Mar
Back and Joint Pain
Non Specific Low Back Pain
The Leading Cause OF Disability World Wide
Low back pain (LBP) has the highest prevalence of all musculoskeletal conditions and is the leading cause of disability worldwide. Most people experience LBP at least once in their life and it can occur at any age. The good news is that out of all conditions, research shows that it is the one which people experience the most benefit with rehabilitation.
Lumbar pain can be described as specific or non-specific. Specific back pain refers to pain that is caused by an identifiable structural problem or disease. Non-specific LBP is more ambiguous, most of the time it is not possible to identify an exact cause of the pain. And there may be no obvious structural damage. Non-specific lumbar pain accounts for approximately 90% of all cases of back pain that people seek medical attention for.
Symptoms of Non-Specific Low Back Pain
- Can be a dull ache or a sharp pain across the lower back (the area between the base of the ribs and the buttocks).
- Stiffness
- Difficulty bending or turning.
- There may be pain radiating down the leg.
- Irritation
- Depression
What Causes Non-Specific LBP?
- Prolonged periods of poor posture
- Intensive physical work
- Weakness in the muscles of the back or abdominals
- Long periods of sitting still
- Previous injury that may be structurally healed but can still be causing pain.
- Having risk factors including obesity, smoking, low activity levels or high physical stress at work. Can all contribute to the development of non-specific LBP.
How Do I Know if my Low Back Pain is Serious?
If your LBP is gradually worsening and has showed no signs of improvement over a two-week period. If you have intense pain at night, particularly worse than in the daytime. Or if you have unremitting LBP, you should seek medical assistance. Additionally, if you have had persistent LBP and have noticed that you are losing weight without trying to, you should have a medical assessment.
What Can I Do About my Non-Specific Low Back Pain?
There are many aspects that make up treatment for non-specific back pain. A multifaceted approach involving a combination of physical rehabilitation, psychological, and pharmacological management can be very effective.
National Institute for Health and Care Excellence (NICE) guidelines recommends manual therapy techniques in combination with exercise therapy.
Psychological therapy may also be utilised if appropriate, and NSAIDs may be considered but should be taken at the lowest effective dose and shortest possible time necessary. In the case of acute lumbar pain, your doctor may consider a weak opioid only for the short term, but these are not recommended for chronic LBP.
Advice and education on self-management should also be provided by a qualified healthcare professional such as a physiotherapist.
The Role of Physiotherapy in the Management of Non-Specific Low Back Pain
Guidelines for managing non-specific LBP recommend manual therapy techniques, including myofascial release and mobilisations which can be performed by a physiotherapist. As well as a progressive rehabilitation exercise programme. Your physio will be able to assess your limitations or deficits and tailor your exercise programme to target these areas while managing your pain.
When to Seek Urgent Medical Attention
If you notice an onset of numbness in your groin area, including your inner thighs and buttocks, any signs of urinary retention, or incontinence of your bladder or bowels, intense pain, or numbness down both legs. And/or sudden onset sexual dysfunction you should seek immediate medical attention. Additionally, if you develop a fever or high temperature with your LBP, or if you are feeling generally unwell, you should also seek urgent medical care.
How Long Will It Take to Recover from Non-Specific Low Back Pain?
Several studies have found that 75-90% of people with acute LBP improve within four weeks, however there is often a high relapse rate. Supervised care and treatment with a healthcare professional or a team of healthcare professionals can be very beneficial. Helping determine possible causes of pain and help to assist with full recovery and prevention of future recurrence.
CITATIONS
- Koes BW, van Tulder MW, Thomas S. Diagnosis, and treatment of LBP. BMJ 2006;332:1430–34
- J. Coste, G. Lefrancois, F. Guillemin, J. Pouchot
Prognosis and quality of life in patients with acute LBP: insights from a comprehensive inception cohort study
Arthritis & Rheumatism, 51 (2004), pp. 168-176 - M. Grotle, J.I. Brox, B. Glomsrod, J.H. Lonn, N.K. Vollestad, N.K. Vallestad, Prognostic factors in first-time care seekers due to acute LBP, European Journal of Pain, 1 (2007), pp. 290-298
- LBP and sciatica in over 16s: assessment and management, NICE guideline [NG59] Published: 30 November 2016, Last updated: 11 December 2020
