The best overview of the back pain industry is the recent book, "Crooked: Outwitting the Back Pain Industry and Getting on the Road to Recovery"[0]. The author's interview here[1] is a chilling survey of how the back pain industry extracts money from the population. The article mentions back pain becoming independent of injury, and that idea is from Dr. Sarno[2] in the 1970s, and he was ridiculed for decades about that idea. It is now recognized that a pain circuit can establish itself and run long after all physical injury is healed.

One reason back pain is tricky is that the intravertebral muscles spasm to protect the spinal core, and the spasms don't stop for up to ten days. By that time, the patient may have seen three doctors and had three different therapies. When the spasms subside, they associate the last treatment as the one that "healed" their back, when in fact, 80% of all back pain resolves itself with or without treatment.

There is a growing body of evidence-based research into exercise and back pain. The most studied device is the MedX lumbar extension machine[3][4], invented by Arthur Jones, the genius behind Nautilus exercise machines. Slowly the knowledge to strengthen the specific perispinal muscles is spreading[5].

[0] https://www.amazon.com/Crooked-Outwitting-Industry-Getting-R...

[1] https://www.youtube.com/watch?v=ztdKosnQHaE

[2] https://en.wikipedia.org/wiki/John_E._Sarno

[3] https://www.youtube.com/watch?v=1Z-FyeG7pqY

[4] http://ssudl.solent.ac.uk/2270/

[5] https://highintensitybusiness.com/podcast/dr-ted-dreisinger/

For a terrific overview of the back pain industry and the scams that many places try to pull, I recommend the new book "Crooked: Outwitting the Back Pain Industry and Getting on the Road to Recovery"[0]. The author gave a great interview on this podcast episode[1]. She goes into the Sarno principles, among other topics. Strength training for the back is often a great help, but rarely prescribed by doctors. Most people have never heard of the multifidus muscles, much less seen the specialized machines for strengthening these muscles so critical to spinal stability[2].

[0] https://www.amazon.com/Crooked-Outwitting-Industry-Getting-R...

[1] https://informfitness.com/podcast/50-outwitting-back-pain-ca...

[2] https://www.youtube.com/watch?v=1Z-FyeG7pqY