Low back pain

Last Wednesday night while carrying a bucket of water from the well, Hannah Williams slipped upon the icy path and fell heavily upon her back. We fear her spine was injured for though she suffers acute pain in her legs she cannot move them. The poor wild beautiful girl is stopped in her wildness at last.

Francis Kilvert 1874

Low back pain accounts for at least 5% of general practice presentations. The most common cause is minor soft tissue injury, but patients with this do not usually seek medical help because the problem settles within a few days.

Most back pain in patients presenting to general practitioners is due to dysfunction of elements of the mobile segment, namely the facet joint, the intervertebral joint (with its disc) and the ligamentous and muscular attachments. This problem, often referred to as mechanical pain or traumatic joint derangement, will be described as vertebral dysfunction—a general term that, while covering radicular and non-radicular pain, includes dysfunction of the joints of the spine.

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