in summary, it is interesting to consider why only some workers become patient
there is not question that damage to tissue can be caused by excessive loading, and damage cause pain
however, pain is a perception that is modulated by psychosocial variables in addition to physiological injury
clearly both psychosocial and biomechanical variables are associated with LBD and are important in preventing low back injury and ensuing chronicity; collectively the evience from several scientific perspectives is overwhelming
the ralative importance of either is often difficult to compare across studies as the metrics for each are different-biomechsnical variables are reported in newton-meters, x cycles, and so forth, while psychosocial variables are reported in ordinal scales linked to perception
some influential reports have ignored biomechanical evidence and promoted psychosocial variables as being more important
however, no study of psychosocial variables has been able to conclusively establish causal links-only association
some biomechanically based studies, together with the chronic pain literature, are strongly convincing in their establishment of both association and causality
thank good ness! we can noe proceed