Scientific stats point out that 85% of low back pain is of unknown etiology. According to back expert Stewart McGill, that simply means that most back problems are not adequately identified and are thus misdiagnosed! Diagnosis often depends on the profession of the treating therapist or physician, each seeing the problem through the lens of their respective training. There’s that old aphorism of the many blind men identifying an elephant according to the respective part that they are each touching. Also, if the tool you have is a hammer, everything looks like a nail!
The source of back pain can’t always be identified. Much research has gone into this question. Often, pain is the result of a microtrauma of the facets or the disc, small aberrant motions causing micro-tears or avulsions which in turn cause other structures to react. Disc endplate fractures from mechanical over-loading is common, and that damage causes pain. Such damage can occur from repeated low force trauma such as lifting boxes wrong at work, or from a one-time accident, such as landing hard on a jet-ski or snowmobile. Such endplate fractures can lead to the disc material draining into the vertebra over time, causing a decrease in its ability to cushion between the vertebra. Another scenario might be a young gymnast doing excessive back bends for years developing a shear injury which leads to a facet fracture the low back that only becomes an issue only as an adult decades later, perhaps following a whiplash auto injury. [Read more…]