Low back pain (LBP) is one of the most common reasons patients seek out Chiropractic care, and they appreciate being told what is causing their back pain. This is why doctors gather a careful and complete history from new patients and perform a physical examination. Once the “pain generator” is determined, a doctor can discuss various treatment options and develop a plan for managing the patient. Let’s review some causes of LBP!
If we divide the various conditions into three categories, it significantly improves diagnostic accuracy. These include: 1) Mechanical LBP; 2) Nerve root pain; and 3) “Red Flags” (serious conditions). The most common conditions are those belonging to the first group. The following is a partial list of conditions that belong to each category:
The majority of patients suffering from LBP fall into the first two categories, and the HISTORY can tell us a lot! If the patient complains of pain that stays mostly in the low back but may spread into the buttocks or thigh without numbness/weakness in the leg and feels better with leaning forwards or curling up in a ball, it probably is a Group 1 (mechanical) diagnosis. If there is numbness, tingling, and/or weakness in the leg to the foot and bending over hurts, it’s most likely disk derangement (bulge, herniated, etc.) with a nerve pinch. If there is unexplained weight loss, a past history of cancer, non-responding LBP to treatment, sleep interruptions, and age >50 years old, we may now be in category three and further tests are needed!
The IMPORTANT point is that spinal manipulation (chiropractic) can manage the most common causes of LBP as a non-surgical, low-risk form of care.