"Are you going to X-ray my back?"
You have been shovelling this endless January snow for hours and your back hurts. You ask: Are you going to X-ray my back?
The short answer is no. Unless you need it.
X-rays, otherwise known as radiographs, emit radiation. It's true the amount of radiation is less than it used to be thanks to newer technology, but radiation is cumulative over the lifespan, so the less we can irradiate you the better.
Adding to that, as a Chiropractor, I have guidelines on when I am to x-ray a patient: I am trained to look for specific red flags that would lead me to believe there is something more sinister than a simple sprain of the muscles or problem with the joint. Those are the rare cases where imaging is the best course of action. If you think about it, the curve on your back is going to look very different if you sit up straight and pull your head back versus leaning forward and slumping. These are subjective changes and do no reflect the structure of your spine.
I use range of motion, orthopedic tests, palpation and functional assessments to determine what the cause of your symptoms are. There is lots of science and research showing that these tests are excellent predictors of muscular and joint problems.
Another thought on the matter is MRI. Your medical doctor has to be the person to requisition an MRI for you, but before you push him or her to do so, here's a thought: there are virtually no people who will have a textbook perfect spine.
At a certain age, most people will have some signs of arthritis, maybe some defects that have been present since birth, and frequently signs of a disc bulge. The thing to note about imaging is that unless the findings match the symptoms, the little “imperfections” in your spine are of very little value when determining the best course of management.
In many cases, even pre-surgical patients will find lots of relief with a course of conservative treatment (see: Chiropractic and exercise!). But that's maybe a topic for another day...
So next time you have an ache or pain, trust that the cause can usually be found even without having to “look deeper”.