Is lumbar spine instability rare?

No, it is common depending on definitions used and patient population.

Can lumbar spine instability influence tissue loading?

Yes. Impaired control of intervertebral translation may alter shear-related displacement and tissue loading, potentially contributing to nociceptive input.

Can clinicians identify lumbar instability?

It depends who you ask! Lumbar instability should not be dismissed simply because individual clinical tests have limited diagnostic accuracy. Consider integrating clinical history, patient-reported symptoms, examination findings, and relevant imaging to develop a provisional hypothesis. The Lumbar Spine Instability Questionnaire as well as a battery of tests can help in hypothesis formation.