The spinal column is one of the most vital parts of the human body, supporting our trunks and making all of our movements possible. When the spine is injured and its function is impaired the consequences can be painful and even disabling. According to estimates, 80 percent of Americans will experience low back pain at least once in their lifetime. A small number of patients will develop chronic or degenerative spinal disorders that can be disabling.
Men and women are equally affected by lower back pain, and most back pain occurs between the ages of 25 and 60. However, no age is completely immune. Approximately 12% to 26% of children and adolescents suffer from low back pain. Fortunately most low back pain is acute, and will resolve itself in three days to six weeks with or without treatment. If pain and symptoms persist for longer than 3 months to a year, the condition is considered chronic.
Humans are born with 33 separate vertebrae. By adulthood, most have only 24, due to the fusion of the vertebrae in certain parts of the spine during normal development. The lumbar spine consists of 5 vertebrae called L1 through -L5. Below the lumbar spine, nine vertebrae at the base of the spine grow together. Five form the triangular bone called the sacrum. The two dimples in most everyone's back (historically known as the "dimples of Venus") are where the sacrum joins the hipbones, called the sacroiliac joint. The lowest four vertebrae form the tailbone or coccyx.
The anatomy of the spinal column is extremely well designed to serve many functions. All of the elements of the spinal column and vertebrae serve the purpose of protecting the spinal cord, which provides communication to the brain, mobility and sensation in the body through the complex interaction of bones, ligaments and muscle structures of the back and the nerves that surround it. The back is also the powerhouse for the entire body, supporting our trunks and making all of the movements of our head, arms, and legs possible.
Diagnosis of Acute Back Pain - Chiropractic Examination and the Following Tests:
X-rays - Painless, non-invasive imaging process that utilizes photographic film to absorb electromagnetic radiation — having an extremely short wavelength of less than 100 angstroms and the ability to penetrate solids of various thicknesses — transmitted through a material body. These images, also known as radiographs or roentgenograms, are used to diagnose and monitor the treatment of various disorders.
CAT Scan (computed axial tomography scan)[also called a CT scan (computed tomography scan)] - Another painless imaging technique that utilizes a computer to produce detailed three-dimensional images of a body from a collation of cross-sectional X-rays taken along an axis. Of all the imaging techniques that are currently available, the CAT scan is best able to produce images of bone, blood, and soft tissues.
MRI (magnetic resonance imaging) - Non-invasive technique for imaging the spine that involves rotating a magnet around the body and exciting its hydrogen atoms. A scanner is then utilized to detect the energy emitted by the excited atoms. MRIs provide exceptional detail of the spine's anatomy, since the human body is composed primarily of water, which is two parts hydrogen. The single most useful test available for diagnosing spinal disorders.
Myelogram - A test procedure that involves injecting a radiographic contrast media (dye) into the sac (dura) surrounding the spinal cord and nerves, and then taking X-rays of the spine. This allows the radiologist to specifically X-ray the nerve roots. In this way, any abnormalities within the spinal canal can potentially be identified to aid in the diagnosis of certain spinal problems, such as nerve compression or a disc rupture.
Bone Scan - A test procedure that involves intravenously injecting a small quantity of a radiographic marker into the patient, and then running a scanner over the area of concern. The scanner detects the marker, which concentrates in any region exhibiting high bone turnover. A bone scan is utilized when there is suspicion of tumor, infection, or small fractures, i.e., conditions that all result in high bone turnover. A Bone Scan does not replace the above tests, but may provide additional information by eliminating other serious problems
Numbness and Weakness
Numbness and weakness are manifestations of abnormal nervous system activity.
Numbness Numbness is felt when nerve impulses aren't traveling properly from the skin to the brain.
A patient with back problems may also experience numbness in other parts of the body, especially the legs and feet. This always indicates some kind of nerve damage in the peripheral nervous system or the central nervous system (i.e. the spine or the brain) and deserves prompt and serious attention.
Numbness can occur in the skin and the linings of body orifices such as the mouth or the vagina.
Common spinal causes of numbness include the following:
Radiculopathy - A pinched nerve due to a herniated disc.
Stenosis - A narrowing of the spinal canal, which can compress sensory nerve fibers causing loss of sensation.
Subluxation - malposition of a vertebrae appying pressure to surrounding tissues including nervous tissue causing radiculopathy and stenosis.
Multiple Sclerosis
Stroke
Common cerebral causes of numbness include the following:
Stroke
Seizures
Congenital abnormalities
Concussion
Other generalized conditions, such as psychological upsets
Weakness Weakness happens when signals don't travel properly from the brain to the muscles or from problems in the muscles themselves.
If weakness cannot be traced to another systemic condition, such as diabetes, it can come from either a nerve or a muscle problem. Paralysis is the extreme manifestation of weakness.
There are many reasons people experience weakness related to low back pain, but the most common cause of overall systemic weakness is inactivity.
A person's posture, gait, step size and degree and amount of arm swing when walking all affect dozens of muscles in the middle and lower back. A minor injury that may have no symptoms can cause a person to compensate in different ways when walking, sometimes without even knowing it. Both large and small adjustments to these everyday activities can have a domino effect sometimes leading to back pain.
Causes of Muscle Weakness
Myopathy As in dermatitis that affects the skin, and neuropathy that affects the nerves, myopathy is a systemic condition that attacks the muscle tissue, most of the time all over the body.
There are various types of myopathy, including that caused by diabetes and other endocrine abnormalities from infections and from autoimmune diseases and then there are toxic and hereditary causes.
Most myopathies show up in the muscles close to the trunk first, in the pectoral muscles in the upper extremities and the muscles in the thigh.
Symptoms Patients with myopathy will detect a weakness walking up stairs, their knees may involuntarily buckle and they may find it harder to do routine tasks such as opening jars.
Osteoarthritis and Osteoporosis These types of diseases that come with age and cause joint derangement sometimes followed by vertebral fractures can cause nerve damage in response to these conditions, therefore weakening muscles.
Common neurological causes of weakness include the following:
Stroke
Spinal Cord Injury
Injury or damage to peripheral nerves - Often the result of trauma, surgery or pressure produced by posture or position
Myopathy - One or more nerves damaged systemic problems reducing reflexes
Osteoporosis/Osteoarthritis - Weakness is sometimes a secondary symptom resulting in complications of these disorders
Functional
Bowel and bladder dysfunction refers to loss of control of these bodily functions due to trauma or a developing disorder ( subluxation ) of the lower back.
Bowel and bladder dysfunction can be caused by a number of other low back disorders. The most common cause of this dysfunction is spinal cord injury. But there are other causes like severe disc injury, such as massive paramedian or central herniation; cauda equine syndrome; severe degenerative spinal disorders; subluxations, myelomeningocele, which is the most severe form of spina bifida, severe spinal stenosis and certain myelopathies, among others.
If a patient presents with bowel or bladder paralysis, it could be symptomatic of the cauda equina syndrome or a massive herniation at a higher level. Often this type of symptom is one of the indications for a laminectomy.
The common thread related to bowel and bladder dysfunction is neurological injury due to a traumatic event or a progressing lower back disorder of some kind. This type of dysfunction is often aggressively treated and often requires surgery.
Sciatica
Sciatica refers to pain that begins in the hip and buttocks and continues all the way down the leg. This condition is often accompanied by low back pain, which can be more or less severe than the leg pain. The term "sciatica" indicates that the sciatic nerve, which travels from the lower back through the buttocks and into the leg, is thought to be the cause of the pain in this condition. True sciatica is a condition that occurs when a herniated lumbar disc compresses one of the contributing roots of the sciatic nerve. This type of low back pain is less common than other causes and conditions that produce back pain. For instance, sporting activities, recreational activities, and heavy labor can cause back and leg pain, which is commonly misdiagnosed as sciatica. The challenge for a physician is to distinguish between radicular pain which is caused by an inflamed nerve root, and referred pain, which is a result of a musculoskeletal sprain or strain.
Symptoms The most common symptom of true sciatica is posterior thigh, lower leg or foot pain that can be much worse than the accompanying lower back pain. Usually a patient will experience moderate to severe pain, which begins in the buttocks and runs down through the leg or foot. It is important to know that true sciatica will produce pain that radiates beyond the knee. Often a patient will have a previous history of lower back pain beginning a few days or weeks before the leg pain occurs, then the leg pain becomes worse than the back pain, and in some cases the back pain will completely disappear.
However, in the case of longstanding history of sciatica, the pain may gradually become localized to the buttocks and back of the leg. In this situation, the patient may have a vague aching pain that does not reach all the way to the lower leg or foot, though it may have done so earlier in the course of the disease
Often there is not a specific traumatic event or motion associated with the onset of sciatica. Standing, sitting, heavy lifting, sneezing, or having a bowel movement may aggravate the pain. Lying down is usually the most comfortable position. Occasionally paresthesias, weakness and diminished bowel or bladder function will accompany sciatica, but these are rare symptoms.
Diagnosis and Treatment
A thorough history and physical examination is an important part of the diagnosis of sciatica. Nerve root tension tests can be used to confirm the presence of sciatica by attempting to reproduce the discomfort with certain motions and body positions. These tests are performed by a doctor and involve moving the legs in certain ways that slightly stretch the sciatic nerve. If the patient experiences pain during these tests, an irritated sciatic nerve is likely to be a source of the pain.
Chiropractic is without a doubt the treatment of choice for sciatica. There are many "medical" answers for this disorder, however the chiropractic answer is the safest and the one that produces the most results. Correction of the spinal misalignments and muscular imbalances relieving pressure or "stress" off the sciatic nerve not only will quelch the syptoms, but allow the body to recover and prevent the problem from re-occuring.
Stiffness & Tightness
Stiffness Patients who awaken early in the morning with an unusual stiffness are likely to be suffering from an inflammatory disease like ankylosing spondylitis. If this type of pain is occurring, there could be a more serious problem, and a physician should rule out metastasis to the spine and severe psychological problems.
Tightness Tightness in the back, neck, arms and legs is most often due to changes in the muscles. More than 80% of neck and back problems are a result of tight, achy muscles brought on by years of bad posture. Additionally, joint stiffness and pain, which sometimes presents itself as lower back pain, could mean you are at risk for osteoarthritis. Studies have shown that there are ways you can help prevent this. Poor posture and a sedentary lifestyle have shown to increase the risk of the condition in later years.
Common spinal causes of numbness include the following:
As in dermatitis that affects the skin, and neuropathy that affects the nerves, myopathy is a systemic condition that attacks the muscle tissue, most of the time all over the body.
Bowel and bladder dysfunction refers to loss of control of these bodily functions due to trauma or a developing disorder ( subluxation ) of the lower back. 
Sciatica refers to pain that begins in the hip and buttocks and continues all the way down the leg. This condition is often accompanied by low back pain, which can be more or less severe than the leg pain. The term "sciatica" indicates that the sciatic nerve, which travels from the lower back through the buttocks and into the leg, is thought to be the cause of the pain in this condition. True sciatica is a condition that occurs when a herniated lumbar disc compresses one of the contributing roots of the sciatic nerve. This type of low back pain is less common than other causes and conditions that produce back pain. For instance, sporting activities, recreational activities, and heavy labor can cause back and leg pain, which is commonly misdiagnosed as sciatica. The challenge for a physician is to distinguish between radicular pain which is caused by an inflamed nerve root, and referred pain, which is a result of a musculoskeletal sprain or strain. 
Often there is not a specific traumatic event or motion associated with the onset of sciatica. Standing, sitting, heavy lifting, sneezing, or having a bowel movement may aggravate the pain. Lying down is usually the most comfortable position. Occasionally paresthesias, weakness and diminished bowel or bladder function will accompany sciatica, but these are rare symptoms.
Patients who awaken early in the morning with an unusual stiffness are likely to be suffering from an inflammatory disease like ankylosing spondylitis. If this type of pain is occurring, there could be a more serious problem, and a physician should rule out metastasis to the spine and severe psychological problems.