Low back pains has a variety of causes, from simple muscle strains from doing yard work to damaged discs from lifting an object and twisting. Previous accidents, slip and falls or sports injuries may lead arthritis which can lead to back pain later in life. There are numerous other condition which may mimic back pain. For example kidney stones or problems with the female reproductive system may at first present it self as back pain.

The Agency for Health Care Policy and Research (AHCPR), in a milestone study involving a multidisciplinary panel of health care experts, concluded that spinal manipulation is the safest drugless initial form of treatment for acute low back problems in adults. The study also recommended that -- for most cases -- conservative treatment such as manipulation should be pursued before surgical interventions are considered. This study included the participation of (and its conclusions were supported by) the American College of Orthopedic Surgeons.

In another study, the prestigious Rand Corporation concluded that spinal manipulation was an appropriate treatment for acute low back pain, and reported from its analysis that 94 percent of all manipulations are performed by doctors of chiropractic.