I am an American working for a U.S. company in Canada. I live too far away to travel to the States for my medical care, so I went to a regional rehab center here for help with my back pain. They want to shuttle me off to a clinic on another campus because I somehow fall into a subgroup of patients who should be treated differently than others. Does any of this make sense to you? I've never heard of such a thing in the U.S. and wonder if I should make a trip home for this.

When it comes to the treatment of mechanical low back pain, physicians and physical therapists have taken a different approach in the last few years. Research has shown that certain subgroups of patients seem to do better with one form of treatment over another. So, efforts are being made to develop a classification system that will help identify which subgroup a patient should be placed in for the best results.

Mechanical low back pain refers to back pain that is related to the way the spine moves. Some movements or positions make it better while other movements or positions make it worse. These patterns are somewhat predictable. The response (pain is better or worse) is the same each time the movement is used or position is assumed. Mechanical pain usually involves the soft tissue structures, joints, discs, cartilage and/or bone. Another term gaining in popularity for this type of pain is nonspecific low back pain (NSLBP). Mechanical or nonspecific low back pain is not caused by tumors, infections, or fractures.

Traditional therapy for mechanical or nonspecific pain has been through a rehab approach. Patients are given reassurance of recovery, an exercise program, and advice to stay active. Bed rest is no longer recommended. Sometimes various forms of heat or cold are used. But this is a one-size-fits-all kind of approach. And many people are left unhappy with the results. They don't really know what is causing their pain and they don't get better.

That's why health care professionals stopped and took a closer look at patients with low back pain and realized there may be subgroups of patients -- patients with certain characteristics, histories, and clinical presentations -- who could be treated in a specific way for a better outcome. It sounds like you've gotten in with a group of health care professionals who are as up-to-date as possible. Give it a try and see if you get the results you are hoping for. If not, then consider your options.