You are not alone if you are troubled with back pain. Estimates include half of working adults suffer a back injury each year.  It is a common cause of disability and loss of productivity.  Its evaluation is complicated and involves consideration of many causes, some not associated with the spine at all.
 It is important to note that often back pain evaluation fails to disclose a pinched nerve or slipped disc.  In these cases alternative causes need to be investigated.  Alternative causes include most commonly the tearing or stretching of pain senstive structures such as muscles or ligaments.  Pain referred from abdominal or pelvic organs can represent serious causes of back pain and may include disease of the large blood vessel in the abdomen, the aorta and disease including cancer of the abdominal and pelvic internal organs.  Pain from muscle spasm is usually dull and gerneralized in nature and is associated with other causes of back pain.  How the patient feels the pain and when it occurs help to identify its cause.
 In addition to causes such as pinched nerve root, slipped disc, and problems with spinal alignment,  it is important for your medical doctor or chiropractor to make certain a more remote and more dangerous problem is not the cause of your back pain pain.  Laboratory testing and specialized imaging of the back, belly and pelvis are available to help better define the anatomy that might be involved as the cause of back pain.  Treatment of back pain has come to include new anti-inflamatory agents such as the cox2 inhibitors Viox and Celebrex the use of steroid medication,  non-medication treatments such as massage,  excercises and alteration in posture.  Occassionallyand rarely a surgery to correct a problem not treatable with more conservative measures will be needed.