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Abstract
Most backaches are due to mechanical derangement of the spine.
An x-ray should always be made to rule out disease and establish a base for evaluating present and future degenerative changes.
Physiologic degeneration of intervertebral disks can produce pain, especially if there is concomitant instability.
Spondylolisthesis produces pain only if the underlying disk deteriorates.
Ruptured disk is not the major problem in low back pain, and operation is not mandatory in all cases.
Incorrect posture can lead to back pain and prevent the natural healing process.