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My old Unibody Aluminum MacBook had this problem...
After taking it into the genius bar they thought it could be battery swelling or an not properly assembled battery that caused this. They replaced my battery and all was well.
This could be the issue for some, but probably not all the people with this problem.

My buddy and his girlfriend both had this problem with their old Aluminum MacBooks. Batteries were both swelling and his girlfriend's trackpad barely functioned at all. All good after replacing the batteries.
 
Hey I'm having the same problem with my tracking pad, it will move the pointer thing around the screen fine, but will not click on anything to open etc,
(It dose physically make a 'click' sound but the function doesn't work)

It was working fine last night now its not. one thing that I'll make note of b4 this happened is, I left the computer running and it ran out of battery, then I 'woke' it up but plugging the power in and it done its whole resume where it left off thing...thats when the clicking ability stopped .

Oh and I'm currently using a USB mouse..

Had the same exact problem and should have known better. I had the battery drain two time before and the problem then, the drive was corrupted and I had to reinstall the system and software. This time however, I got the same problem mentioned here; could not click on my user image at the startup/login screen. I restarted in safe mode(hold shift during reboot http://support.apple.com/kb/HT1533) and the mouse/click worked fine. Rebooted into normal mode and haven't had a problem since.

Moral of the store, don't let the battery run down!

As for battery swelling and tight screws, don't believe it. If you've got a swelling battery, this is quite dangerous and there would/should be recalls. As for screws to tight, the screws are meant to be tight. The proper operation of the mouse pad is not dependant on the tightness of the screws, but, more than likely, on the clearance provided between the pad controller device and the seating bracket it resides in. If a "genious" proposed either of these as the cause of the problem, I would grab my gear and get the heck out of there.
 
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