The Gonstead Technique is a popular chiropractic practice method. For decades, it has been a trusted practice among a significant percentage of chiropractors. One essential component of this technique is the frequent use of X-rays for assessment and treatment. 

As chiropractic methods have evolved, however, guidelines for X-rays began recommending a much more limited use since X-rays do not have the usefulness to justify the risk to patients of frequent use. 

This raises serious concerns for us at Bergen Chiropractic. Here we will look into the Gonstead technique and the role of X-rays, explaining why we neither use nor recommend this technique.  

 

What Is the Gonstead Technique?

History

Chiropractor Dr. Clarence Gonstead developed the Gonstead Technique beginning in 1923. It quickly became a famous, preferred method among chiropractors. Its basics are routinely taught in chiropractic schools today. 

 

The Principles of the System

The pelvic girdle (hip and lower back bones) is the body’s foundation. The spinal column is most balanced and stable when the pelvic girdle is level. Any misalignment pressures the spinal discs and compresses and inflames the nerves. Once all affected vertebrae are identified, alignments will focus on those discs to restore healthy motion.

The Gonstead method targets specific, primary areas for adjustment. Studies show that the technique may effectively treat various conditions, including migraines, Bell’s palsy, temporomandibular joint disorder, infertility, and poor posture.

 

The Gonstead Technique’s Five Components

The Gonstead technique consists of five components. The list differs slightly among various sources; some exclude case management. 

Version 1 Version 2
X-rays Visualization
Palpation (Static and Motion) Instrumentation
Instrumentation Static Palpation
Visualization Motion Palpation
Case Management X-Rays

 

Case Management: Understanding the patient’s overall health helps to identify specific areas needing adjustment. 

Instrumentation: Using a Nervoscope probe, the Gonstead method chiropractor measures and compares temperature along the spine to detect inflammation and pressure on the nerves.

Palpation (Motion and Static): The chiropractor feels the spine while the patient is either sitting still (Static) or moving (Motion), feeling for signs of swelling and pain. 

Visualization: The chiropractor observes the patient’s posture, gait, shoulders, and hips to identify potential problems.  

X-rays: The technique uses full spine X-rays for accurate analysis of posture and identification of problems. It is a vital assessment tool of the Gonstead technique. 

 

Our Concerns about the Gonstead Technique

At Bergen Chiropractic, we do not use the Gonstead method of chiropractic practices. Several aspects of the technique concern us greatly, especially the heavy reliance on X-rays to assess patients and guide their treatment plans. 

In our view, this method is outdated. Chiropractic practices and guidelines have evolved since the Gonstead methods were first developed almost 100 years ago. The science has improved, and current guidelines recommend the use of X-rays only when necessary.

We believe that X-rays are not necessary to perform good manipulation and treat patients successfully. The X-rays expose patients to unnecessary radiation and additional expense. It’s not that the adjustments taught in Gonstead are wrong, but the X-ray evaluations have been highly criticized. We’re not moving a bone back into place. 

To better understand our concerns, let’s take a more in-depth look at the use of X-rays. 

 

X-rays in Chiropractic Practice

Controversy and Disagreement

Within the chiropractor community, there has been much debate regarding the use of X-rays. Some consider it a standard part of initial evaluation and believe it necessary for successful patient management. However, even chiropractic schools vary in their teaching, with some supporting more frequent X-ray use.

The American Chiropractic Association’s current guidelines recommend against standard X-ray use. Instead, they should be used only when the chiropractor has reason to believe severe trauma or pathology is involved in the patient’s condition or when treatment does not lead to improvement.  

What has driven the evolution of modern guidelines for less reliance on X-rays is that many of the patient’s concerns don’t show on an X-ray. Most patients can be easily treated with manipulation or mobilization. At Bergen Chiropractic, we choose to follow these modern guidelines.

 

When X-rays Are Inappropriate

For the majority of patients, X-rays are not medically necessary. They are not needed to detect soft tissue problems or neck and back pain. Using X-rays for general purposes, such as exploration or monitoring patient progress, is not helpful. Also, there is no evidence that X-rays can determine the location requiring spinal manipulation. 

Guidelines say that X-rays should only be used when there is evidence of severe trauma or pathology as a cause of the patient’s condition. However,  studies indicate this occurrence between 0.2 and 3.1 percent for pathology as a cause and between 0.2 and 6.8 percent for injury. Given these rates, it isn’t easy to justify the general use of X-rays. 

Patients should steer clear of chiropractors who routinely use X-rays for all patients. Also, if they develop treatments using only X-ray results, it would be wise to seek a second opinion. 

Not only is general X-ray use inappropriate, but it can also be harmful to the patient. While X-rays are safe with minimal use, it still exposes the patient to radiation. Therefore, overuse may put the patient at higher risk of cancer. Routine X-ray use can also lead to overdiagnosis and may even cause the patient undue worry and stress

 

When X-Rays Are Appropriate

X-rays should only be used after the chiropractor determines that manipulations and adjustments have not worked or when there is underlying illness or injury involved, such as scoliosis or fractures. These are cases where an X-ray can provide important information affecting treatment options. In sum, X-rays should only be used when they truly benefit the patient, and even then, they should be used sparingly.

 

Conclusion

The Gonstead technique has played an essential role in the growth of the chiropractic profession. It was developed at a time when X-rays were prevalent and deemed necessary in routine practice. However,  the professional has evolved, and current, accepted guidelines recognize the limitations of X-rays and recommend its limited use. The Gonstead method runs counter to those guidelines. 

We at Bergen Chiropractic choose not to use the Gonstead method. We owe our patients our best judgment regarding their health and safety. For that reason, we will continue to provide the services that produce the best outcomes and improve the quality of their lives.

At the Bergen Chiropractic and Sports Rehabilitation Center, our chiropractic team, led by Dr. Gregory Doerr, follows the highest and most professional medical standards to provide superior chiropractic help. After all, our mission is to provide unparalleled patient care and services in a comfortable healing atmosphere. Contact us to learn more about our chiropractic services!