Defining The Disease of Movement Dysfunction Related Low Back Pain - An Observational Study and Description of The Necessary Paradigm Shift Required to Cure the Root Cause of Globally Prevalent Low Back Pain Symptoms

Abstract

Study Design: This observational study examined defined movement points of performance of a random sample of twentysix subjects working in an inner-city tertiary hospital. Based on the observed biomechanical movement points of performance expressed, Movement Dysfunction or Movement Proficiency for a simple bending task was determined. No subjects declined participation in the study.Background: Movement Dysfunction (MD) is hypothesised to be a significant contributor to the high prevalence of Non-Specific Low Back Pain (NSLBP) in our modern industrialized society. Treatment of low back pain symptoms is conventionally directed towards symptoms. This is clearly apparent by the misguided yet accepted diagnosis and often misused label of "Non-Specific Low Back Pain" which itself is not a diagnosis at all but an admission that the disease causing the symptom remains nebulous. This is unacceptable if progress is to be achieved in controlling the rising prevalence and economic burden of this condition. If the aforementioned hypothesis and authors are correct, in that the disease causing NSLBP symtoms is spino-pelvic Movement Dysfunction, a distinctive management paradigm shift can be implemented with the treatment targets being those of neurologically corrupted motor patterns which manifest as default poor bending technique during activities of daily living, be they trivial or physically demanding. Accelerated musculo-skeletal structural degeneration (degeneritis) and back pain symptoms are secondary sequelae. Tertiary sequale include multifidus muscle fatty atrophy, micro-instability, symtomatic neural compression, macroinstability and central sensitisation. The progression from episodic back pain to chronic back pain and structural changes that require surgical consideration are all preventable if low back pain is considered to be a primary neurological movement disorder and we shift our focus away from common, expensive, invasive and often poorly efficacious strategies such as interventional nociceptor blocks (interventional pain blocks), strengthening and stretching exercise therapy, manual therapy adjustments and deep tissue release in favour of primarily restoring the primary condition of corrupted central nervous system motor patterns that express movement dysfunction of the lumbo-pelvic spine. This is observable as default poor bending technique for simple