What are the mechanical or activity-related causes of low back pain (LBP)?

Updated: Aug 22, 2018
  • Author: Jasvinder Chawla, MD, MBA; Chief Editor: Stephen A Berman, MD, PhD, MBA  more...
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Answer

Answer

When LBP persists beyond 3 months, into the chronic phase, appropriate clinical and diagnostic information supporting a benign or mechanical cause should be collected, if it has not been already. Also, a prompt physician evaluation, including reasonable radiographic, laboratory, and electrophysiological testing, is indicated in patients with persistent severe neurological deficit, intractable limb pain, suspected systemic illness, or changes in bowel or bladder control. The spectra of mechanical (or activity-related) and nonmechanical causes of LBP are outlined below.

Mechanical or activity-related causes of LBP

See the list below:

  • Diskal and segmental degeneration - May include facet arthropathy from osteoarthritis

  • Myofascial, muscle spasm, or other soft-tissue injuries and/or disorders

  • Disk herniation - May include radiculopathy

  • Radiographic spinal instability with possible fracture or spondylolisthesis - May be due to trauma or degeneration

  • Fracture of bony vertebral body or trijoint complex - May not reveal overt radiographic instability

  • Spinal canal or lateral recess stenosis

  • Arachnoiditis, including postoperative scarring

Differential diagnosis can include many neurological and systemic disorders, as well as referred pain from viscera or other skeletal structures such as the hip.


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