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Back pain isn’t about being “unstable”

 •  • 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.

Dr. O’Sullivan in 2021, summarizing his 2012 editorial in the British Journal of Sports Medicine:

I used to believe instability in the lumbar spine was a thing — even published about it — but the evidence just didn’t stack up. Discussed here [full text PDF].

A nugget from the editorial:

“It is now clear that there is little evidence to support the view that ‘instability’ underpins the basis of disabling non-specific chronic low back pain. There are no studies that demonstrate a clear relationship between spinal or pelvic mobility, degenerative processes, pain and disability.”

The citation:

O'Sullivan P. It's time for change with the management of non-specific chronic low back pain. Br J Sports Med. 2012 Mar;46(4):224–7. PubMed 21821612 ❐ PainSci Bibliography 52124 ❐

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