Can acute low back pain result from segmental spinal buckling during sub-maximal activities? A review of the current literature

This paper provides a review of the current literature supporting the hypothesis that segmental spine buckling resulting in tissue damage may be a primary cause of sudden onset low back pain, even during activities that are sub-maximal with respect to loading and muscle activation. While a temporal link exists, it is supported primarily by anecdotal and clinical reports. More pertinent to this review is the biological plausibility of segmental spine buckling as a mechanism of acute injury, supported by modelling studies as well as current knowledge of tissue mechanics and neurophysiology. One antithesis, however, is the low incidence of low back injuries reported during sub-maximal tasks. In order to account for this discrepancy, several predisposing factors are addressed, both constant and situation-dependent, which may contribute to the occurrence of segmental spinal buckling during sub-maximal activities.