We introduced in a previous post how complex pain is. We now see pain as a “bio-psycho-social” entity.
In back pain, while psycho-social factors remain important in changing patient behavior, an emphasis is put towards biomechanics to identify the cause of pain and prevent future episodes. Links among pain, images, and biomechanics are not simple. They are patient-specific, too, and can vary over the natural history of back pain.
A common belief about back troubles is that most of them are “ non-specific”, as in of unknown cause. One of the problems might be that each practitioner tends to identify the primary source of pain according to the type of treatment he provides. A physio will provide exercises, a surgeon will offer surgery. It all makes sense.
But even with a tissue-based diagnosis, no single therapy has been proven to be effective all the time. Being patient-centered, and identifying the movements, postures and loads causing or relieving pain, all together help to come up with a more precise diagnosis.