I’ve been in practice for 19 years. In 2006, I received an advanced certification in whiplash and brain injury from the San Diego Spine Research Institute. The major cause of most back pain is joint injury. The muscle spasms and muscle pain follows after. Evaluating the spine to determine the extent of the damage determines the course of care. Degeneration (arthritis) caused from injury, whether from repetitive movements or an auto injury progress and worsen with time.