Most of us are aware that the destinies of chiropractic and X-ray have been somewhat intertwined through the years. Both were discovered in the same year (1895), chiropractic, as we know, in the Holy City of Davenport, by D.D. Palmer, and X-ray, by Wilhelm Roentgen in Germany.

B.J. imported the fifth X-ray unit into the United States, and the first west of the Mississippi River. X-ray loomed prominently at the B.J. Palmer Clinic, where it was the basis for listings in Upper Cervical Specific Technique, and it figured prominently in his research. Through the years, X-ray analysis played pivotal roles in many techniques, including Gonstead, Logan, and Biophysics, and the later upper cervical techniques, including Orthogonal, Sweat and Blair.

X-ray, or the restriction thereof, played a role in chiropractic's harassment and persecution by the medical establishment. In my home state of New York, for many years after chiropractic was finally legalized (NYS was the third-to-last state to do so), it was illegal for a D.C. to X-ray above the sella tursica, below the inferior half of the first lumbar, or to X-ray extremities or anyone under 21 years of age. I understand that there are still countries in Europe where chiropractors cannot take X-rays.

I am well aware that there are chiropractic techniques that are "non-X-ray-dependent." Amongst them are Network, and Directional Non-Force Technique (DNFT). The latter is my chief technique. I was taught by the developer himself, Richard Van Rumpt ("Van, the Innate Man"). He was vociferously against "cancer-causing X-rays," and considered them unnecessary.

I respect these (non-X-ray-dependent) techniques (and practice one of them), and I respect the developers and the practitioners, but I respectfully disagree with their non-use of X-ray in day-to-day chiropractic practice.

Then, there are many D.C.s today that do not utilize X-ray as a matter of lassitude rather than conscientious decision-making. The excuses: "I can't get a loan," "the managed care won't pay for X-rays," "people won't pay for X-rays," "people are afraid of X-rays," etc. These are obviously thoughts of those with substantial deficiency of esteem in chiropractic, and self-esteem. What really concerns me is the core excuse: "I don't need X-rays."

There are techniques that take their listings from X-rays, and those that do not. I cannot conceive of a listing as a static thing, which would be the assumption if it were taken from X-rays. (The old-fashioned referral cards with a patient's subluxations, and the listings of those subluxations, are, thankfully, a thing of the past.) However, it is, I believe, illogical to assume X-rays to be unnecessary for D.C.s using techniques that do not derive their listings from X-ray.

Chiropractic analysis is, like any other sort of analysis, a system of deriving questions, and then, seeking the answers. If one asks the wrong questions, or omits one or more relevant questions, the analysis is doomed to be incorrect, or, at best, sub-optimal.

What if a set of X-rays reveals asymmetrical femur heads, or necks, or sacro-iliac joints? What of one or several old, healed compression fractures? What of an "S" shaped cervical curve with multiple breaks in George's Line, with an atlas plane line angle of 30 degrees, and the odontoid bent over to one side (relative to the body)?

My own X-rays show an anterior-leaning military configuration with Phase III+ subluxation degeneration in the cervical spine, with a Grade II+ spondylolisthesis. Sure, I can get adjusted without one seeing my X-rays, but can I get a proper analysis and optimal chiropractic care over time? If we are utilizing less chiropractic science, will we not end up with a lower level of chiropractic art, which is, in the end, the service that we deliver to our practice members?

What could be the philosophical importance of X-ray in chiropractic practice? You and I know that your fresh-in-your-door potential practice member's first subluxation probably occurred a birth, not last week when his or her latest episode of sciatica started. If you cannot replace that person's irrational and uneducated belief that their "problem" started when their pain started, with the truth as we know it, their care, their health, and the health of your practice, is doomed to failure.

Without your input of chiropractic reality, they will either be gone when the pain is gone, or at least minimized, or worse, they will bad-mouth you in your community for not being able to "fix" them in the three visits authorized by their managed care.

A week of pain, even excruciating pain, does not translate into the appreciation of health and chiropractic that will lead that potential practice member to invest the time and money necessary for months of corrective care, let alone a lifetime of wellness care. They will expect and demand "fast, fast relief!" If you do not enlighten them, how can you expect them to act rationally?

Yes, a VSC-based history and exam are important, as is an orientation class BEFORE their Report of Findings, so that they can appreciate the big picture before they are exposed to their individual findings. At that Report, how will you impart their individual history of VSC?

The cliche is absolutely apropos here: "A picture is worth a thousand words." If you can show them advanced subluxation degeneration in their X-rays, you can say, with authority, that their "problem" started many years, if not decades, ago. If you can demonstrate abnormal curvatures, they will be able to appreciate the abnormal biomechanical forces continuously doing nasty things inside.

If you can show them anomalies, such as bent spinouses or asymmetrical neural arches, you might pose the thought: "When you are a child, your bones are soft, yes? If you get subluxated as a child, and you do not get corrected by chiropractic adjustments, could your bones grow in wrong?" (I know, they didn't teach you that in school.)

So, their attention goes all the way back to their childhood (hopefully, you have already inquired as to childhood traumas), and if they have kids at home, they will have them checked "while their bones are still soft."

How about a significant anomaly in the upper cervical spine? You could speak of the very strong possibility of serious birth trauma. At that point, their "problem" becomes as old as they are. At that point, they can become rational, and take rational action in accepting real (as opposed to "band-aid") chiropractic care.

What of your own expectations? What of the potential practice member that has minor complaints and minor exam findings? Your expectations will be short-term as well. You will share your disappointment, and your failure, with that practice member, all for lack of vital information that can easily be had with the use of X-rays.

The argument that X-rays are harmful is a specious one. Of course, X-rays should not be done indiscriminately. However, taking X-rays for the purpose of a more complete understanding of the states of vertebral subluxation complex, and subluxation degeneration, of a practice member is of very great importance that far outweighs the downside of minimal radiation. The effects of VSC are far more serious than the minimal amount of radiation received through a standard chiropractic set of X-rays.