ABSTRACT
Like a modern skyscraper, the human spine defies gravity and defines people as vertical bipeds. It forms the infrastructure of a biological machine that anchors the kinetic chain and transfers biomechanical forces into coordinated functional activities. Most commonly, diagnoses of acute painful spinal conditions are nonspecific, such as neck or back strain, although injuries may affect any of several pain-sensitive structures, which include the disk, facet joints, spinal musculature, and ligamentous support. The spinal lesion occurs when injury or disease adversely affects the capacity of the vertebral motion segment and its components, both contractile and noncontractile, to maintain normal function and manage normal biomechanical forces due to impending or actual tissue damage. When interviewing a patient with spinal pain, it is important to establish the portion of the pain that is axial relative to its distribution in the ipsilateral extremity.
