We do get asked a lot by patients when they first come in, whether their spine is out of alignment. While there may be small deviations that have resulted in them experiencing back or neck pain to begin with, a lot of people can be told they have a scoliosis or another type of misalignment, by practitioners who have simply looked at the patient or who don’t have the capability of performing X-rays.

Judging a person’s alignment by just looking at them, especially judging that one shoulder is higher than the other, or one leg is longer than the other – without having X-ray proof often these findings can be completely inaccurate. Looking at someone’s posture as a judge of their alignment is really just scratching the surface of the health of their spine. In reality, especially if you’re a bigger person and not completely skin and bone, the way skin hangs over your body and taking into account the way your muscles hang over your body as well, this can be quite misleading as to how your alignment is positioned underneath.

How To Properly Measure Alignment

From the perspective of a practitioner that works regularly with imaging, sometimes the way a patient presents from a physical examination is completely different when you get the X-ray imaging back. We perform our X-rays standing up, as the spine is a load bearing structure, so to analyse exactly how injuries have occurred it’s very useful to see the spine  actually load-bearing as this will tell us where the structures are being compromised the most. Our specialist software takes the X-ray imaging and we measure up the angles of your spine to see how it’s deviated from its natural alignment, and by how much. If it’s significantly out of alignment, we can explain to the patient how exactly this can affect their back pain and risk of relapsing if their alignment is not corrected, as well as what the prospects are of getting back into a normal, healthy range. Having a spine that’s out of alignment can lead to an all manner of challenges that you might be unaware of in recovering from back pain, neck pain, slipped discs, sciatica and those types of issues.

Is An X-ray Or MRI Better For Measuring Alignment?

A lot of patients wonder whether an X-ray or an MRI is better for diagnosing their problem, and this is only natural since the normal progression of diagnostics under the NHS would be potentially initially having an X-ray followed by an MRI later, they are often thought of as a more useful type of imaging. To be the most helpful to the patient, it’s much better to have an image of the patient standing. In most cases when people come to us, it’s often a last resort meaning they’ve tried visiting their GP, perhaps they might have tried physiotherapy, injections, chiropractors etc. so we need to understand how exactly to treat them in the way that will get them the best results, and understand why their problem hasn’t resolved or responded well to treatment in the past.

To understand all of this, a standing image will give the most information – but a standing MRI is very difficult to do as you’ll have to be stood still for long periods of time – something that a lot of people with back pain may struggle to do. They’re also substantially more expensive – compared to standing X-rays which are relatively inexpensive, a snapshot is taken immediately and it clearly shows a patient’s alignment.

One of the most common misdiagnoses that can occur is distinguishing between an anterior pelvic tilt and a lordosis. The lordosis is the natural curve in the lumbar spine, it should have a backward bend to it around where your trousers or belt will sit. It’s common to have an increased or decreased curve In your lumbar spine – but just by looking at a patient, from the way their glutes hang over their spine and buttocks region, or where someone is storing extra fat tissue or no fat tissue at all, can be quite misleading. In this instance, just looking at a person you can’t objectively say how that person’s spine is actually aligned underneath that tissue, the only way you’re going to get to grips with the patient’s alignment is by doing a set of images.

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Common Misdiagnosis Analysing Alignment

Another common misdiagnosis that can occur is leg length issues, often we hear of patients being told that one leg is longer than the other just by a practitioner looking at their legs while lying down. This is simply not an accurate way to measure a leg length discrepancy, and if you’ve ever had your posture analysed in this way you can find our full article on leg length discrepancy here, Often the leg is measured between the bony bit of your leg at the front of your pelvis, and the ankle. However, as these bones can become rotated it can actually give you an artificially false reading. The most accurate way to measure leg length is through X-ray imaging, which can only be done if there is clinical relevance, with the patient positioned with both heels together. The practitioner will then examine the hip angles at the top of the leg bone, and if there is a leg length difference it can usually be quantified. A difference of a couple of millimetres is unlikely to cause a patient side-effects or impact the patient’s quality of life, but more than a few millimetres and it might be recommended the patient use orthotics to balance out the discrepancy.

If you do think your spine is not aligned correctly, or you have issues with back or neck pain and no-one has explained the impact your alignment can have on your recovery, give us a call. Get in contact with us by calling the clinic on 0203 947 3222 or emailing us at info@themayfairclinic.com, you can also visit our website at www.themayfairclinic.com to find out more information on how we approach these sorts of problems to get your spine back into the right alignment. Remember, if you know someone suffering with back or neck pain, share this article with them using the share options below!