Question
I've had chronic lower back pain for some time. Some days it's a mild ache deep in the middle of my lower back, sometimes it's much more acute-a sharp stabbing pain. I also semi-regularly experience an achy tiredness in my middle back that can stretch up to my neck.

I've been reluctant to see anyone regarding these issues because of the stereotypes of chiropractors taking advantage of patients and not really helping them and also because of a lack of funds. My friends say it's just because of my chest. I am a 36D which I don't think is big enough to cause the kind of back pain that much larger breasted women complain of. I jog and exercise moderately, but on a regular basis and I like to think I have pretty good posture. Is this likely just caused by my chest or could there be other reasons for it? I've had the pain almost all my adult life and I am in my early 20s. I've also never injured my back.

Another thing I experience and have had trouble finding any explanation for on the internet is back cracking. Not the kind that you force yourself, but involuntary cracking that happens regularly throughout the day. If I move from a hunched position to straight, my back cracks in a few places. If I pull my shoulders back and/or arch my back, it usually cracks in a few places. Sometimes it cracks just when I inhale deeply. Is this normal or is it a sign of something else going on?

I've tried exercising my core, back and stomach, building up those muscle to help support my frame, but it hasn't seem to help the pain any and it seems as time goes by, the pain gradually gets worse. I am a literature major so I spend a lot of time sitting, mildly hunched over a novel, and I've found when I do that for long periods of time, the pain worsens, but I don't feel like this is the only cause because I also spend plenty of time being up and active.

So I guess my two questions are what do you think may be responsible for my back pain and is the involuntary cracking normal?

Answer
Dear H,

Thank you for your question.  Your question is similar to those I have heard from others who are investigating chiropractic.  To give you the greatest benefit in answering, I抣l first need to give you some background on the chiropractic profession.

There are two branches or schools of thought in chiropractic.  Briefly, they are differentiated by whether they deal with the limited therapeutic approach for aches and pains (commonly termed "mixed" chiropractic because it represents a mixture of a chiropractor with a non-chiropractic matter) or a non-therapeutic approach to optimum body performance (termed "straight" chiropractic because there is no mixing of chiropractic with anything else).  My expertise is in non-therapeutic straight chiropractic.

Therapeutic "mixed" chiropractic is the older approach based on a split from the founding principles of chiropractic about a century ago.

Non-therapeutic "straight" chiropractic is the more modern of the two.  It deals with a particular, common situation called a vertebral subluxation.  This is not revealed by 揷racking?noises, as in your question, though the two may exist together.  The spine is made of many bone segments which house and protect the spinal cord and the smaller spinal nerve branches that come off the spinal cord and exit between the bones.  These nerve pathways carry information or messages between the brain and the cells of the body.  These messages are essential for the life of the cells.  Without brain messages, the cells immediately begin the process of dying; i.e., they can no longer function the way they should to maintain life.

Because the bones are moveable, they can misalign in such a way as to interfere with the messages and, ultimately, the ability of the person to function at their best or express their optimum potential.  People with vertebral subluxations are not able to get all they can out of life.

Vertebral subluxations can be caused by a wide variety of factors, what we'll generally call stresses.  These stresses can be physical (such as being born, strenuous physical activity, sleeping posture and mattress condition, sneezing, falling down, even changes in physical condition such as body shape and size, etc.), mental / emotional (in its many forms, probably the most familiar use of the word stress), or chemical (such as pollution, drugs, etc.), which are, unfortunately, regular parts of daily living for all age groups.  In short, a vertebral subluxation can occur for a multitude of reasons.

Tragically, vertebral subluxations are rarely obvious to the individual they affect.  They usually have no symptoms.  The reason is that most of what goes on inside you happens without your awareness.  As an example, try to "feel" your liver.  What's it doing right now?  You can't know, so you can't know if it's functioning at its best or something less.  To complicate things, nerve pathways that carry messages of control (termed "motor" nerves) have no way of transmitting ache or pain messages, so your body function may be far from perfect and you'd not have any alerting signal whatsoever.  The branching of the nerve pathways is complex and extensive, making it exceedingly difficult to predict or determine exactly how the person will be affected.  For this reason alone, it is impossible for anyone to give you reliable answers as to what may cause the 揷racking?you describe in your question or if it may be related to a vertebral subluxation.  Even if it were possible to guess at what may be causing the noises, it is not pertinent to the matter of whether you will benefit from being free of vertebral subluxations.  In order to know if someone has a vertebral subluxation, it is necessary to have that person抯 spine checked by a non-therapeutic straight chiropractor using a method of "analysis."  When a vertebral subluxation is detected this way, it is obviously important to correct it as soon as possible.

Since vertebral subluxations are caused by so many different things, people choose to go to a non-therapeutic straight chiropractor on a regular basis to enjoy the most time free of the life-robbing effects of vertebral subluxation. There's a saying that straight chiropractic is not about your back, it's not about your pain, it's about your life.  Each person has a unique potential in life.  With vertebral subluxation, it's impossible to realize that potential.

A key question to ask for your purposes, then, would be, Is someone who has had the symptoms and history you describe be better off with vertebral subluxation / nerve interference or free of subluxation / with the nerve channels open?  It is easy to see that having all the available nerve messages getting through is better than only some of them getting through, regardless of the person's situation otherwise.  So, having one抯 spine checked for vertebral subluxation is tremendously important, but it抯 not for the purpose of dealing with back pain or cracking noises.  In other words, non-therapeutic straight chiropractic can be of benefit to any spine-owner, but perhaps in ways that you may not have considered.  It抯 not that you should see a non-therapeutic straight chiropractor FOR your back pain or the noises ?you should visit one in an effort to be free of vertebral subluxations, even WITH such matters in your history.  

As I mentioned earlier, not all chiropractors adhere to this and it is important that you be able to distinguish which ones do if you're going to seek this type of service.  I don抰 know the origins of your admitted mistrust or skepticism, but I suspect it stems from a lack of information.  You need to understand very clearly that the practice objectives of therapeutic mixed chiropractic and non-therapeutic straight chiropractic are quite different, as described above.  What I can tell you must not be interpreted from the mixed viewpoint.  

It is impossible to tell you why the back pain or noises are occurring or if there is cause to be concerned in this format.  Additionally, this issue deals with the limited objective of therapeutic care.  Remember, what we抳e covered here is about non-therapeutic matters and the two objectives are not the same.  Further, even though this is not a service that I would provide in my field, I would say to you that diagnosis under the best of circumstances is something of an art.  It would be irresponsible for anyone to give you a guess by e-mail or the web about your situation.  Diagnostic work and therapeutic advice is difficult enough when done properly.  It becomes a riskier proposition when done poorly.  You would be best served getting opinions from someone with first-hand knowledge about you, not a limited acquaintance through correspondence.  Anyone who is willing to speculate about your situation by e-mail is providing you little more than a guess and perhaps a dangerous one, at that!  

All that said, it would certainly be wise to have your spine checked for subluxations by a non-therapeutic straight chiropractor, even if you still elect to have therapeutic attention for your reported pain or 揷racking.? If you are interested in finding out how to locate a non-therapeutic straight chiropractor in your area, please contact me at this site again or directly at [email protected].  

H, I wish you the best in understanding what non-therapeutic straight chiropractic has to offer.  It has been my pleasure to provide you with some information.

Sincerely,
James W. Healey, D.C.