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  • John K Maltby II, D.C.

What's with the X-Rays?



I take X-Rays here, and for the most part I do not get much push back from people when I tell them I am going to take X-rays. There are a few questions that I get from people from time to time when I mentions X-Rays. Before I address some of the common questions below, I would like to provide a link to the most definitive document ever written on X-Rays and Chiropractic, http://www.pccrp.org/, Practicing Chiropractors’ Committee on Radiology Protocols. (I will use a lot of information from this document to help with this blog, and in no means claim to be the one to discover these claims, but give credit to the original authors of said document, the PCCRP). Nothing out there is more extensive, better researched, and defends the X-Ray better than this document. Every single Doctor (MD, DC, DO etc.) out there who claims X-Rays are not necessary or not accurate enough for diagnosis have not read this document, period.


This is a view taken specifically of the Atlas Vertebra
Base Posterior View

Are they safe?


This is a common question and it is asked in many different ways. The simple answer is yes. There is a joke I have seen floating around about how we claim x-rays are safe, but when it is time to take them, the Doctor hides behind a leaded wall to take them, thus implying they are not safe. The reason the Doctor is protecting himself is because we are taking multiple sets of x-rays a day, while you are only getting one set taken of you every few years or so. Like almost everything else in the world they are safe if you do not over do them. The ionizing radiation levels associated with the x-rays taken in a typical Chiropractor’s office are associated with possible health benefits, which is termed Radiation Hormesis. There is strong evidence that health benefits have occurred in plants, microorganisms, invertebrates, and experimental animals in some studies. It was proven with statistically significant results from a very large number of studies that low levels of radiation benefits improved physiologic function from immunity and reproduction to growth and longevity. Many of these studies were done to find the risks that come from radiation, which would make the probability of author bias very unlikely.

Why do you need them, my last Chiropractor didn’t take any?


I practice an Upper Cervical Specific technique here called Knee Chest Specific. It requires x-rays to get the most precise listing possible. A “listing” is what we Chiropractors call the specific direction a vertebra has moved. We use this listing to know which way to adjust it in order to release the pressure from the nervous system that it is being caused by the vertebra being stuck in an improper position. There are several techniques that a Chiropractor can use to find the direction a spinal segment has moved, and I use many of them in my analysis of the spine, but they will only give you an estimate, a best guess if you will. With that being said, I would put any Chiropractors best guess of where the spine is moving without an x-ray over any other health care professional in the world. What the x-ray provides is a visual and measurable (millimeters and degrees) representation of your spine. You would never allow a surgeon to begin surgery without an MRI or a CT first? In fact, during many surgeries now x-rays or some other kind of imagining are being taken throughout the surgery to make sure everything is going to plan. Not every technique out there uses listings provided by x-rays to tell the Chiropractor how they are going to adjust you, and there are many, many very successful and competent Chiropractors who I trust who do those techniques. I practice techniques that use x-rays, I believe in using all that I can to deliver the best and most accurate adjustment possible, and that includes x-rays. There are over 1,000 peer-reviewed studies on the reliability, repeatability, and safety of Chiropractic X-Rays for the purpose of finding the subluxation. So, the claims of them not being accurate or repeatable are completely false.

My MD said that spinal curves do not affect your health and that these films are normal?


The is a view taken of the cervical spine.
Nasium View

MDs and DCs are different. They are both Doctors, and are both primary care physicians, but are different in how they approach analyzing the body. If this statement were true, then why are so many people being diagnosed with scoliosis by MDs, and sent to a PT to have it fixed? In fact, I have had a number of patients who have been diagnosed by an MD with scoliosis and have never had an x-ray taken. When x-rays are taken, there is no scoliosis present. Again, I ask the question; if spinal curves do not matter to health, then why the scoliosis diagnosis from the Medical profession sent out for corrective care (sometimes surgery) to correct it? The fact is that spinal curves do matter. One study shows that a correlation between nerve conduction velocity and amplitude was altered by improper cervical spine curves. In a 2002 study, they found that loss of lateral curvature (the normal curve in the neck if you look at it from the side) can lead to spinal arthritis and disc disease that has been linked to heart disease and related disorders in other studies. Now, I am not saying that going to your Chiropractor and having your neck adjusted will cure your heart disease, I am only pointing out that having x-rays of only ONE angle of your cervical spine can help determine your overall spines health by being able to measure that curve.


This is a view taken of the lateral cervical spine.
Lateral Cervical View

Above is only one example. We do not only take one x-ray of one angle of the spine; we take two at a minimum. If I am taking an Upper Cervical Series, then I will be taking three. This is to get three angles of measurements to tailor the adjustment you receive for you specifically.


I take x-rays because I want to be accurate and deliver to best adjustment possible to you every time. Chiropractors take over 250 hours of radiology courses during there time in Chiropractic school as a part of their Doctorate program. I take the taking of x-rays very seriously and take every precaution possible, which includes the set-up process that is the same for everyone so that all x-rays are similar.


If you still have questions about this subject click on the link at the beginning of the article in order to learn more.

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Biased.