It is estimated that more than 75% of humans will experience low back pain at least once during their lifetimes. The good news is that a large percentage of these patients will recover with minimal therapeutic intervention. The bad news is that the chances of reoccurrence are very high, and thus, it is important that the simplest case be managed properly.

Low back pain is known to arise from trauma (acute or several, i.e., repetitive) such as a fall, a motor vehicle accident, a twisting injury, prolonged poor postures, mental stress, fatigue, disc prolapsed, degenerative disc disease, lost flexibility, decreased muscle strength, reduction in joint motion etc.

Causes such as infection, hormonal problems, visceral dysfunction (such as kidney and gynaecological), broken bones, systemic disease, tumours etc require medical intervention and are beyond the scope of this discussion.

Acute low back pain is defined as pain and dysfunction due to low back or back related leg symptoms (radiating or referred pain, tingling and/or numbness) of less than three months. Chronic low back pain is considered pain that lasts longer than three months. Both types of back pain lead to inflammatory processes in the underlying tissue that produce substances that directly or indirectly cause pain, spasm, stiffness and disability. It is important to understand that it is difficult to determine exactly which tissue(s) is responsible for causing the pain; usually it is a combination of several. It could be muscle(s), ligament(s), disc, joint(s) and/or other connective tissue(s). Interestingly, several of them produce similar symptoms, the common one being pain, and thus diagnosing and pin-pointing the exact cause necessitates systematic assessment and skill. In both cases pain in the low back can be accompanied by pain that radiates down the leg or is limited to the buttock region. Sometimes it may be accompanied by painful spasm in the muscles that support the spine.

X rays are of little help in determining the cause of low back pain, except in rare cases of severe trauma or bone pathology – such as fractures, metastasis, infection etc. MRI (magnetic resonance imaging) is effective in isolating defective tissue pathology – such as prolapsed disc(s) and degenerative joint pathologies but research has shown this technique to have a high probability of false positives; thus, these findings have to be closely correlated to clinical findings.