Understood. In my experience though, I have many thin patients with back pain, so back pain is multi factorial.
New research is identifying exactly which muscle groups need strengthening, and surprisingly it’s not the anterior abdominal muscles. Researchers in Australia have identified the lateral oblique muscles in low back instability. So rotational exercises that target those “love handle” areas on the sides of the abdomen are most helpful.
Absolutely. Even in one person. You sound like a good doc.
There is a similar issue in all engineering failures. Typically more than one thing amiss and more than one fix for one symptom.
For me I had to use. Good back health (care in lifting and movements). Weight control. Occasional ice. NSIDs. and even had to get a bit of surgery (micro diskectomy to remove a free disk fragment). Any one or two of these does not do squat. Need to do it all.