There are many different types of back pain, with different causes. The key to getting the right treatment is to establish which type of back pain you may be suffering from and to seek advice if it is not improving.

Your spine is one of the strongest parts of your body. It is made of solid blocks of bone known as vertebra, joined together by softer pads or discs which act as shock absorbers and maintain flexibility. Your back is reinforced by strong ligaments, surrounded by powerful muscles for support. It is, in fact, surprisingly difficult to damage your spine.

Mechanical Low Back Pain

The majority of people with back pain are suffering from what is known as ‘simple’ or ‘mechanical’ back pain. This means that the pain is not related to any serious underlying condition and there are no trapped or compressed nerves. We do not always know the exact tissues that are involved in simple back pain. Muscles, joints and ligaments can all be involved. Simple back pain can be caused by poor posture, prolonged sitting in an uncomfortable position, and even muscular tension due emotional or work-related stress.

Age  related

As we get older, wear and tear may contribute to back pain. The shock-absorbing pads or discs between the bones of the back can narrow with age and this can cause stiffness, pain and make it difficult to move.

Nerve Irritation

Simple back pain is relatively common. Less frequently, the nerves of the back can sometimes become irritated, compressed or trapped. Again, there can be many reasons why this happens, but slipped discs or wear and tear can lead to pain spreading down the leg, which is commonly referred to as sciatica. This can be accompanied by pins and needles, tingling, numbness and weakness in all or part of the leg and foot.

Sacroiliac Joints

The sacroiliac joint connects the sacrum (triangular bone at the bottom of the spine) with the pelvis (iliac bone that is part of the hip joint) on each side of the lower spine. It transmits all the forces of the upper body to the pelvis and legs. There is not a lot of motion in the joint and it is very strong and stable.

It is not clearly understood why sacroiliac joint dysfunction occurs, although some believe it is due to a limitation in its normal motion patterns and/or misalignment of the joint. Sacroiliac joint (SI joint) pain typically results in pain on one side very low in the back or in the buttocks. Another term for sacroiliac joint pain is sacroiliitis, a term that describes inflammation in the joint.

http://www.spine-health.com/conditions/spine-anatomy/sacroiliac-joint-anatomy 

About half of people who have an episode of back pain will have another episode within a couple of years. But that still doesn’t mean that it is necessarily serious. Between episodes most people return to normal activities within two or three weeks, with few remaining symptoms.

Back pain can be very painful due to inflammation and muscle spasm, and you may need to take it easy for a while. But resting for more than a day or two does not usually help, and may actually do more harm than good. It is best to try to keep moving and seek the help of a trained professional, such as a chiropractor, if you are finding it difficult to cope, or to speed up recovery.

Your back is designed for movement. The sooner you get back to normal activity, the sooner your back will feel better. The people who cope best are those who stay active and get on with their life despite the pain.

If your back pain does not improve, it is important to seek help. Early treatment will get you better faster.

Chiropractors specialise in assessing, diagnosing and managing conditions of the spine. They are highly trained in finding the cause of pain in the spine. In the UK they undergo a minimum of four years’ full-time training. Importantly, chiropractors are regulated by law and must work within strict professional and ethical boundaries.

Before starting treatment, a chiropractor will do a full assessment. This will involve taking details about your condition, current health and medical history, and performing a physical examination. Sometimes it may be necessary to refer you for other tests, such as X-rays, MRI scans or blood tests. It is important for your chiropractor to gather as much information about your back pain as possible so that the most precise diagnosis can be made.

Your chiropractor will then explain what is wrong, what can be done and what you can expect from chiropractic treatment.

As with any new symptoms it is always important to visit your GP or Chiropractor to rule out any other disorders before reaching a diagnosis yourself.

New NICE guidelines for low back pain and sciatica have just been published.  These guidelines recognise the role of manual therapy in the treatment of low back pain and sciatica.

The guidelines state:

“Consider manual therapy (spinal manipulation, mobilisation or soft tissue techniques such as massage) for managing low back pain with or without sciatica, but only as part of a treatment package including exercise, with or without psychological therapy.”

Notably the full guideline states manipulation requires special training:
“Mobilisation and soft tissue techniques are performed by a wide variety of practitioners; whereas spinal manipulation is usually performed by chiropractors or osteopaths, and by doctors or
physiotherapists who have undergone additional training in spinal manipulation.”

The full report can be found at https://www.nice.org.uk/guidance/NG59/chapter/Recommendations#non-invasive-treatments-for-low-back-pain-and-sciatica