A Patient's Guide to Low Back Pain
Low back pain is one of the main reasons Americans visit their doctor. For adults over 40, it ranks third as a cause for doctor visits, after heart disease and arthritis.   Eighty percent of people will have low back pain at some point in their lives. And nearly everyone who has low back pain once will have it again.  Very few people who feel pain in their low back have a serious medical problem. Ninety percent of people who experience low back pain for the first time get better in two to six weeks. Only rarely do people with low back pain develop chronic back problems.  With these facts in mind, you can be assured that back pain is common, that it usually only causes problems for a short period of time, and that you can take steps to ease symptoms and prevent future problems.

Causes of low back pain:
Why do I have low back pain?   There are many causes of low back pain. Doctors are not always able to pinpoint the source of a patient's pain. But your doctor will make every effort to ensure that your symptoms are not from a serious medical cause, such as cancer or a spinal infection.  The vast majority of back problems are a result of wear and tear on the parts of the spine over many years. This process is called degeneration. Over time, the normal process of aging can result in degenerative changes in all parts of the spine.  Injuries to the spine, such as a fracture or injury to the disc, can make the changes happen even faster. There is strong evidence that cigarette smoking also speeds up degeneration of the spine. Scientists have found links among family members, showing that genetics plays a role in how fast these changes occur.

Symptoms of low back pain
What are some of the symptoms of low back problems?   Symptoms from low back problems vary. They depend on a person's condition and which structures are affected. Some of the more common symptoms of low back problems are:

• low back pain
• pain spreading into the buttocks and thighs
• pain radiating from the buttock to the foot
• back stiffness and reduced range of motion
• muscle weakness in the hip, thigh, leg, or foot
• sensory changes (numbness, prickling, or tingling) in the leg, foot, or toes

Rarely, symptoms involve changes in bowel or bladder function. A large disc herniation that pushes straight back into the spinal canal can put pressure on the nerves that go to the bowels and bladder. The pressure may cause symptoms of low back pain, pain running down the back of both legs, and numbness or tingling between the legs in the area you would contact if you were seated on a saddle. The pressure on the nerves can cause a loss of control in the bowels or bladder.

This is an emergency.
If the pressure isn't relieved, it can lead to permanent paralysis of the bowels and bladder. This condition is called cauda equina syndrome. Doctors recommend immediate surgery to remove pressure from the nerves.

Diagnosis of low back pain:
How will my doctor find out what's causing my problem?   The diagnosis of low back problems begins with a thorough history of your condition. You might be asked to fill out a questionnaire describing your back problems. Your doctor will ask you questions to find out when you first started having problems, what makes your symptoms worse or better, and how the symptoms affect your daily activity. Your answers will help guide the physical examination.  Your doctor will then physically examine the muscles and joints of your low back. It is important that your doctor see how your back is aligned, how it moves, and exactly where it hurts.  Your doctor may do some simple tests to check the function of the nerves. These tests are used to measure the strength in your lower limbs, check your reflexes, and determine whether you have numbness in your legs or feet.  The information from your medical history and physical examination will help your doctor decide which further tests to run. The tests give different types of information.

What Causes Sciatica?
Sciatica is an inflammation of the sciatic nerve, the longest nerve in your body. It runs from your lower spine, through your buttocks, and into your leg and foot. When the sciatic nerve is inflamed, it can cause numbness, tingling, pain, or weakness in your lower back and legs.

Inflamed Joint
If a bone (vertebra) in your lower back isn't moving properly or is out of position, the joint can become inflamed and irritate the sciatic nerve.

Bulging Disc
If one of the cushions (discs) between your vertebrae is bulging, it can irritate or put pressure on the sciatic nerve. 

Muscle Spasm
If a muscle in your back or buttocks is inflamed or tightening (in spasm), it can irritate or put pressure on the sciatic nerve.

How Does a Chiropractor Treat Sciatica?
Dr. Hope is trained to restore the health of your spine and sciatic nerve. Special chiropractic methods, called adjustments, may relieve the irritation that's causing your low-back or leg pain.

Spinal Adjustments
Your treatment depends on the cause of your sciatica. During a spinal adjustment, Dr. Hope gently presses on your spine to relieve irritated nerves and increase movement in your joints.

Related Treatment
Dr. Hope may recommend other types of treatment to relieve irritated nerves. These treatments may include electrical stimulation, ice or heat, massage, traction, or ultrasound. Dr. Hope can discuss these with you personally.