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The intervertebral disc: a biologically active tissue challenging therapy.

The primary role of intervertebral disc as the tissue related to low back pain was confirmed 60 years ago when disc prolapses were described. Recent studies are providing more information on what other types of changes in discs can cause low back pain and how pain and clinical findings are related to disc herniations. This differs greatly from what the scientific community has generally accepted in the past and so it is evident that the new knowledge will change both diagnostic and treatment procedures. These new studies give very little, if any, support to the old methods of physical medicine in treating back pain as being anything more than palliative. However, the increased understanding of how cartilaginous tissues maintain, lose, or even improve their loading capacity supports active, dynamic rehabilitation which has led to good clinical results.