In the medical model, technicians often have the patient lie down for X-rays and MRIs. It is very rare for a patient to be injured in a lying down position. Many times when people have come to us as a last resort, their doctor has not been able to clearly tell them why they are in severe constant pain. When we take the seated X-rays, all of a sudden a severe spinal curvature pattern is revealed that was not seen standing or lying down.
In a scenario like this, most doctors X-ray and evaluate the local pathology, but do not look at position of injury. Meaning, if they were to take a series of segmental X-rays standing on the lower back spine and then a series of lower back X-rays in the seated position. In the majority of cases the structural damage would be much more severe in the seated position than the standing.
We see this discrepancy because it refers to the root of the issue. This is exactly why evaluations need to be taken in the position of injury. Never being able to see the full extent of a problem because of how a picture is taken is unfortunate¦ That™s why my Dad termed it the sad tale of the missing injury.
Seated Injuries = Seated X-rays
If your injury occurred in the seated position (e.g. vehicle accidents, slip-and-falls, forward bending lifting), then a seated full-spine X-ray is needed to show the full extent of the injury.
We take full spine X-rays in two different positions of stress: standing and seated. People ask, Why do you do that? Why not just look at the spine in the standing position?
What position was the person in when they were injured? Does your pain change from one position to the next? The patient then tells their history. If their injury occurred while seated, then we should really study their injury in that position.
What we see over and over again in full-spine X-ray evaluations is that the severity of the spine is far more severe when a person sits than when they stand. The curvature of the spine changes dramatically from the standing position to the seated position. In cases where it does not change (e.g., an elderly person severely hunched forward in both standing and seated positions. These types of cases are more difficult to help. The more the spine changes from one position of stress to the other, the better the prognosis.