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Similarly, a study by Yang and Haldeman, derived from the 2009-2012 National Health Interview Survey of the civilian US population, indicated that risk factors for LBP include current or previous smoking, current or previous alcohol use, lack of sleep, obesity, and lack of leisure-time physical activity.The pathophysiology of mechanical LBP remains complex and multifaceted.The image below illustrates a herniated nucleus pulposus at multiple levels, one of the causes of LBP.An important part of the physical examination is the general observation of the patient.By 12-month follow-up, the integrated care group had experienced significantly greater improvement in functional status than had the conventional care patients.However, the investigators found no significant difference in pain reduction between the 2 groups at 12 months.Of the US population, 85% will experience an episode of mechanical LBP at some point during their lifetime.

Mechanical LBP due to cumulative trauma tends to occur more commonly in the workplace.Multiple anatomic structures and elements of the lumber spine (eg, bones, ligaments, tendons, disks, muscle) are all suspected to have a role.