1 Treating Mechanical Dysfunctions of Lower Back through Lumbar Spine Assessment of Structural Diagnosis and Management (SDM): A New Comprehensive Approach of Musculoskeletal Medicine KM Amran Hossain 1 , Mohammad Shahadat Hossain 2 , Sapia Akter 3 , Mohammad Anwar Hossain 4 and Md Obaidul Haque 1 * 1 Department of Physiotherapy, Bangladesh Health Professions Institute, Bangladesh 2 Jahangirnagar University, Bangladesh 3 Agrani Specialized Physiotherapy Centre, Bangladesh 4 Centre for the Rehabilitation of the Paralyzed, Bangladesh *Corresponding author: Obaidul Haque, Head of Physiotherapy Department and Vice-principal, Bangladesh Health Professions Institute (BHPI), Bangladesh To Cite This Article: Md Obaidul Haque, Treating Mechanical Dysfunctions of Lower Back through Lumbar Spine Assessment of Structural Diagnosis and Management (SDM): A New Comprehensive Approach of Musculoskeletal Medicine. Am J Biomed Sci & Res. 2020 - 7(1). AJBSR. MS.ID.001101. DOI: 10.34297/AJBSR.2020.07.001101. Received: December 02, 2019 ; Published: January 17, 2020 Copy Right@ Md Obaidul Haque This work is licensed under Creative Commons Attribution 4.0 License AJBSR.MS.ID.001101. American Journal of Biomedical Science & Research www.biomedgrid.com --------------------------------------------------------------------------------------------------------------------------------- ISSN: 2642-1747 Short Communication Abstract Low back pain and radiculopathies are leading health issues and mainly managed through conservative approaches concentrating on articular and neural structures of lumbar spinal segments. Although more than one-third of the sources causing lumbar pain, radiculopathy or associated impairments may not arise from the lumbar spine, articulations, nerve roots or local structures. Structural Diagnosis and Management is a comprehensive and systematic approach of taking history, examination of arthokinemetic and osteokinemtic motions of lumbar spine, stretching the series of muscles in lumbopelvic and lower extremities with biomechanical rationale, strength test to relative prime, segmental and regional stabilizer, neurological examination to the biomechanical contributor, myotomes and isolated neural structures to generate a diagnosis. The concept is developed by Dr. M Shahadat Hossain with a hypothesis that, disc herniation, degenerative disc disease or other structural and mechanical phenomenon might be treated creating a biomechanical correction by strengthening the week structures and stretching the adherent or spasmodic structures with or without localized release to the adherent neural sensitivity. The concept integrates articular, contractile, inert structural dysfunctions concentrating on spinal, regional and biomechanical connections to ensure assessment and treatment through the appropriate clinical reasoning process. Keywords: SDM; Lumbar spine assessment; Low back pain Introduction Low back pain is a prominent musculoskeletal condition that affects health and impacts upon the social and economic status of any population worldwide [1]. Hoy, Brooks, Blyth, and Buchbinder [2] avowed more than three fourth of global populations suffer low back pain anytime in their life. Low back pain is manifested by sev- eral structural involvements of the lumbosacral spine as, the inter vertebral disc, facet joint, sacroiliac joint, spinal body and arches, neural tissues and surrounding soft tissues [3]. Lumbar spine as- sessment needs a comprehensive evaluation of contractile and non-contractile structures that contribute to the mechanical pain, structural dysfunction or even neurological symptoms that might manifest differently over time [4]. In lumbar spine assessment, the conventional protocol and approaches focus on the lumbar region,