By Dr Andrew Ullo (Chiropractor)


Back pain is a common ailment that affects millions of people worldwide. While the symptoms may manifest as discomfort or limited mobility, they are often just the tip of the iceberg. In this blog, we delve into the concept that back pain symptoms represent only a fraction of the larger picture, highlighting the importance of identifying and addressing underlying causes for effective treatment.


Understanding Underlying Causes

Back pain can arise from various underlying causes, including muscle imbalances, poor posture, structural issues, spinal misalignment, herniated discs, or degenerative conditions. Symptoms like localized pain, stiffness, or radiating pain down the legs (sciatica) may indicate these underlying problems. It is crucial to recognize that solely focusing on symptom management may provide temporary relief but fail to address the root cause.


Holistic Approach to Diagnosis

A comprehensive diagnosis is essential to uncover the underlying causes of back pain. It typically involves a combination of patient history, physical examination, and diagnostic tests such as X-rays, MRIs, or CT scans. Furthermore, considering factors like lifestyle, ergonomics, stress levels, and overall health can provide valuable insights into the contributing factors.


Common Underlying Causes

Muscle imbalances, often resulting from sedentary lifestyles or poor posture habits, can cause strain on the spine and lead to back pain. Structural issues, such as spinal abnormalities or skeletal irregularities, may contribute to chronic discomfort. Disc-related problems, such as herniated discs or degenerative disc disease, can compress nerves and cause pain. Additionally, conditions like osteoarthritis, osteoporosis, or fibromyalgia can manifest as back pain.


Treatment Approaches

Aiming to solely alleviate symptoms without addressing underlying causes may lead to recurring or chronic back pain. Treatment options should focus on a holistic approach, incorporating pain management, targeted therapies, lifestyle modifications, and rehabilitation exercises. Physical therapy, chiropractic care, massage therapy, acupuncture, and ergonomic adjustments can be valuable components of a comprehensive treatment plan.


Prevention and Maintenance

Preventing back pain and maintaining a healthy spine involve proactive measures. Regular exercise to strengthen the core muscles, maintaining proper posture, and using ergonomic furniture and equipment can help prevent back pain. Additionally, maintaining a healthy weight, adopting stress management techniques, and avoiding excessive lifting or repetitive motions can contribute to a healthier back.



Understanding that symptoms are only the tip of the iceberg for back pain allows for a comprehensive approach to diagnosis and treatment. By identifying and addressing underlying causes, we can provide more effective solutions and long-term relief.



  1. Hoy D, et al. The global burden of low back pain: estimates from the Global Burden of Disease 2010 study. Ann Rheum Dis. 2014 Jun;73(6):968-74.
  2. Airaksinen O, et al. Chapter 4. European guidelines for the management of chronic nonspecific low back pain. Eur Spine J. 2006 Mar;15(Suppl 2):S192-300.
  3. Chou R, et al. Noninvasive Treatments for Low Back Pain. Comparative Effectiveness Review No. 169. AHRQ Publication No. 16-EHC004-EF. 2016 Feb.