Back pain has many causes. Among them are mood and attitude, formative experiences of pain in self and others, and the state of a person’s spirit.
When people with low back pain think about going to a chiropractor, most are expecting an adjustment to put the spine back in place.
The first thing I look at when I see a client is their posture, movement, energetics, and mood. This tells me far more about how to help them get better than my evaluation of joint position or restriction.
Most people know at some level that their mind is something that happens largely or entirely in the body. Many know that according to physics, energy and matter are the same things.
Theoretically, it makes sense that your body state determines thoughts and feelings, and vice versa Theoretically, it makes sense that when your energy changes, your body changes.
But when it comes to daily thinking and acting, most people default to thinking that back pain is strictly a mechanical thing that occurs in a place distinct from consciousness. 
Of course, I think about structure when I approach a client. But I don’t separate their structure from their attitudes, thoughts, and feelings – because they’re all dimensions of the same person. As I work, I suggest changes to a person’s body. If I want those changes to integrate, I have to negotiate with the unconscious nervous system, and also with several different parts of the conscious mind, from simple body awareness, to emotional integration, to changed attitudes, to an understanding of how to train one’s body to make different choices each day.
This negotiation, whether verbal or not, also involves the emotional and spiritual state of the person: how they see themself in relation to their past and history, how they describe their pain to themself, and how their spirit connects itself to a community and a larger reality.
Your history is inscribed in your body – all of it. And so it’s also inscribed in your spirit, psyche, etc.
To think of pain arising from dimensions of a person other than structural is not to define the pain as “psychosomatic”. Your psyche affects your comfort and pain, but the word psychosomatic is often used by MDs when they can’t figure out what’s wrong with a client via their methods. It functions as a dismissal of the client rather than an affirmation that all pain can be approached from multiple perspectives. Telling someone “it’s all in your head” is judgmental, and never the whole story.
I like to tell MDs that I’m going to give them chronic pain for 18 months and then do psychological testing. Pain is psychological, but the pain may come first. 
There’s a reason why feelings are called “feelings” – they are always a physical experience, so of course, you will “feel” them. But that doesn’t mean that your mind somehow “invented” your pain, or that it’s not real. From the standpoint of the Hindu chakra system, the low back represents our relationship to concrete and ancestral aspects of us. This includes our ancestry, our family of origin, our legs, grounding, our bones, food/clothing/shelter, and money.
In this way of defining the self, the low back/hips support our generative organs, the nuclear family and family of choice, and our organs of elimination.
The chakras are useful ways of understanding the self because they don’t distinguish explicitly between physical and whole-life realities, nor between a person’s energetics and their concrete manifestation. In the chakra system, as in physics, these events are in continuous flux/coexistence and never exist independently.
From a chakric standpoint, issues in the low back may be connected – in a non-causal way, with issues of
- basic survival
- feeling support
- the ability to provide for others
- money
- fundamental security
I find the chakra system helpful, among other lenses, in figuring out what aspects of a low client’s issue are most coordinated with an injury or issue, and what the most fruitful point of access is to help them get and stay healthy and efficient.
That’s because sometimes, improving low back pain will be the quickest if a person focuses on issues like depression, insecurity, or grief.
When you have a physical problem, scan the period in which it emerged. Was there a change in your life circumstances? Your mood? Is there an issue or situation in your life that needs to be addressed? Because sometimes the most efficient way to address physical pain isn’t explicitly physical.
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