Low back pain: Time to get off the treadmill

The present conceptual framework pertaining to low back pain (LBP) is useless for the individual practitioner. Granted, LBP is difficult to study and understand. It is often labeled “nonspecific,” “idiopathic,” “mechanical,” or “activity-related,” because it is usually impossible to make a specific diagnosis on the basis of obvious pathologic findings. Clearly, there have been some fundamental changes in the conceptual framework surrounding nonspecific LBP. The pathoanatomical and monocausal explanatory model (eg, spondylolisthesis) has largely given way to the biopsychosocial, and hence multicausal, concept.