Determining which specific tissues are responsible for generating low back pain is often difficult, if not impossible. Any structure in the low back that is innervated could be a potential source of pain.
Approximately 39% of low back pain is due to disc disruption, although the occurrence of full herniations may be as low as 5%. Other sources include: facet joint (spinal joint) involvement, sacroiliac joint dysfunction, soft tissue injury and lack of flexibility.
Here is what some prominent MD’s and DC’s have to say on the subject:
Kuritzky, MD. Physician & Sports Medicine 1997; 25(1): 56-64.
Bend your index finger backward until it’s intensely painful. A biopsy of the finger won’t reveal a tumor, infection or any identifiable lesion, because there is none. But releasing the finger and letting it return to its “position of comfort” will allow the pain to subside. We need to re-orient ourselves to think about low back pain in a similar way – functionally instead of pathoanatomically.
Troyanovich, S. DC et al. Journal of Manipulative and Physiological Therapeutics 1998; 21(1): 37-50.
Tissue growth and repair is influenced by mechanical loading and is positively affected by body postures that minimize adverse mechanical stresses and strains. Altered alignment may lead to poor healing of tissues and eventual pathological architectural changes. Minimization of altered postural/structural loading may take longer than resolution of symptoms. Chiropractic rehabilitation should focus on normalization of aberrant stresses and strains on spinal tissues. Manipulation alone can’t restore body postures or improve altered spinal curves. Therefore postural chiropractic adjustments, active exercises, and stretches are necessary for maximal spinal rehabilitation. The use of passive treatment modalities as a sole means of chiropractic intervention no longer has a place in modern chiropractic practice after the acute phase of healing has passed.