Non-specific Lower Back Pain

Non-specific lower back pain is the term used to describe lower back pain an individual experiences that has no specific pathology that can be attributed to the cause. It is one of the most common forms of lower back pain, with a vast majority of acute back pain individuals being classified as “non-specific”. This form of lower back pain is classified into 3 sub categories (acute, sub-acute & chronic), depending on the duration of pain.

In order for an individual to be classified as “non-specific”, the medical practitioner is confident there are no serious spinal conditions associated with the pain based on the clients’ history of events and physical examination. According to the NICE, no imagery (X-ray or MRI) is necessary if the medical practitioner is satisfied that there are no signs and symptoms present that could represent any serious underlying causes. Some signs and symptoms to look out for that may indicate a more serious cause (red flags):

  • Pain that develops gradually and slowly gets worse and worse over days or weeks.
  • Constant back pain that is not eased by lying down or resting.
  • Pain that travels to the chest, or is higher in the back behind the chest.
  • Weakness of any muscles in a leg or foot.
  • Numbness (lack of feeling) in any part of your bottom or leg.
  • Symptoms that may indicate an inflammatory (arthritis) cause such as ankylosing spondylitis, such as pain which is worse in the second half of the night or after waking, stiffness, in addition to pain, of the back muscles in the morning after getting up from bed that lasts more than 30 minutes, pain that is eased (and not made worse) by activity.
  • Symptoms that may indicate cauda equina syndrome, such as numbness around the anus (the ‘saddle’ area), bladder symptoms such as loss of bladder sensation; loss of bladder control, incontinence, loss of sensation when passing urine, incontinence of faeces.
  • Symptoms that may indicate a fracture in the spine, such as back pain following major trauma such as a road accident or fall from a height, back pain following minor trauma in people with osteoporosis.
  • Symptoms that may indicate infection or spread of cancer affecting the spine, such as onset of pain in a person over 50 years, or under 20 years, of age, pain that remains when lying down; aching night-time pain disturbing sleep.

Because there is no known pathological cause, treatment of this condition includes patient education, pain reduction, analgesic medicines and encouragement of physical activity. The prognosis for individuals experiencing non-specific lower back pain is good with most recovering within in a few weeks.

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