Do Chiropractors Take X-Rays Before Treatment?

Disclaimer: The information in this blog is general in nature and based on publicly available sources. It is not a substitute for professional medical advice. If you have specific health concerns or conditions, please consult a qualified healthcare professional.

Chiropractors assess the spine and musculoskeletal system to diagnose and treat pain or dysfunction. One tool they may use during this process is an X-ray. But do chiropractors take X-rays before treatment every single time?

Not necessarily. While routine imaging is not required for every patient, X-rays can be crucial in certain cases to rule out serious conditions or guide safe care. According to research%20persist%20undiminished.&text=Start%20with%20a%20review%20and,Patient%20over%20age%2070.), imaging is recommended when there are red flags, such as trauma, suspected pathology or neurological symptoms.

Read on to understand when X-rays might be used, what they reveal and why they matter.

When Do Chiropractors Take X-Rays?

Chiropractors follow evidence-based guidelines when deciding whether to use imaging. X-rays are not taken routinely, but rather when clinical indicators, known as red flags, suggest underlying structural issues or pathology. Below are the most common scenarios when an X-ray may be warranted:

• After a recent injury or trauma
• When pain is severe or unexplained
• If symptoms last for a long time
• When there is a limited range of motion
• If there is a history of bone or joint issues
• When a spinal deformity is suspected
• To rule out serious conditions before starting care

What Can X-Rays Show?

X-rays provide valuable structural insights that help chiropractors assess the integrity of the spine and surrounding joints. They are particularly useful for detecting changes in bone alignment, joint space and signs of degenerative conditions. A 2015 review.-,Diagnostic%20Testing,and%20vision%20and%20hearing%20testing.) noted that diagnostic imaging, when used selectively, enhances clinical decision-making and reduces the risk of inappropriate care. Below are some of the most common findings revealed by spinal X-rays:

Spinal Misalignment

X-rays can reveal vertebral misalignments or abnormal spinal curvatures, such as scoliosis or kyphosis. A study found that these misalignments were associated with increased pain and reduced physical function in older adults.. Chiropractors use this data to guide targeted adjustments and support spinal balance.

Disc Space Issues

Reduced disc height or uneven spacing between vertebrae may indicate early disc degeneration or possible herniation. While X‑rays do not show soft tissue, narrowing of intervertebral spaces is a well-established marker of disc degeneration in older adults.

Bone Spurs

Bone spurs, or osteophytes, are common in individuals over 50 and can be visualised clearly on X-rays. These bony growths often develop in response to joint stress or osteoarthritis, contributing to stiffness and restricted movement.

Joint Degeneration

Signs of joint wear, such as reduced joint space, sclerosis or bony deformity, are visible on X-rays and often point to osteoarthritis. The World Health Organization notes that musculoskeletal conditions like osteoarthritis are among the leading causes of disability globally.

Signs of Arthritis or Scoliosis

X-rays can confirm spinal curvature abnormalities like scoliosis or signs of inflammatory arthritis. Early imaging allows chiropractors to modify or refer to care when structural conditions are present. A South Australian study found a 3.1% scoliosis rate in 15-year-olds, with most cases previously undetected, highlighting the importance of early screening.

Fractures or Abnormalities

X-rays are critical for detecting fractures, bone cysts, or congenital malformations before manual therapy begins. Missing such findings can increase the risk of harm during treatment.

What Happens if an X-Ray Isn’t Taken Before Treatment

Failing to take an X-ray can make it harder to accurately diagnose underlying issues like scoliosis or arthritis. The following points are based on recent studies mentioned earlier in the article, highlighting the importance of early imaging in guiding appropriate chiropractic care.

• Hidden fractures may go unnoticed
• Serious conditions might be missed
• The wrong area may be treated
• Delayed healing due to misdiagnosis
• Increased risk of making the problem worse
• Treatment may not be as effective

Benefits of Taking X-Rays Before Treatment

Based on the recent studies mentioned earlier, imaging plays a crucial role in ensuring chiropractic care is both safe and effective. Below are the key reasons why taking X-rays before treatment can make a significant difference.

Clear View of Spine and Joints

X-rays offer a detailed snapshot of the skeletal system, which allows chiropractors to detect misalignments, bone spurs and other structural anomalies. This visual roadmap supports more accurate assessments and clinical decisions. It also helps prevent misdiagnosis by providing clear, objective data about the patient’s spine and joints.

Helps Find the Exact Cause of Pain

Many forms of pain originate from hidden structural issues like disc degeneration or facet joint dysfunction. X-rays can reveal these changes early, guiding the chiropractor to the most likely pain source. This reduces trial-and-error approaches and speeds up the path to relief.

Guides Safe and Targeted Adjustments

When structural vulnerabilities, such as thinning discs or fused vertebrae, are present, chiropractors can modify their adjustment techniques accordingly. This not only protects the patient from further injury but also ensures the most effective areas are targeted. It adds a layer of clinical precision to manual therapies.

Avoids Guesswork During Treatment

Without imaging, chiropractors may rely solely on external examination, which doesn’t always capture internal structural changes. X-rays remove this uncertainty by showing exactly what’s happening beneath the surface. This allows for a more confident and data-driven approach to care.

Reveals Conditions that Need Medical Referral

X-rays are sometimes the first clue that something more serious is going on, such as tumours, fractures or advanced osteoarthritis. Identifying these early means chiropractors can refer the patient to the appropriate specialist. Timely medical referral can significantly improve long-term health outcomes.

Tracks Progress Over Time

Periodic X-rays can provide a visual record of changes in alignment, posture, or joint spacing. This allows both the patient and the practitioner to see how well the treatment plan is working. It also supports better long-term planning and goal-setting in care.

Builds a Personalised Care Plan

Each spine is unique, and X-rays help chiropractors understand exactly what each patient needs. With that insight, a more tailored and strategic care plan can be developed. This level of personalisation often leads to more effective and satisfying results.

Final Thoughts

While not always necessary, X-rays play an important role in chiropractic care when used appropriately. They help detect structural issues, support safer treatment and ensure that serious conditions are not overlooked.Chiropractors typically use imaging when symptoms suggest an underlying pathology, or when a clearer view of the spine is needed to guide care. If you're unsure whether you need an X-ray before treatment, your chiropractor will assess your history, symptoms and risk factors to decide the best course of action.

Ready to Take the Next Step?

Whether you're dealing with persistent pain or just want a clearer picture of your spinal health, Goto Health is here to help. Our experienced chiropractors use safe, evidence-informed practices, including X-rays when needed, to tailor treatment that works for you.Book your consultation today and take the first step toward feeling your best, because your health deserves clarity and care.