"Your spine affects every aspect of your life." 

Chiropractors have the opportunity to offer the public a specific health service that is un-duplicated by any other profession. Many professions look at the spine and even manipulate the spine. To make matters more confusing, many chiropractors overlook the spine and opt to practice in therapeutic modalities, weight loss, nutrition, and various other non-chiropractic related treatments. Despite a lack of uniformity in chiropractic services, state laws in this country define chiropractic practice as adjusting the spine to restore nerve transmission potential. This (adjustment of spinal subluxation) has been the foundation of the profession since its beginnings in 1895. There's a good reason for this, too.

No other profession is adjusting spinal subluxation. Chiropractors who adjust subluxation are providing their patients increased health potential through reduction of neurological interference caused by misaligned spinal segments. This is a very safe practice, a chiropractor pays less for malpractice insurance in a year compared to most other doctors. 

Many professions do manipulate the spine with their hands; however, "manipulation" and "adjustment" are not interchangeable terms. Manual manipulation is like sending a bull into a china shop for a teacup. An effective chiropractic adjustment would be equivalent to sending "Mission-Impossible" Tom Cruise into the same china shop amidst alarm lasers while hanging from the ceiling. Precise, expertly-delivered adjustments achieve definite results with minimal interruption to surrounding spinal segments and soft-tissue buttressing that are otherwise healthy. This speeds up the improvement process in which spine-related soft tissues must maintain or regain their integrity. 

Accordingly, a precise and scientific application of chiropractic requires objective evidence of the need for spinal adjustment as well as follow-up evidence that the spine and nerve system was better after the adjustment and on subsequent visits. X-rays are absolutely vital in this process. The goal of an adjustment or course of adjustive care is to promote restoration of normal spinal alignment and integrity over time. Manipulation that is not justified by objective measures could cause damage to soft tissues that determine the stability and integrity of the spine and nervous system (could possibly make matters worse).

Under a majority of circumstances, spinal subluxation can be reduced via chiropractic adjustment(s). Over time, correction is possible as soft tissues heal and remodel according to normal spinal alignment. For this reason, the relief of symptoms associated with subluxation takes time. Manipulations of the spine (even unnecessary adjustments) may delay spinal and neurological healing in the restoration of normal health.

Christopher Kent DC, JD wrote an eminent paper on the use of x-ray in chiropractic practice; An Evidence-Informed Approach to Spinal Radiography in Vertebral Subluxation Centered Chiropractic Practice. He points out several reasons why we need to take films of patients before care begins and as a follow-up procedure under certain circumstances:

1. To determine the safety and appropriateness of chiropractic care.

2. To detect and characterize vertebral (spinal) subluxation. (we measure and calculate spinal deviations as compared to normal, healthy anatomy)

3. To determine congenital or developmental anomolies which need special consideration regarding procedure.

4. To rule out contraindications to chiropractic care.

5. To reveal conditions that may need referral to another healthcare provider. 

Common findings such as tumors, aneurysms of the abdominal aorta, and other conditions of concern can be found on x-ray. Most commonly; advanced degeneration, congenital fusion of segments, and spinal hardware from surgery are visualized. These advanced cases can be helped, but only by thorough investigation and precision analysis.

Oakley and Harrison also produced this paper; Radiogenic Cancer Risks from Chiropractic X-rays are Zero: 10 Reasons to Take Routine Radiographs in Clinical Practice. They concluded that x-rays 1) are not harmful to patients and 2) are necessary to deliver optimal care. Their ten reasons are:

1. No Harm to Patient (no data exists supporting x-rays induce cancers)

2. Contemporary Spine Care Methods Necessitate It

3. Radiographic Information Leads to Better Patient Outcomes

4. Incidental Findings are Important

5. Increased Patient Satisfaction

6. Completes a Thorough Examination

7. Satisfies Practitioner Medico-Legal Liability Concerns

8. Costs are Minimal

9. Alternative Methods Do Not Convey Appropriate Biomechanical Information

10. Possible Patient Health Enhancement via Hormesis

To conclude, chiropractors have a wonderful service to offer the public. The effectiveness and usefulness of that service is directly related to the chiropractor's commitment to precise analysis and effective adjustment of spinal subluxation. X-ray is an absolutely vital and prudent aspect of the process. It is a tool of utmost importance for chiropractors and their patients to achieve success. 

1. Kent, Christopher. (2017). An Evidence-Informed Approach to Spinal Radiography in Vertebral Subluxation Centered Chiropractic Practice. Rationale for Radiography in Chiropractic Practice Best Practices. Annals of Vertebral Subluxation Research. 2017. 142-147.

2. Oakley, Paul & Harrison, Deed. (2018). Radiogenic Cancer Risks from Chiropractic X-rays are Zero: 10 Reasons to Take Routine Radiographs in Clinical Practice.