Most patients that come to a chiropractic office naturally assume that their back pain is coming from the muscles, bones and nerves in their spine. And for the vast majority of patients, that is indeed the case. But in rare circumstances, back pain can actually be caused by problems with other body parts. We’ve had a couple of cases over the past few weeks that illustrate this point. One of these scenarios involved a regular patient who usually attends for maintenance care once a month. This particular visit, she presented with worsening flank pain that started about a week earlier. This was different than her usual stiffness. It was worse with activity and didn’t radiate into the hips or legs. As with any new complaint, we asked the patient if they had any other symptoms. Since the pain was located in and around the kidney area, we specifically asked about fever, nausea or any changes to urination such as increased frequency, pain or colour changes in her urine. The patient had indeed noticed some colour changes and slightly increased frequency. We advised the patient to see her family doctor and after a urine sample, she was diagnosed with an infection. Antibiotics quickly cleared it up and she returned for her regular chiropractic adjustments. Another case involved a new patient that came to our office with severe mid back pain. There was no history of injury, no shortness of breath and no cardiovascular issues. And there were no associated digestive symptoms like heartburn or nausea, and no correlation with eating. Overall the patient seemed healthy. After a thorough exam, we diagnosed the patient with a thoracic strain, likely the result of poor posture. This type of problem usually resolves quickly so when the patient did not experience any lasting relief after 3 treatments, we again reviewed her overall health status. This time she did report a worsening of pain after eating some french fries. We then suggested she consult with her family doctor or urgent care centre to evaluate any potential involvement of her gall bladder. As it turns out, gallstones were the cause of her pain. These two cases highlight a very important point about chiropractic care: Chiropractors are trained to be able recognize signs of non-musculoskeletal injury or illness. We always have our radar on the look out for problems that require medical care. A thorough history is the key to detecting signs of other underlying issues. Pain that is accompanied by things such as fever, shortness of breath, acute digestive issues or changes in bladder or bowel function are just some of the things we look for. Sudden neurological changes such as double vision, speech problems or loss of motor function may also be a sign of other underlying diseases. Thankfully, these types of scenarios are rare. So choosing your chiropractor as your primary care provider for any type of neck or back pain remains the logical choice. And you can do so with the confidence that should there be any other problems causing your pain, your chiropractor can help spot them so that you get the care you need.