Mal di schiena, classificazione secondo le Sindromi da Disfunzione del Movimento [Low back pain, movement impairement syndromes classification]

According to literature up to 85 percent of low back pain (LBP) cannot match a precise pathoanatomical diagnosis, particularly when the association between symptoms and imaging is weak. Effective diagnostic strategy is mainly needed by occupational and rehabilitation medicine. The present study is based on the hypothesis that cumulative effect of repetitive movements and sustained postures, particularly when the movement deviates from the optimal kinesiologic standard, can lead to tissue damage. Therefore this cross-sectional study answers to lack of standardization for LBP diagnosis by means of the classification proposed from Sahrmann within the Movement Impairment Syndromes (MSI) concept. The classification defines 5 categories of LBP: flexion, extension, rotation, extension-rotation and flexion-rotation. The present study results on 84 health workers with LBP match previous published data on the prevalence of MSI categories: 54.8% extension-rotation, 13% flexion-rotation, 11.9% rotation, 3.5% and 16.6% unclassified. MSI could also contribute to better understand LBP severity and the following restricted duty evaluation. Further studies to increase the sample size and to set up randomized clinical trials are needed.