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Back pain/ leg pain X-ray

X-ray usually includes anterior -posterior (front/back) and lateral (side) images.

It may also include bending forward and backward (flexion-extension) images if you also have leg pain/ numbness/ tingling. This is to look for instability.

Fractures, infection or instability are concerning. Most have some degenerative disease with age, and is not necessarily the cause of the back pain

a: Normal

b: Mild degenerative disease with development of bone spurs and decrease in disc space

c: Moderate degenerative disease with further decrease in disc space with more prominent bone spurs.

In this degenerative disease, there is sliding of a vertebra away from the normal alignment (spondylolisthesis). Flexion and Extension X-rays can see if displacement changes significantly during flexion vs extension. If it does, and if the resulting nerve pinching corresponds to your symptoms, then it means there is instability.

Fracture of a vertebral body causing “compression fracture”. Unless new or causing severe or worsening nerve compression, this is managed conservatively (medicines, exercises, fall prevention). Bone density test/scan can also be done to see if weak bones are contributing to the fracture (osteoporosis)


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