X-ray Imaging

Digital X-ray imaging in Glasgow and London

A clearer picture to help inform your spinal care. At Reliable Spine, we provide digital X-ray imaging at both our Thornliebank (Glasgow) and Shepherd’s Bush (London) clinics as part of our wider approach to assessing spinal and musculoskeletal conditions when imaging is clinically appropriate.

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Pain, stiffness and restricted movement do not always tell the full story. In selected cases, X-ray imaging can help us examine the structure of the spine, identify relevant bony changes and consider findings that may influence your care.

Having digital X-ray facilities in-house allows us to integrate imaging into the assessment process when indicated, rather than relying solely on information from a physical examination or arranging imaging elsewhere when suitable in-house imaging is available. Our goal is not to X-ray everyone. It is to use imaging when it can help answer a relevant clinical question and inform an appropriate care plan.

Why do chiropractors take X-rays?

A clinical examination provides important information about your symptoms, movement, medical history and function. However, there are situations where additional information about the bones and structure of the spine may be useful. When clinically justified, X-ray imaging can help us assess certain structural features that may be relevant to your presentation.

Assessing spinal bone structure

X-rays can show the alignment and appearance of the vertebrae, the bones that form the spine. Depending on the area imaged, they may help identify certain structural changes, including degenerative changes, some fractures and other bony abnormalities. These findings can provide additional context when considered alongside your symptoms and examination.

Investigating relevant clinical findings

Sometimes a patient’s history or examination raises a question that cannot be adequately answered through physical assessment alone. Where X-ray imaging is appropriate and likely to influence clinical decisions, it may help clarify aspects of the spinal structure. If the clinical question requires a different type of investigation, such as an MRI to assess discs, nerves or other soft tissues, we will explain this and advise on appropriate referral.

Supporting safe clinical decisions

Imaging can sometimes identify findings that affect whether a particular treatment is suitable. For example, certain structural abnormalities may mean that a proposed treatment should be modified, avoided or discussed with another healthcare professional. X-rays are therefore one potential source of information within a wider clinical assessment, rather than a stand-alone test that determines the entire treatment plan.

Why do we offer digital X-rays in-house?

At both Reliable Spine clinics, having digital X-ray facilities available on site can make the assessment process more convenient when imaging is indicated.

• A more integrated assessment. When an X-ray is clinically justified, in-house imaging allows us to incorporate the relevant images into our assessment process, considering the clinical history, examination findings and imaging together when discussing your options.
• Greater convenience. Depending on your circumstances and the imaging required, having facilities at the clinic may reduce the need to arrange a separate visit to another imaging provider. Whether imaging can be performed on the same day will depend on clinical suitability, the necessary procedures and appointment availability.
• Digital images for clinical review. Digital imaging allows X-ray images to be viewed electronically, making them available for clinical review and appropriate storage. Images can also be shared with other healthcare professionals when needed and with appropriate arrangements in place.

We do not believe that everyone attending a chiropractic clinic needs an X-ray. Imaging should only be considered when there is a clear clinical reason, the expected information may be useful and the benefits justify the radiation exposure. If an X-ray is unlikely to change your management, it may not be necessary.

How can X-rays help us customise your care plan?

Every patient presents differently. Two people may report similar back pain but have different histories, examination findings and clinical needs. When imaging is justified, the findings can contribute to a more informed discussion about your care.

1. Understanding relevant structural findings. X-rays can provide information about the appearance and alignment of the bones in the imaged area, and may reveal certain degenerative or other structural changes that need to be considered alongside your symptoms. Not every finding seen on an X-ray is responsible for pain; we consider the images in the context of your clinical presentation.
2. Considering appropriate treatment options. Some imaging findings may influence the treatment options that are reasonable to consider. The care plan is based on the combined information from your history, examination and any relevant investigations, not the X-ray alone.
3. Identifying when further investigation may be needed. An X-ray does not show every structure in the spine in detail and is particularly limited for assessing discs, nerves and many soft-tissue conditions. If your symptoms or examination suggest that further investigation is needed, we may recommend additional imaging or specialist assessment.
4. Helping you understand your findings. We aim to explain relevant findings in straightforward language and discuss how they may, or may not, relate to your symptoms, so you can make informed decisions about your care.

Digital X-rays and radiation safety

We understand that patients may have questions about radiation exposure. X-rays use ionising radiation to create images of structures inside the body, so each examination must have a clear clinical justification. Digital X-ray technology can support efficient image acquisition and dose optimisation. However, digital imaging does not automatically mean that every X-ray uses less radiation than every conventional system; the dose depends on the equipment, the body region, the number of images and the examination technique. At Reliable Spine, patient radiation exposure should be kept as low as reasonably practicable while still obtaining images of sufficient quality to answer the clinical question.

How much radiation does an X-ray use?

The dose varies according to the part of the body being examined. For context, UK guidance gives typical effective doses of approximately:

• Neck (cervical spine): 0.08 mSv.
• Lower back (lumbar spine): 1.3 mSv.

These are national typical-dose figures, not measurements of the dose you would receive at Reliable Spine. Your actual exposure may differ depending on the examination and equipment. Radiation exposure can also be compared with natural background radiation or exposure during air travel, but the comparison depends on the X-ray examination and the flight conditions, so we avoid suggesting that every spinal X-ray is equivalent to one hour of flying.

Is digital X-ray imaging safe?

When medically justified and performed with appropriate safeguards, diagnostic X-ray imaging is widely used in healthcare. However, the exposure is not entirely risk-free, and the potential benefit must be weighed against the small potential radiation risk. We consider whether imaging is necessary before proceeding and aim to avoid unnecessary or repeated examinations.

Regulation, equipment and radiation protection

Medical X-ray imaging in the UK is subject to radiation-safety requirements designed to protect patients, staff and the public. Two important regulatory frameworks are relevant:

• Ionising Radiations Regulations 2017 (IRR17): these address the safety of people working with ionising radiation, including requirements relating to radiation risks and safe working practices.
• Ionising Radiation (Medical Exposure) Regulations (IR(ME)R): these govern medical exposures and include requirements relating to justification, optimisation and the responsibilities of those involved in requesting, authorising and carrying out examinations.

The requirements are distinct but complementary. Equipment must be appropriately installed, tested, maintained and subject to quality assurance, with suitable radiation-protection arrangements in place. Each proposed examination should be clinically justified, and the radiation dose should be optimised for the diagnostic purpose. If you have questions about why an X-ray has been recommended, we will explain the clinical reason and discuss the relevant benefits and risks before proceeding.

What happens during an X-ray appointment?

If imaging is considered appropriate, the process will generally involve the following steps.

1. Clinical review: we consider your symptoms, history and examination findings to establish whether an X-ray is justified.
2. Explanation and preparation: we explain the proposed examination and provide any relevant instructions. Please tell us if you are pregnant or think you may be pregnant before an X-ray is performed.
3. Image acquisition: you will be positioned for the required views and asked to remain still briefly while the images are taken.
4. Image review: the images are reviewed in the appropriate clinical context. If additional investigation or a specialist report is needed, we will explain the next steps.
5. Care planning: where relevant, the findings are considered alongside your symptoms and examination to inform the discussion about suitable care options.

Frequently asked questions

Does every chiropractic patient need an X-ray?

No. X-rays are not necessary for every patient. They should be taken only when there is a clinical reason and the expected benefit justifies the radiation exposure.

Can an X-ray show a slipped or herniated disc?

A standard X-ray does not directly show a disc herniation. It primarily shows bones and certain structural features. MRI is generally more suitable when detailed assessment of discs, nerves and other soft tissues is required.

Will an X-ray tell you exactly what is causing my pain?

Not always. Imaging findings need to be interpreted alongside your symptoms and examination. Some structural changes are common in people who have no pain, so an X-ray result does not automatically establish the cause of your symptoms.

Is digital X-ray better than conventional X-ray?

Digital systems allow images to be captured and reviewed electronically and can support dose optimisation. The actual radiation dose depends on the equipment and examination technique, so digital imaging should not automatically be described as lower-dose in every situation.

Can I have an X-ray at either Reliable Spine clinic?

Both our Thornliebank and Shepherd’s Bush clinics have digital X-ray facilities. Whether imaging is appropriate for you depends on your clinical presentation and the relevant examination requirements. We will discuss this with you before proceeding.

This page is for general information and does not replace individual medical advice. X-ray imaging is recommended only when clinically justified. The need for imaging and the appropriate care plan depend on your individual circumstances.