Herniated disc x-ray films are not an accurate way to diagnose any disc pathology or any soft tissue condition, in general. X-rays are used to image bones and do not detail soft anatomical structures. While x-rays may be useful in determining that some form of disc abnormality exists, it is virtually impossible to determine the exact nature of the disc problem without a more comprehensive visualization test, such as an MRI.
This article will explain why the use of x-rays should not be
part of the herniated disc or degenerative disc disease diagnostic
processes, despite the fact that narrowed intervertebral spaces can be
clearly visualized on x-ray images.
Every day, I get letters from patients who say that they were diagnosed with a herniated disc and possibly even a pinched nerve by a doctor or chiropractor who took x-rays. It never ceases to amaze me. X-rays will show a loss of intervertebral disc space, but will usually not be able to determine the cause of the narrowed intervertebral space. After all, there are many reasons for this to occur, ranging from a herniated disc to a ruptured disc to the occurrence of degenerative disc disease.
Normal spinal degeneration or a congenital, genetic or developmental disc abnormality might all look identical on x-ray imaging studies. None of these conditions will be definitively recognizable from an x-ray, nor will their potential effects on the surrounding neurological tissues. The only thing which will be decisively noticed is a lack of typical disc space, with the vertebral bones closer together than would normally occur.
X-rays are terrific for imaging osteoarthritic changes, spinal curvatures, spondylolisthesis, fractures and a host of other bone-related concerns. When used for these purposes, x-rays are still a valuable part of the modern diagnostic arsenal. When used to focus on disc abnormalities, x-rays are a complete waste of time, money and offer an unnecessary exposure to dangerous radiation.
Even though there is a lack of intervertebral disc space noted at a vertebral level, there is no inherent need for concern. Normal spinal degeneration causes this to occur in virtually every human and is especially prevalent in the lower lumbar and cervical spinal regions.
X-rays can not determine which condition is causing this to occur, but will provide the doctor with a reason to order a more detailed test, such as an MRI or CT scan, to better visualize the affected spinal levels. In this regard, x-rays provides a specific purpose. However, x-rays should not be used to make a diagnosis without further and more comprehensive testing via magnetic resonance imaging.
Do not allow any doctor or chiropractor to diagnose a specific disc condition simply based upon x-ray studies. Insist on a better diagnostic tool or find a different doctor who will grant your request for a more comprehensive imaging exam.