Low back pain
Low back pain is one of the most common reasons people consult. It can come on suddenly, after lifting or an awkward movement, with the feeling that the back has locked up. It can also settle in gradually, or return in repeated episodes.
Some episodes improve in a few days or weeks. Others persist or recur. Joints, muscles, discs and nerve roots can all contribute, as can factors such as sleep, activity level and work posture. The assessment aims to sort out what is involved in your situation.
When pain travels down the leg, the page on sciatica describes the specific aspects of the assessment.
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When to see a doctor without waiting
Some signs call for prompt medical assessment rather than a chiropractic appointment. See a doctor right away, or go to the emergency department, if back pain comes with any of the following:
- Loss of bladder or bowel control, or difficulty urinating
- Numbness in the genital area, inner thighs or around the anus
- Weakness in the legs that is getting worse
- Fever, unexplained weight loss or a history of cancer
- Constant pain that does not ease with rest or at night
- Pain following a fall or significant accident, particularly in someone with osteoporosis
What an assessment involves
Screening for warning signs
Before anything else, the examination aims to rule out signs that may point to a condition requiring medical investigation. If one is present, you will be referred to a doctor.
The history of your pain
How it began, whether it is a first episode or a recurrence, what aggravates and relieves it, how it affects work and sleep, and what has already been tried.
The clinical examination
Movement of the lower back and hips, joints and muscles, and a neurological examination of the legs when indicated.
The sustaining factors
Work posture, activity level, sleep and apprehension about movement can influence how back pain evolves. They form part of the clinical picture.
A plan discussed with you
If chiropractic care is indicated, your chiropractor explains the options and the reasoning behind them, and gives you an estimate of how long care should last and how many visits to expect. If it is not, he will tell you and direct you to the appropriate professional.
Care, when indicated
Depending on what the assessment shows and on your preferences, care may include manual techniques, myofascial therapy, spinal mobilisation or manipulation, and an exercise programme adapted to your situation. Advice on staying active, lifting and returning to work is also part of it.
Progress is reassessed at planned intervals. If your condition does not evolve as expected, or if further tests such as imaging appear necessary, your chiropractor will refer you to your doctor.
When back pain has lasted several months, the page on chronic pain and complex conditions describes the approach to persistent pain.
Common questions
Should I rest in bed?
Current guidelines generally favour staying active, with activities adapted to the pain, over complete bed rest. Your chiropractor will advise you based on your situation.
Do I need an X-ray or MRI?
Imaging is not requested routinely. It is considered when clinical signs warrant it or when the condition does not evolve as expected. If you already have imaging results or reports, bring them to your first visit.
How many visits will I need?
It depends on your situation. After the assessment, your chiropractor will give you an estimate of how long care should last and how many visits to expect.
Talk to us about your pain
Reach our team directly. No online form needed.