When to get a spinal X-ray for back pain

If you’ve turned to a physician for help with your back pain, a spinal X-ray may be recommended as part of the diagnostic process. X-rays are simple, fast and painless outpatient imaging tests that can reveal several different problems within the spine. However, many back problems go away on their own, so your physician may recommend that you delay diagnostic imaging and allow your body a bit of time to heal.

How do spinal X-rays work?

X-rays send powerful beams of energy (photons) through the body. These photons pass through soft tissues but are absorbed by dense tissues, such as bones. On an X-ray image, tissues that have not absorbed the radiation (muscles and ligaments, for instance) show up as black, while tissues that have absorbed the radiation show up as white. The images produced by X-rays are known as radiographs.

What can an X-ray diagnose?

An X-ray for back pain may be useful if your physician suspects that you might have:

  • A fracture
  • A broken bone
  • Arthritis
  • Spondylolisthesis (vertebral slippage)
  • Degenerative disc disease
  • Kyphosis (forward rounding of the spine)
  • Scoliosis (a sideways curvature of the spine)

X-rays are not capable of showing damage to nerves or other soft tissues, however. If your physician suspects this sort of issue, he or she might recommend a different diagnostic test, such as a CT scan or MRI. A bone scan or diagnostic injection may also be used to help pinpoint your specific diagnosis.

What happens after an X-ray for back pain?

Spinal X-rays are outpatient procedures, which means you’ll most likely be able to go home right after your test. Results can be available in as little as a few hours, although in some situations the images can take a few days to process and interpret. Your physician will reach out to you as soon as he or she has the results.

Once your physician has evaluated your diagnostic images, he or she can then determine the best approach to treatment. This may include medications, exercises, therapeutic injections, physical therapy and hot/cold therapy. Most likely, surgery will not be recommended in the initial stages of treatment — or perhaps even at all — depending on your body’s response to conservative care. Your physician can help you explore various options based on your specific diagnosis and other individual factors.