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May 12, 1945


JAMA. 1945;128(2):92-93. doi:10.1001/jama.1945.92860190003007a

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Low back pain, in most cases, is due to a strain which causes an inflammation in the region of the lumbosacral and sacroiliac articulations. Strain is the result of an imbalance between the capacity of the structures of the back and the physiologic demands made on them. This imbalance is called a functional decompensation. A decompensation of the back gives rise to certain symptoms and findings.

The symptoms are low back pain and tiredness ; this fatigue of the back is often associated with a general fatigue. The first pain noted is usually generalized and is in the muscles, with associated stiffness on arising after rest. Later the pain localizes and may involve the lumbosacral angle or the sacroiliac joint. In the acute phase of this condition there is a sudden "catch," associated with lumbar muscle spasm, loss of the lumbar curve, a protective list with a pelvic tilt, limitation of motion

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