I occasionally find myself in conversations with people who wonder why I 'waste peoples’ money' and take such state-of-the-art x-rays on every patient I serve. Just this week, I consulted with a new patient and upon reviewing her x-rays, I noticed a severely unstable section of her middle neck. I explained to her how important it was that we saw that instability and how dangerous it would have been had she been somewhere that didn’t take x-rays and was forcefully adjusted in her neck.
We don’t forcefully adjust, but a lot of offices do. While it’s generally safe, there are times high velocity low amplitude (HVLA) adjustments are contraindicated. This means it’s an unsafe procedure and should be avoided in these situations.
If you look at the area in the red circle above, that's the area that is unstable. Forcefully adjusting there could paralyze the patient. Nothing to worry about since we don't adjust forcefully, right? And since it's imaged, we are aware, so no worries, right? Well, that may be true in our clinical setting, but what about people that get adjusted by doctors who don't utilize x-rays?
This is why we insist on imaging patients first. SAFETY FIRST!
Here's another example of a twelve year old boy. At his young age, he has had significant head-neck trauma, causing the equivalent of 30-40 years of arthritic damage to his spine. If you look below where the red arrows are pointing, he is already bone on bone in his neck. Forcefully adjusting here (which we don't do) will actually make this friction problem worse, grinding away the disc material between the bones. This will make the bone-on-bone problem progress faster. This is very important for us to know. We also found that the top two bones in his neck are rotated opposite each other. Adjusting one would make the other worse and visa versa. Pretty important to know, don't you think?
This same patient also has a very unstable section in his low back (see image below where the side view of his low back shows his bones don't line up. They are almost 11mm out of alignment.) It was my responsibility to advise him that contact sports like football, lacrosse, or rugby are out of the question. A hard hit in his low back (or a forceful adjustment) could lead to the inability for him to control his bowels, bladder, and legs.
Do x-rays cost money? Yes. Is it worth it? Absolutely! While others may tout they can offer care for cheaper, we contest that state-of-the-art equipment comes at a cost. But, how much money is your safety, health, and vitality worth? We believe if we're going to do something, we should do it well.