The main object of physical medicine in instances of lame back is to restore the normal physiology of the spine. It must be remembered that backache is only a symptom of some underlying postural difficulty, trauma or diseased condition which produces a train of events resulting in pain low in the back. In addition to this. there may be pain in some of the nerves of the lumbar or sacral plexus, the sciatic nerve being most frequently affected.
The integrity of a joint depends on a normal alinement of the articular surfaces, strong ligaments and a normal musculature which moves and aids in supporting that joint. When disease, injury or postural abnormalities occur, this whole mechanism is thrown out of gear. The muscles which support and activate the joints lose tone and strength, with the result that additional burdens of stress and strain are thrown on the supporting structures and
OBER FR. PHYSICAL MEDICINE AND THE LAME BACK. JAMA. 1948;137(2):133–134. doi:10.1001/jama.1948.02890360015004
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