Low back pain: Part I: Anatomy, physiology, and pathophysiology

Diseased structures of the lumbar spine, and their associated muscular and nervous structures are most often related to the symptoms of pain in the lower back. However, there are many other structures that may refer pain to the lower back (i.e., renal calculus, lymphoma etc.). It is commonly stated that in the majority of low back pain cases, the origin of the pain remains ambiguous. Even though the scientific evidence may be limited for low back pain, it is reasonable to try to relate a given symptom with a probable pathology by first understanding both normal and potential alteration of anatomy and physiology. This is the only way that a physician can teach prevention, provide a reasonable prognosis, and select an appropriate treatment.