Not necessarily.
This is one of the most common questions people ask before starting chiropractic care — and a really important one.
The Short Answer?
X-rays are not needed for everyone.
In many cases, your chiropractor can assess, diagnose, and begin treatment without needing to see an image of your spine.
They’ll use a combination of:
• Health history
• Physical and orthopaedic examination
• Neurological tests
• Postural and movement analysis
From this, they can often get a very clear picture of what’s going on — without needing an X-ray at all.
So When Would an X-ray Be Needed?
While not routine, X-rays may be recommended if your chiropractor suspects something that needs deeper investigation — such as:
• Significant trauma (e.g. car accident, fall)
• Signs of degeneration or arthritis
• Unexplained or worsening symptoms
• Suspicion of a structural abnormality
• Red flags like sudden weight loss, night pain, or neurological symptoms
In these cases, imaging can help confirm a diagnosis, rule out serious pathology, or simply give a clearer view of what’s happening under the surface.
But What About Clinics That Take X-rays for Everyone?
Some chiropractic clinics take routine X-rays on all new patients, regardless of symptoms. This is controversial — and not always in line with current clinical guidelines.
Why?
Because X-rays do expose you to radiation.
Yes, modern digital imaging is low-dose — but it’s still radiation. And exposure should be clinically justified, not used as a blanket rule.
Current recommendations (from bodies like NICE and the General Chiropractic Council in the UK) suggest that imaging should only be used when:
• It will change or inform the care plan
• It’s needed to rule out a serious condition
• Or when a patient hasn’t responded to conservative treatment
In other words: not just because.
What If I Do Need One?
If your chiropractor determines that an X-ray would be helpful — and you agree — they’ll either refer you to a local imaging centre or, if they have the equipment, take it in-house.
Either way, they should explain:
• Why it’s needed
• What they’re looking for
• What the risks and benefits are
• And how the results will guide your care
This is part of a process called informed consent — where you’re fully aware of all the facts before making a decision.
The Bottom Line Is..
• You do not need an X-ray just to see a chiropractor.
• You do not need one just because you’re in pain.
• But you might need one if something in your assessment suggests it’s clinically necessary.
A good chiropractor will explain their reasoning, answer your questions, and work with you to make a decision that’s right for your body and your health.
You should never feel pressured — only informed.
