Unless you have had a history of trauma, cancer or other more serious symptoms you do not need x-rays. Research has clearly showed the things that show up on x-rays such as arthritis/degeneration, misalignment etc… are not related to pain. You could take an x-ray of a group of people who never/rarely gets back pain and the findings will be almost identical to someone who has back pain. The Chiropractic Board of Australia strongly recommends against the use of x-rays without proper clinical justification. Taking x-rays to look for misalignments & arthritis is not clinical justification & goes against not only chiropractic, but medical & physiotherapy guidelines.
I have seen them used countless times as a scare tactic and a marketing scam. Someone has back pain, they get x-rays taken, told there “spine is out” and they have “arthritis” (which everyone has) and that’s the cause of their pain & will need to commit to excessive & expensive “care plans” & out of fear a more likely to do so. A 2019 study in the prestigious European Spine Journal found imaging in low back pain is associated with higher treatment costs & increased treatment utilization. Which is great if you’re a dishonest practitioner or therapist looking to increase profits.