What is non lower back pain?

Low back pain refers to pain in the area between your lowest ribs (around your waist) and your bottom. Non-specific means the cause of the pain is not serious or triggered from infection sciatica (an irritated nerve in your back) or a serious pathology such as a fracture. It also means that it is not possible to find a specific source of the pain (eg, joint, muscle, ligament, disc). Most low back pain is non-specific. Even the best imaging techniques cannot identify what is causing your back pain. The good news is that imaging is not required for you to manage the problem effectively. Many patients and clinicians find ‘non-specific’ hard to accept. However, specific diagnoses, for example, disc injury, joint problem or muscle strain for low back pain are not well supported by scientific evidence and are not needed to manage your pain.

For non specific back pain the majority is mechanical in nature, meaning that there is a disruption in the way the components of the back (the spine, muscle, intervertebral discs, and nerves) fit together and move.

About 80 percent of adults experience low back pain at some point in their lifetimes. For most people back pain comes on quickly (acute back pain), but then improves or goes away within three to six weeks. However, it is common for it to come back, with some people going on to develop more persistent pain (that lasts for more than three months). Having education and advice in the acute stages is very important to prevent you from developing chronic pain.

Signs and symptoms

  • Severity of pain will vary
  • Type of pain can range from being a dull constant ache or a sudden sharp pain in the lower back
  • Back pain may be experienced anywhere along the spine – from the ribs to the buttocks. In some cases, pain may also be felt in one or both legs.
  • Pain can begin abruptly as a result of lifting something heavy and incorrectly, or it can develop over time due to age-related changes of the spine.
  • Stiffness is also a common complaint for people with back pain

What causes non specific low back pain? 

There are many causes with lower back pain, some risk factors include:

  • Back pain becomes more common with ageing
  • Pregnancy
  • Obesity or rapid weight gain
  • Poor sustained postures such as sitting for too long
  • Work and lifestyle related causes include repetitive or heavy lifting with incorrect technique
  • Not getting enough regular physical activity and having a sedentary lifestyle can increase risk of developing back pain as the spine is made to move and studies show that low-impact aerobic exercise is beneficial for the maintaining the integrity of intervertebral discs.

Conservative treatment

  • Education: the physiotherapist will explain to you that the back pain is a symptoms and in most situations does not indicate serious disease and does not mean damage. Education is important to prevent people from protecting their back and avoiding movements as this will make pain worse. Reassurance that most episodes will settle quickly and the spine is a very strong structure is important to understand.
  • Changing poor habits: Following certain guidelines of postures and positioning will help your recovery.
  • Staying active: continuing with daily activities as normal as possible and staying at work leads to the most rapid and complete recovery and less risk of reoccurrence of your back pain
  • Pain relief. Where pain medicines are required it is best to begin with simple analgesics such as panadol using time-contingent dosing. Anti inflammatories can be used in the short term and should be guided by your GP.
  • Exercise: relaxed movements will help your back pain settle. Exercises will vary for people but may include stretching, core strengthening and lower limb strengthening to help with lifting techniques
  • Hands on therapy: massage may offer short term relief however it is exercise that will help you with strategies for self management