Chronic low back pain and its clinical management

Abstract

Chronic low back pain is a multifactorial condition that affects the spine and has a complex pathophysiological basis. This article aims to analyze the clinical consequences and factors that influence the phenotypic diversity of this condition. Phenotypic variation is crucial to allow adaptation throughout evolution, but this variation must be controlled to avoid compromising the vital functions of the musculoskeletal system. Vertebral structures maintain their characteristics and signaling pathways over time, with conserved epigenetic modifications. Phenotypic diversity in the vertebral unit occurs due to processes of ontogeny, remodeling, phenotypic variation, adaptation, and environmental sensitivity. These processes involve internal and external stressors, orderly transitions of cell development, temporal changes in development, rapid adaptation, and epigenetic modifications.