Everyone knows that heart disease = lack of blood flow. Stroke in the brain typically = lack of blood flow. Impotence = lack of blood flow to the Johnson. Less are aware that lack of blood flow is major cause of blindness and hearing loss. I call this “TBI” = Total Body Ischemia. Ischemia is most common cause of back pain = title of book I wrote about the spine. Video explains how ischemia causes back pain. To prevent spine ischemia, one does the same things as they do to optimize blood flow to every part of the body. The different types of treatment for back pain are briefly discussed.