ABSTRACT
One of the most difficult tasks in treating patients with low back pain is narrowing the differential or defining the patient’s problems. Before beginning treatment, whether operative or nonoperative, determining the pain generator is essential. A complete history and physical examination are mandatory, as is defining exacerbating activities, and pain at rest or during activity, as well as psychosocial issues and issues of secondary gain.1 The latter two can confound both the diagnosis and treatment.
