Low back pain is one of the most frequent problems treated by chiropractors. Four out of five adults will experience significant low back pain sometime during their life. After the common cold, problems caused by the lower back are the most frequent cause of lost work days in adults under the age of 45.

Most cases of low back pain are not serious and respond to simple treatments. Your chiropractor can accurately diagnose and effectively treat most types of low back pain in the office. You will be asked about the nature of your symptoms and whether you sustained an injury. You also will have an examination of your spine and legs. For many episodes of low back pain no expensive tests are needed for initial assessment and treatment.

In some cases, imaging tests may be required. Plain X-rays will show arthritis and bone diseases. For conditions or injuries that involve the soft tissues, a CT scan or MRI may be needed. Occasionally, a bone scan will be needed to assess bone activity and electrical tests, EMG may be needed to determine if the spine condition has caused nerve or muscle damage.

Low back pain can be caused by a number of factors from injuries to the effects of aging.

Low Back Sprain and Strain - A sprain of the low back can occur when a sudden, forceful movement injures a ligament which has become stiff or weakthrough poor conditioning or overuse.

These injuries, are the most common causes of low back pain. Frequently, a combination of other factors may increase the likelihood of injury or disease:

• poor conditioning
• improper use
• obesity
• smoking

The natural effects of normal aging on the body, in general, and low back, in particular, are osteoporosis or decreased bone density; decrease in strength and elasticity of muscles; and decrease in elasticity and strength of ligaments

Although you cannot totally halt the progress of these effects, they can be slowed by regular exercise, knowing the proper way to lift and move objects, proper nutrition, and avoidance of smoking.

Age - "Wear and tear" and inherited factors will cause degenerative changes in the discs, called degenerative disc disease, and arthritic changes in the spinal joints. These changes occur to some degree in everyone. When severe, they can cause low back stiffness and pain. Arthritic bone spurs and inflamed joints can cause nerve irritation and leg pain.

Osteoporosis and Fractures - All bones lose bone strength over time and the lumbar vertebrae, particularly in postmenopausal women, can be fractured or compressed from a fall or even from the stress of lifting or everyday activities.

Protruding Disc - The disc is composed of a soft center or nucleus, which, in children and young adults, is jelly-like. The nucleus is surrounded by a tougher outer portion called the anulus. With normal aging, the nucleus begins to resemble the anulus. During middle-age, fissures or cracks may occur in the disc. These may be the source of back pain. If the crack extends out of the disc, material from the disc may push out or rupture. This often is referred to as a herniated or slipped disc. If the protruded disc presses a nerve, it may cause pain in the leg.

Most low back pain can be safely and effectively treated following an examination by your chiropractor and a prescribed period of treatment to relieve the pain and diminish the inflammation. Although a brief period of rest may be helpful, most studies show that light activity speeds healing and recovery. It may not be necessary for you to discontinue all activities, including work. Instead, you may adjust your activity under your chiropractor's guidance.

Once the initial pain has eased, a rehabilitation program may be suggested to increase your muscle strength in your low back and abdominal muscles as well as some stretching exercises to increase your flexibility. Weight loss if you are overweight, and quitting smoking if you are a smoker, also will decrease the chances of a recurrence of your low back pain. The best long-term treatment is an active prevention program of maintaining your physical condition and observing proper lifting and postural activities to prevent further injuries.

Most low back pain, whether acute or chronic, almost always can be treated without surgery. The most common reason for surgery on the lower back is to remove the pressure from a "slipped disc" when it causes nerve and leg pain and has not responded to other treatments.

The normal effects of aging that result in decreased bone mass, and decreased strength and elasticity of muscles and ligaments, can't be avoided. However, the effects can be slowed by:

• exercising regularly to keep the muscles that support your back strong and flexible
• regular chiropractic treatments
• using the correct lifting and moving techniques; get help if an object is too heavy or an awkward size
• maintaining your proper body weight; being overweight puts a strain on your back muscles
• avoid smoking
• maintaining a proper posture when standing and sitting; don't slouch