Non-Specific Low Back Pain

Non-specific low back pain is the most common form of low back pain. The symptoms, genesis and location of the complaints can vary greatly per patient.

Low back pain is generally classified into two - specific low back pain and non-specific low back pain. In the case of non-specific low back pain, the patient has symptoms for which no specific cause can yet be demonstrated. When we can point out a structure that causes back pain, we speak of specific low back pain. Sometimes this can indicate a more serious problem in the back. The best known example of specific low back pain is the back hernia.

Description of the disorder
Non-specific low back pain is by far the largest group of low back pain patients. In about 90% of all people with low back pain, the back pain is non-specific. The duration of a period of low back pain is classified into: acute (0-6 weeks), sub-acute (7-12 weeks) and chronic (longer than 3 months). When more than two periods of low back pain occur within a year, we call the back pain recurrent (recurring).
The diagnosis 'non-specific low back pain' can sometimes be frustrating because the patient wants to know what the underlying cause of the back pain is. Although no specific structure can be indicated in the body that causes the symptoms, the symptoms are taken very seriously by physiotherapists and specialists.

Cause and genesis
Aging or injury to an inter-vertebral disc is believed to play an important role in the development of non-specific low back pain. Other possible causes are injuries to the ligaments, muscles or (facet) joints of the spine. In general, several structures will be jointly responsible for the experienced back complaints.

Complaints and symptoms: symptoms
The pain in the lower back is in the foreground. This can radiate to the buttock region or the thighs. The pain can be exacerbated by certain postures and movements. Activities that can provoke the pain are lifting or working in the wrong working posture. There may be morning or starting stiffness. If you’re suffering with chronic back pain then you should contact Sheba Medical Center’s Rehabilitation Campus and ask experts for all possible treatments.

The patient is generally further healthy and there are no general symptoms of illness such as fever, nausea or weight loss. The pain may be present continuously or expire in episodes. The first episode generally starts between the 20th and 50th year of life.

Symptoms that may indicate specific low back pain are: a deaf feeling between the legs, accidental loss of urine (or unable to urinate), a sudden sharp increase in loss of muscle strength, an accident or fall, constant pain that continues to increase regardless of rest or exercise, history cancer, low body weight or unexplained weight loss, long-term use of anti-inflammatory drugs, drug use, immune suppression, HIV, disease or fever, changes in knee or knee pain or signs of infection.

Diagnosis
The diagnosis is made by excluding the typical characteristics of specific low back pain. The patient's history, the symptoms experienced and the physiotherapy examination are in many cases sufficient to make the diagnosis. Extensive imaging such as an X-ray, CT scan or MRI can be an aid in assessing the complaints. In many cases, however, this is unnecessary and the abnormalities found say very little about the patient's back pain.

Treatment and recovery
Although no specific structure can be indicated in the body, there is often the possibility of treatment.

In the case of acute low back pain, it is advisable to remain active (dosed), for example by taking a short walk and doing exercises for the back. There is strong evidence that bed rest does not make a positive contribution to recovery. Sometimes anti-inflammatory drugs or muscle relaxants are used. Normally the complaints disappear in 80-90% of people with low back pain within four to six weeks.

If the complaints (and the limitations that this entails) do not decrease within three weeks, there is a different course. It is wise to visit a physical therapist for advice. In the chronic phase, exercise therapy has a better result than no treatment.

Exercises
Follow the exercise program here with special exercises for non-specific low back pain. At Sheba Medical Center’s Rehabilitation Campus, you can check your complaints with the free online physiotherapy check or make an appointment at a physiotherapy practice in your area. You can also ask questions about your complaints anonymously on the forum.