While cervical disc pathology can unquestionably produce radiculopathy, many patients presenting with arm pain, paresthesia or perceived weakness do not exhibit the clinical behavior of true nerve-root compromise. In these cases, failure to differentiate the primary pain generator may lead to unnecessary spinal injections, nerve ablation procedures or surgical consultation despite limited likelihood of benefit.
The New Jersey Board of Chiropractic Examiners has made a precedential decision, concurring with the Association of New Jersey Chiropractors' (ANJC) position paper on chiropractic X-ray guidelines. In plain terms, the board ruled, consistent with the ANJC position, that insurance companies cannot use medical X-ray rules or recommendations, like those written by the American College of Radiology (ACR), to decide whether a chiropractor's X-ray was necessary.
For decades, chiropractors have been told the answer to more professional referrals is simple: educate medical doctors about chiropractic. There is some truth in that advice; but it is also incomplete. The modern challenge is not simply getting another healthcare professional to know that chiropractors exist. It is becoming the kind of clinician (and building the kind of professional relationship) that makes collaboration easy and sustainable.
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