI is in order to confirm the diagnosis. If after talking to your doctor you still feel that nothing is changing or you are getting nowhere with treatment then get another opinion, a new set of eyes is always valuable and could be better than spinal imaging too.
Author bio:
Michael O’Doherty is a Doctor of Chiropractic at Chiropractic Moves in Paddington, Brisbane. He’s dedicated to providing the most effective and up to date treatment techniques available in a friendly and relaxed environment and passionate about the role of chiropractic care in the management of sports injuries and optimising performance.