Back pain, both upper and lower, is an incredibly common complaint, in fact it is one of the most common reasons for people missing work. Lower back pain is the single leading cause of disability worldwide.
When it comes to sources of pain in the back we can simply separate it into pain originating from muscular, joint and neurological structures.
The joints of the spine include the weight-bearing disc and the movement-controlling facet joints. Injuries to either of these structures can cause localised pain that is exacerbated by certain movements. Disc related pain is typically worse on forward bending and facet related pain typically worsens on extension (or backward bending.
If the injury and subsequent damage to these structures is great enough there may be resultant compression or injury of nerve roots as they leave the spinal cord and exit the spine. This may result in both localised pain and radiating pain or symptoms that spread away from the spine, including into arms or legs.
The final piece of the puzzle is the involvement of the muscle that surrounds, stabilises, and moves the spine. Direct injury to muscle may result in tears or spasm, while injury to other structures may result in muscle spasm in an attempt to protect the region, or as a result of altered mechanics.
Most back pain will be a combination of these sources and it is extremely important for a careful history taking and examination to be done to determine the exact mechanism of injury and particular structures that may be damaged. Only then can an accurate diagnosis be made and appropriate treatment be performed or prescribed.
Chiropractors are trained specifically in neuromusculoskeletal conditions, making them well equipped to examine and treat back pain. As primary spinal care practitioners their role is to be the first stop for back pain patients, and then provide the appropriate care or refer to the relevant specialists when needed.