Why Take X-Rays

There are arguments both for and against the use of x-rays as a part of chiropractic health care. Some patients who see doctors of chiropractic do not require x-rays; however, many Chiropractors take them as a standard procedure, either as a defensive practice to rule out pathology and/or to aid in determining where to adjust the spine.

Lateral-Cervical-Normal-Web lateral-cervical-abnormal-web

X-rays are the window to your spine.

By knowing how your spine is lined up, we are able to accurately create a care plan based on your unique needs. We will also take progress x-rays in order to determine how rapidly your spine is changing.

If you are concerned about radiation from having x-rays, our x-ray system is regularly checked and calibarted to the strict Health Canada standards. You will actually receive more radiation flying from Toronto to Paris than you would from a set of x-rays.

X-Ray Analysis is used to further understand the condition of your spine and to determine the type of care needed.

We look for signs of pathology (disease) and fracture; evaluate posture, the joints of the spine, the condition of the discs, subluxation and other conditions of the spine.

A detailed analysis is given to our patients to show abnormal deviations of spinal curves and what corrections are necessary to improve the alignment and function of the spine.
Our goal is to correct the underlying problem to enable the spine to better cope with the stresses of everyday living.

New patients can bring along any recent x-rays taken elsewhere.

Any other questions or concerns can be addressed with Dr.  Hollingsworth.

Risk Perspective

Whilst no radiation dose is risk free studies show that medical x-rays are of very minimal health risk.

From Butler [Butler G. Inflight Occupational Exposures to Cosmis Radiation and Magnetic Fields. Air Line Pilot 2000; Jan: 30], one can calculate the routine exposure of airplane passengers and crew. For example, based on 0.60 mSv (= 0.6 x 0.1 rem) per 100 block hours (the mean for a flight between New York City and Athens, Greece), a pilot flying 700 block hours per year would receive an annual occupational exposure of 4.2 mSv (= 0.42 rem). In contrast, a pilot flying 700 block hours on a Chicago-to-San Francisco route (0.41 mSv/100 block hours) would receive an annual dose of approximately 2.8 mSv (= 0.28 rem).

This Chicago-San Francisco dose is 0.28 rem/yr = 280 mrem/yr = 5.4 mrem/wk, while according to Cohen and Lee (Cohen BL, Lee IS. A Catalog of risks. Health Physics 1979; 36(Jun): 707-722.) “smoking a cigarette has the risk equivalent of 7 mrem of radiation , and an overweight person eating a pie a-la-mode runs a risk equal to that of 35 mrem”.

Risk Perspective

by Edward L. Maurer, D.C., D.A.C.B.R.
Kalamazoo, Michigan

Environmental pollution, cholesterol, steroids, drugs, iatrogenic disease, radiation effects, and others, have all been highly visible in the media over the past few years. Near daily announcements are made of items which are purported to be carcinogenic. One begins to wonder if it would be easier to list the things that do not cause cancer.

Radiation health and safety are being discussed at social gatherings, and people are generally more aware of associated risks. Many still have visions of Nagasaki, Hiroshima, Chernobyl, and Three Mile Island whenever radiation is mentioned. Little wonder then that patients frequently ask questions related to the necessity and safety of radiographic procedures. At times simple reassurance will suffice, but often we must attempt to help put things in perspective.

Science and technology have combined to provide some of the most in-depth studies of ionizing radiation known to man. The International Atomic Energy Agency (IAEA) states that “radiation and its effects have been studied by expert bodies for over half a century and more is known today about radiation risks than about those of practically any other physical or chemical agent in our environment.”
Authorities agree that while no radiation dose level is risk-free, the level used in diagnostic radiology provides low-dose risk and is considered as acceptable to the average individual. According to the 1949 National Council on Radiation Protection and Measurements (NCRP), the definition of permissible dose is: “Permissible dose may then be defined as the dose of ionizing radiation that, in light of present knowledge, is not expected to cause appreciable bodily injury to a person at any time during his lifetime.” Since this NCRP statement, the trend in science has been away from the “permissible or acceptable” dose concept to the current “risk” concept. In either approach, the end result is similar, e.g., for the information gained with diagnostic radiology, the radiation risk is minimal.
The IAEA states that “one should not disregard the risks posed by radiation as a health hazard, but it does not pose a unique set of health affects.” Other agents pose a much greater health risk. “It is about 100 times more likely that cancer will be produced in the average individual by some other cause than by radiation.”

An interesting article by Cohen and Lee entitled, “A Catalog of Risks,” published in Health Physics, provides a look at radiation risk levels, along with other examples of risks associated with various activities and how they translate into loss of life expectancy. It provides the likely results of both general patterns of behavior and one-time occurrences. According to the study: The drinking of one diet soft drink per day reduces life expectancy by two days; ingesting 100 calories per day by drinking regular soft drinks increases body weight by 7 pounds and reduces life expectancy by 210 days. If you are 30 percent overweight you lose 1,300 days; 20 percent overweight 900 days. Unmarried males lose 3,500 days, smokers 2,250.

While accidents in an average job cause 74 days of life loss, a job with radiation exposure carries only a 40 day loss. An average person who receives a lifetime of medical (diagnostic) x-rays, results in a life expectancy loss of six days. Radiation to workers in the nuclear industry lose 0.02 days. Single, individual acts and their associated risks were also reviewed. Smoking one cigarette reduces life expectancy by 10 minutes, eating a calorie-rich dessert by 50 minutes; and the missing of an annual PAP test will cost the average woman 6,000 minutes. One millirem of radiation reduces life expectancy by 1.5 minutes.

This study and many others point out that risks are associated with nearly all activities of daily living. Some can be guarded against, for example, wearing a seat belt, losing weight, stopping smoking, etc., but even these measures will not eliminate all risk. Minimal risk in everything we do during the human experience is near-inherent. While we must constantly work towards the reduction of risk, in all endeavors, we must accept a minimal level as normal. Diagnostic radiology does present risk; but the radiation dose when compared to the benefits of useful information gained, necessary for appropriate treatment selection, is indeed an acceptable trade-off when put into perspective.

References
1. International Atomic Energy Agency, “Facts About Low-Level Radiation,” American
Nuclear Society, 1982.
2. Cohen, B.L.; Lee, I.S. “A Catalog of Risks.” Health Physics June 1979; 36: 707-722.”

In summary, logic must prevail and the use of radiography in chiropractic given the respect that is deserved. Clinical x-rays are of minimal exposure (health risk) and provide the necessary information for doctors interested in structural outcomes.