Eight out of ten people in the United States will experience at least one episode of low back pain throughout their lifetime. Some people might suffer from severe, acute episodes, with possible recurrences, while other people might suffer from chronic pain that never resolves. The total expenses related to this epidemic alone exceeds 50 billion dollars per year. Low back pain is the second leading reason why people visit the doctor. (The number one reason is for the treatment of colds and flus.) This problem has reached epidemic proportions.

Low back pain can be complex, with no simple solutions or explanations. Pain comes in all shapes and sizes and for different reasons. The most important tool when evaluating a patient with lower back pain is the history. A careful, detailed history can offer enough clues for the chiropractic doctor to determine a probable cause and/or causes, and the appropriate management of the patient. The history is usually followed by a physical examination, including, orthopedic and neurological testing, a functional assessment, palpation, x-rays and laboratory tests if necessary.

There can be various causative factors involved in the production of low back pain. Causes of low back pain can be biomechanical or systemic. Usually, the cause is benign, non- specific and uncomplicated, the result of improper biomechanics. These causes can be perpetuated by poor posture, inappropriate body mechanics while lifting objects of any size or weight, a functional or structural short leg, muscle imbalances and more. Other causes can include previous trauma, a herniated disc, chronic, degenerative disorders, such as, spondylosis deformans (arthritis of the spine), ankylosing spondylitis and other specific, but less common diseases.

Systemic causes can arise from organic origins, such as, kidney stones, kidney and bladder infections, pancreatic cancer, and prostate cancer in men. When back pain is from an organic origin, there are usually other symptoms that accompany it. For example, prostate cancer, found in men usually over the age of fifty, can travel to the bones of the pelvis and low back, resulting in low back pain. Of course, this is in the advanced stages after the cancer has metastasized. This is a less common concern for most people, especially when considering the whole spectrum of low back pain, but in men over fifty, this possibility should be ruled out after a thorough examination by your doctor. Kidney stones, kidney infections and bladder infections can also cause low back pain. Most people with a kidney stone suffer from severe, acute pain that is relieved once the stone passes. Kidney and bladder infections are less dramatic, however, can still be extremely painful. Orthopedic and laboratory tests are useful in confirming these types of causes.

Low back pain from biomechanical or structural causes is more common in people of all ages. Low back pain is usually not serious, but anyone who has suffered from it, can attest to the discomfort and debilitation it causes. You need to see a medical or chiropractic doctor to determine the cause of your low back pain. At that point, the appropriate management of your condition can be determined. Chiropractic care can be extremely effective in the treatment of certain types of low back pain. In a study by the RAND corporation, which is now endorsed by the federal government, the guidelines for the care of low back pain include chiropractic manipulation.

Louis S. Pastis, D.C. is in private practice in Pasadena, California. He earned his Bachelor's of Science degree in Nutrition from the University of Arizona and his Chiropractic degree from the Los Angeles College of Chiropractic. He can be reached at www.syner-quest.com.