Radiophobic Fear-Mongering, Misappropriation of Medical References and Dismissing Relevant Data Forms the False Stance for Advocating Against the Use of Routine and Repeat Radiography in Chiropractic and Manual Therapy

Abstract

There is a faction within the chiropractic profession passionately advocating against the routine use of X-rays in the diagnosis, treatment and management of patients with spinal disorders (aka subluxation). These activists reiterate common false statements such as “there is no evidence” for biomechanical spine assessment by X-ray, “there are no guidelines” supporting routine imaging, and also promulgate the reiterating narrative that “X-rays are dangerous.” These arguments come in the form of recycled allopathic “red flag only” medical guidelines for spine care, opinion pieces and consensus statements. Herein, we review these common arguments and present compelling data refuting such claims. It quickly becomes evident that these statements are false. They are based on cherry-picked medical references and, most importantly, expansive evidence against this narrative continues to be ignored. Factually, there is considerable evidential support for routine use of radiological imaging in chiropractic and manual therapies for 3 main purposes: 1. To assess spinopelvic biomechanical parameters; 2. To screen for relative and absolute contraindications; 3. To reassess a patient’s progress from some forms of spine altering treatments. Finally, and most importantly, we summarize why the long-held notion of carcinogenicity from X-rays is not a valid argument.

Re-establishing the cervical lordosis after whiplash: a Chiropractic Biophysics^® spinal corrective care methods pre-auto injury and post-auto injury case report with follow-up

“…First, as mentioned, comprehensive assessment of the cervical lordosis can only be done by routine X-rays to the region and quantification of important spinal parameters including global lordosis, AHT etc 6 ) . There are however, hesitancies to expose patients to radiation which are outdated concerns, because X-rays do not provide a high enough exposure of radiation to cause harm 26 , 27 , 28 , 29 , 30 , 31 , 32 ) . Further, no other assessment methods (e.g.…”

Examining Clinical Opinion and Experience Regarding Utilization of Plain Radiography of the Spine: Evidence from Surveying the Chiropractic Profession

“…While there is not consensus on the use of PROTS for chiropractic patient management, we surveyed a national sample of DCs to help clarify this topic with the most extensive investigation into the clinical expertise of the chiropractic profession regarding utilization of plain radiography to date. We demonstrate that DCs embrace a spectrum of opinions, ranging from possible perspectives that, due to safety concerns, utilization of PROTS be limited to diagnosing pathology in the presence of red flags [ 68 , 69 , 70 , 71 ] to an absolute necessity of X-ray images to determine spine and biomechanical parameters [ 71 , 72 , 73 ].…”

Reduction of lumbar hyperlordosis in a pediatric: a Chiropractic Biophysics^® case report

“…This raises the issue of radiation exposure to the patient, and in this particular case it is the pediatric patient. It should be known that much recent literature has brought light to the fact that low-dose radiation (plain film X-rays and CT scans) are not carcinogenic [24][25][26] . For this reason, as well as the fact that plain X-rays remain a most efficient method to screen and diagnose spinal biomechanical patterns 27) , it is recommended that LBP patients, regardless of age are screened by X-ray for biomechanical assessment.…”