What Makes Back Pain So Common?

In years past, healthcare providers would focus the majority of their attention on the physical characteristics of LBP and when treatment results were ineffective, blame psychological aspects for which little, if any, treatment was offered. However, over the last twenty years, the shift towards treating the whole person or adopting the biopsychosocial model (bio- = physical, psycho- = mental, and social = how LBP is perceived and affects daily social interaction) has been emphasized as the appropriate approach when managing patients with low back pain. No longer should the psychological aspect be ignored but rather identified and treated so that this significant barrier to recovery can be properly managed.

Regarding treatment, unless someone presents with a “red-flag”—for LBP sufferers, red flags include cancer, fracture (especially unstable fractures), cauda equine syndrome (spinal cord pinching resulting in bowel / bladder control loss), or infection—immediate/emergent care is not required. A careful health history followed by appropriate tests can usually identify these “red flags.” Otherwise, surgery for LBP is not recommended until at least 4-6 weeks of treatment with non-surgical approaches are first utilized and an identifiable “lesion” can be identified that clearly is causing the presenting complaints and clinical findings. In regards to chiropractic care, all the international guidelines published for treating LBP recommend spinal manipulation BEFORE most of the other non-surgical approaches are tried due to medication side-effects and the successes reported in many studies where spinal manipulation is performed on patients with LBP.