Low back covers a very wide spectrum of conditions and the diagnosis can be very difficult at times. Part of the problem with finding an effective management technique for back pain is that back pain is not one thing. It has long been suspected that there are subtypes of back pain which must be taken into account if a successful approach to this most common of disabling conditions is to be developed. Numerous diagnoses can be proposed: discogenic back pain; joint related back pain; muscle pain; trigger point problems; postural pain; lumbar stenosis; nerve root impingement and neuropathic pain.

The spinal facet joints, intervertebral discs, muscles and ligaments are all potential sources of mechanical back pain, a pain derived from the damaged or injured tissues and transmitted by the nervous system. When the nervous system is damaged or injured it can start generating pain itself, leading to the production of what is termed neuropathic pain. Typical diagnoses of this kind of pain are post-shingles pain, phantom pain, nerve root damage pain and diabetic neuropathy pain. Patients suffer badly with this kind of unpleasant pain and it is difficult to treat.

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