The cause of the majority of back problems can be found in basic physical principles. To function correctly, the spine must be supple and elastic, like the spine of a healthy teenager. It must also be free from conditions such as abnormal curvatures (scoliosis, kyphosis and lordosis) and patterns of pre-rotated vertebrae. These have a profound effect on the mechanical efficiency of the spine and the stressing of joints. Curvatures and pre-rotated vertebrae may develop progressively or rapidly following an event such as a whiplash injury.

As the spine becomes less supple, stresses begin to concentrate at particular joints in the spine during activity. Where stresses concentrate (usually in the low back and at the base of the neck), the joints are overstressed. Back pain, stretched ligaments, excessive wear and tear and disc prolapse are the natural consequences of this overstressing.

As the spine begins to fail, patients typically suffer a series of back pain episodes characterised by pain and a protective posture response ( the patient often recognises that one hip appears higher than the other). This response acts to protect against further nerve root irritation and the episodes subsides. However, this is significant in that it causes a further massive increase in the overstressing of the joint.

Back pain episods are an early warning sign and if function is not restored, joint degeneration is inevitable. The nerve supply to other parts of the body can be compromised possibly leading to tingling, numbness or pain in the arms or legs. Further complications might occur such as a bulging or a prolapsed disc.