Most cases of back pain are mechanical; they are not caused by critical conditions (such as infection, fracture, aneurism, or cancer) or organ disease (such as kidney stones, kidney infections, blood clots, uterine problems). Since back pain can have a variety of causes an careful examination and diagnosis is essential.
The back is a complicated structure of bones, joints, ligaments, and muscles. You can sprain ligaments, strain muscles, rupture disks, and irritate joints, all of which can lead to mechanical back pain. While sports injuries or accidents can cause back pain, sometimes the simplest of movements-for example, picking up a pencil from the floor-can have painful results if the mechanics of the back are at fault. In addition, arthritis, poor posture, obesity, and psychological stress can complicate mechanical back pain problems. Most people have low back pain that they cannot attribute to a specific injury; the back simple failed to stabilize itself against the torque and compression of normal movements and postures.
Since most back pain is a failure of the intrinsic stability system, then why is so much back pain treatment focused on strengthening trunk flexor/extensor muscles?
Next week I’ll be posting about recent changes in our understanding of the natural course of low back pain.