Detailed guides to painful problems, treatments & more

The back is still important in back pain

 •  • by Paul Ingraham
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Weekly nuggets of pain science news and insight, usually 100-300 words, with the occasional longer post. The blog is the “director’s commentary” on the core content of a library of major articles and books about common painful problems and popular treatments. See the blog archives or updates for the whole site.

These things are terrible at finding the causes of back pain. But that doesn’t mean it’s not there.

Radical idea! For several years now, it’s been progressive — maybe almost fashionable — for back pain educators (like me) to trash talk magnetic resonance imaging (MRI) as a tool for finding the causes of back pain. (Because it has a really poor track record. Which is the most thoroughly referenced point made anywhere on And that’s really saying something!)

However, just because we can’t seem to reliably find smoking gun causes of back pain with modern imaging technology does not mean it isn’t there. Physical therapist and researcher Tony Ingram makes this important point in a short, clear, evidence-based opinion piece [content no longer available]. See also this academic paper from 2011: What happened to the ‘bio’ in the bio-psycho-social model of low back pain?