HOW MANY PEOPLE ARE BORN WITH CHRONIC PROBLEMS? I DON’T THINK PEOPLE ARE TYPICALLY BORN WITH CHRONIC PROBLEMS BUT YOU HAVE A SMALL SUB SET WHO MIGHT BE BORN WITH AN ANATOMICAL VARIANT OR DIFFERENCE SUCH AS SCOLIOSIS THAT COULD LEAD TO SOMETHING. THE VAST MAJORITY OF AMERICANS WHO SUFFER FROM BACK PROBLEMS, HOWEVER, HAS NOTHING TO DO WITH WHAT THEY WERE BORN WITH JUST THE WAY THEY LIVE THEIR LIVES. IT IS A COMBINATION OF THREE THINGS. YOU HAVE GENETICS AND THAT PLAYS SOME PART AND THAT IS WHAT YOU ARE BORN WITH. NOT MUCH YOU CAN DO ABOUT THAT. AND THEN YOU HAVE THE AMOUNT OF TIME YOU HAVE BEEN ALIVE, RIGHT, AND THE WAY THAT YOU ARE USING YOUR SPINE DURING THAT TIME. THE THIRD AND PROBABLY THE MOST COME IN TO SEE YOU AND DO THEY COME IN A LITTLE BIT LATE? EXERCISING I THINK THAT MANY AMERICANS DO COME IN A LITTLE BIT LATE AND THEY HAVE GOTTEN TO THE POINT WHERE THE PAIN IS OUT OF CONTROL BY THE TIME THEY GET TO ME. I SEE A VARIETY OF DIFFERENT HAVE SEEN YOU, THEY HAVE BEEN TO OTHER PHYSICIANS WHO HAVE TRIED OTHER TECHNIQUES? TYPICALLY YES. AS A SPECIALIST MOST OF THE TIME THERE IS QUITE A FEW STEPS BEFORE PEOPLE GET TO ME. AND THE VAST MAJORITY OF AMERICANS HAVE BACK PAIN BUT I DON’T SEE ALL OF THEM. RIGHT, BECAUSE OTHER TECHNIQUES MAYBE WORK ABSOLUTELY. MEDICINE OR PHYSICAL THERAPY. ABSOLUTELY. STATISTICALLY SPEAKING YOU USUAL USUALLY DON’T NEED SURGERY FOR THE BACK PAIN. AND MO OF THE IS FROM REPET — MOST IS FROM REPETITIVE STRESS ON THE BACK, NOT A ONE-TIME INJURY? I WOULD SAY YES. TRAUMA CAN CAUSE SIGNIFICANT BACK PAIN AND CERTAINLY RESULT IN A SITUATION WHERE YOU ARE STRUCTUREALLY UNSTABLE AND YOU MIGHT NEED SURGERY. AGAIN, LOOKING AT THE NUMBERS AND JUST TALKING ABOUT WHAT IS HAPPENING ON A DAY TO DAY BASIS, THIS IS A DEGENERATIVE DISEASE