Making a Back Pain Diagnosis: Imaging Tests X-Ray

Making a back pain diagnosis may include imaging tests to view the structures involving the spine, such as the discs, facet joints, and ligaments and joints of the spine. Following the physical exam, the doctor may order an X-Ray to measure the distance between the vertebral bones to address possible degenerative joints disease, look for scoliosis, and observe whether the lateral and vertical curvature of the spine is normal. Though the CT Scan and MRI both show more in-depth detail of the soft tissues of the spine, X-Ray tests are often good enough to give doctors the appropriate amount of information they need.

X-Rays are the oldest imaging tests used to see the interior structures of the body to check for bone fractures, alignment of the spine, and osteoarthritis. X-Ray imaging involves shooting an X-Ray beam from an X-Ray machine. The beam is emitted from one side of the patient and captures on the opposite side. Some elements and structures of the patient are more likely than others to block the penetration of the X-Ray beam, which accounts for the various degrees of light and dark that are produced on an X-Ray image. For example, the calcium in bone blocks penetration of the X-Ray beam and the image of a bone is picked up as a shadow on the X-Ray film. Usually on an X-Ray, the bones project as lighter and joint cartilage project as darker. Doctors can assess for degenerative diseases such as arthritis and degenerative disc disease by observing the space between bones in the elbow, knees, hips, and vertebral bones. To take an X-Ray, a radiographic (X-Ray) technician will have you lie on a table while an X-Ray machine passes low-level radiation through your body to project a picture called a radiograph on a piece of film. In some clinics and chiropractic offices, the technician will ask the patient to stand for X-Ray pictures.



A plain X-Ray mostly provides information of the bones and spaces between the bones. The X-Ray will also show certain bony changes in the spine, helping doctors diagnose such diseases as ankylosing spondyloarthropathies. The X-Ray procedure is not painful. In fact, patients don't feel anything at all during the procedure, except for the possibly difficulty of having to get on the table or holding certain positions for a number of seconds or minutes. If you are fearful of the procedure or have difficulty sitting up or holding a standing position for a period of time, speak up. The technician will be able to help you about your fear of the procedures, or be able to get another tech to assist you with moving into, and holding, the proper position for the procedure.

X-Ray procedures are safe, unless you are repeatedly having them, or are pregnant. If you are pregnant, or suspect that you are pregnant, you should give the medical personnel that information. Pregnant women should not have an X-Ray. It is impossible to get an X-ray of the lumbar spine without the reproductive organs absorbing radiation, potentially threatening the developing fetus.

Your doctor may order an X-Ray if the patient's medical record or something they found in the examination indicated possible musculoskeletal problems such as ankylosing spondylitis and other spondyloarthropathies, vertebral misalignment (vertical or lateral), vertebral fracture, or osteoarthritis.

Click here to learn more about the CT Scan as a diagnostic tool for diagnosing the cause of back pain.