Back pain is a crazy topic to examine in the literature – it’s all over the place. In the video below, I discuss two different models of back pain: one pertaining to the body’s structure, posture, and biomechanics, and the other pertaining to biological, psychological, and social phenomenon. It is very important for those who work with individuals in back pain to understand each model. These two distinct but interrelated models help explain both acute and chronic low back pain.

Notes

Here are the notes I took for the video:

Postural Structural Biomechanical (PSB) Model

Applies more to athletes & lifters and acute pain

This model makes sense to strength coaches – they’ve witnessed it

Posture

Structure

Biomechanics

Shape, size, length, strength balances, posture

Anatomy does influence likelihood of pain & injury in sport and weightroom

Merging of functional anatomy & physics

Anterior pelvic tilt/lumbar hyperlordosis

Posterior pelvic tilt/lumbar hypolordosis

Sleep in awkward position – hurts next day

Round back deadlift – hurts next day

In lifting, often biomechanical explanation

Knees hurt due to knee valgus

Back typically hurts due to excessive motion under heavy load

Hip mobility, core stability, glute activation, motor control – doesn’t work for everyone

If all you have is a hammer, everything looks like a nail

Biopsychosocial (BPS) Model

Applies more to non-athletes and chronic pain

Biology

Psychology

Sociology

MRIs – most of us are jacked up at most joints and also discs

Pain = brain, nerves – pain signal must go up and back down

PSB not highly correlated to chronic pain – pain is a physiological process

Depression, # of friends, confidence (and even smoking) correlated with chronic back pain

Knowledge is first step

Movement, exercise, and manual therapy work but often by different reasons

Altering brain’s perceptions and nervous system’s response

Decreasing fear and threat-response

Start with pain-free movement and gradually progress

Touch

Praise

Increase confidence, decrease depression & fear

Recommended Links

Dr. Stu McGill

Soma Simple

Recommended Articles

Enough is Enough

A Revolution in the Understanding of Pain and Treatment of Chronic Pain

The Myth of Core Stability

The fall of the postural–structural–biomechanical model in

manual and physical therapies: Exemplified by lower back

pain

Is a postural-structural-biomechanical model, within

manual therapies, viable?: A JBMT debate

Biomechanics of Lifting and

Lower Back Pain

Biomechanics of back pain

Recommended Videos

Lorimer Moseley – Why Things Hurt

Pain. Is it all just in your mind? Professor Lorimer Moseley



Biomechanics of the Lumbopelvic-Hip Complex and Applications to Resistance Training