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Low Back Patterns of Pain

woman with severe back pain on couch
We recognize that the number 1 reason people will think of seeing a chiropractor will be for low back pain. Over the next few months, we will be diving deeper into helping you understand how we evaluate the clinical patterns of low back pain that lead to appropriate treatment. Pattern recognition is based on the history of your complaint and confirmed on our physical examination. It begins with the question, “where is the pain worst?” Pain may be present in the low back and/or in the leg, but it will always be worse in one location. That is an important distinction to make.

Back dominant pain is referred pain from a physical structure in the spine, often with local tenderness. The locations include:

  • Back
  • Upper buttocks
  • Tailbone
  • Sides of the hips
  • Groin

Leg dominant pain is radicular pain from direct nerve root involvement. The locations include:

  • Around and below the buttock. May extend down the leg.
  • Thigh
  • Calf
  • Ankle
  • Foot

If you have a hard time localizing your pain, it is helpful to ask yourself: “If you could stop one pain today, which one would you want gone first?” This is a starting point for us to understand the main cause of your low back pain. Always remember, your body is allowed to have more than one thing happening at a time. The question is about prioritizing the areas that will give you the relief quickest so that you can get back to doing things that you love to do.

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