Let me add further here.
X-Ray changes are non specific regarding the disc lesions. However, X-rays are usually required to rule out the other pathologies like fractures, mechanical derangements likespondylolisthesis, spodylosis, spondlolysis, diffuse idiopathic skeletal hyperostosis (DISH), inflamatory arthropathies like Ankylosing spondylitis showing fusion of
SIJ, congenital anomalies like hemivertebra, spina bifida, measuring the degree of
scoliosis or kyphosis, watch the osteolytic or osteosclerotic lesion indicating bone tumours, vertebral collapse due to osteomyelitis, potts disease ( to assess the psoas abscess), etc.
Spinal X-Rays in a patient with back pain are required if the pain:
a- Start before the age of 20 and after 50 years
b- is persistent and a serious cause is suspected.
c- is worse in the night and in the morning, when an inflammatory arthritis(e.g. Ankylosing sponylitis), infection or a spinal tumour may be the cause.
d- is associated with a systemic illness, fever or weight loss
e- is associated with neurological symptoms and signs.
Spinal myelography, CT Scan both contrast or plain,MRI of spinal provide better and detailed interpretation of soft tissue and bony tissue.
I think that it is sufficient to make the discussion more clear. Any more ideas are welcomed.