Health care professionals are actively seeking ways to classify patients according to their clinical presentation. Clinical presentation refers to the patient's signs and symptoms. What makes them better? What makes them worse? How long does it last? Frequency, intensity, and duration of the painful symptoms are all part of the presentation.

One approach to LBP is called treatment-base classification (TBC). The idea is to find groups of patients with a similar history and presentation. Place them in groups or subcategories. Then look for a treatment program that works for each group.

The current TBC system places LBP patients into one of four groups. If the pain can be changed by specific movements, then flexion or extension exercises might work best. Other patients may do better with mobilization or manipulation. A third group may respond best to spinal stabilization called core training.

The fourth treatment category is traction. Traction is the application of a mechanical force on the soft tissue and bones of the spine. It is reserved for patients who have back and leg pain that doesn't change with spinal flexion or extension. The traction force helps relieve pressure on the musculoskeletal system.

If you do not get results from treatment, then the therapist will re-evaluate your case and modify the treatment plan. If you do not respond to any of the treatment techniques, then a medical exam is needed.