The next step in the process was an X-ray. Having an X-ray done of your spine can help the chiropractor determine your treatment plan and can aid in the adjustment. That said, not all chiropractors will recommend an X-ray at your appointment. It turns out some chiropractors say that X-rays should be part of routine chiropractic care, while others argue X-rays aren't necessary for every patient. When researching potential chiropractors, feel free to ask if they recommend X-rays for all patients and how the X-rays can benefit your treatment plan.

A 2006 systematic cost-effectiveness review found that the reported cost-effectiveness of spinal manipulation in the United Kingdom compared favorably with other treatments for back pain, but that reports were based on data from clinical trials without sham controls and that the specific cost-effectiveness of the treatment (as opposed to non-specific effects) remains uncertain.[161] A 2005 American systematic review of economic evaluations of conservative treatments for low back pain found that significant quality problems in available studies meant that definite conclusions could not be drawn about the most cost-effective intervention.[162] The cost-effectiveness of maintenance chiropractic care is unknown.[12]
All treatment is based on an accurate diagnosis of your back pain. The chiropractor should be well informed regarding your medical history, including ongoing medical conditions, current medications, traumatic/surgical history, and lifestyle factors. Although rare, there have been cases in which treatment worsened a herniated or slipped disc, or neck manipulation resulted spinal cord injury. To be safe, always check with your medical doctor to make sure your condition will benefit from chiropractic or other pain relief alternatives. 
Studies have not confirmed the effectiveness of prolotherapy or sclerotherapy for pain relief, used by some chiropractors, osteopaths, and medical doctors, to treat chronic back pain, the type of pain that may come on suddenly or gradually and lasts more than three months. The therapy involves injections such as sugar water or anesthetic in hopes of strengthening the ligaments in the back.
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