I just had my first episode of back pain ever. I'm 55 years old and thought I was immune to back problems. The doctor couldn't find the exact problem. Is back pain like one-size-fits-all? Everyone gets one kind of back pain when there's no known cause?

Back pain affects most people at some time in their life--usually beginning in mid-life. When the pain isn't caused by a single problem, it can pose a big mystery. About 80 percent of back pain sufferers get better and return to their previous activities.

Most of these folks are labeled with mechanical low back pain. This means that the bones and soft tissue structures of the low back area may not be lined up and/or are not moving properly. Usually it's not something that shows up on an X-ray or MRI.

In cases like these, physical therapists categorize back pain based on which movements cause the pain. So if bending and twisting increases your pain, you may have a Rotation-Flexion problem. If rotation with extension is painful, you would have a Rotation- Extension problem. Some patients only have pain with extension have an Extension Syndrome.

With this model, the one-size-fits-all notion doesn't work. Treatment is individual to each specific movement problem.

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