Ever experienced or heard someone complain about low-back pain for which there does not seem to be an explainable reason? It could be non-specific low back pain. Yes, that is the correct medical terminology. Read on to find out more.

What is Non-Specific Low Back Pain?

Non-specific low back pain is one that is not attributable to a specific condition or pathology (e.g., infection, fracture of the lumbar spine, deformity, inflammatory disorders, musculoskeletal disorders, etc). 

It is typically classified into three subtypes based on its duration: acute (< 6 weeks), sub-acute (6 to 12 weeks) and chronic (> 12 weeks) non-specific low back pain.

What Causes Non-Specific Low Back Pain?

There are several causes of non-specific low back pain, including:

  • Traumatic injury.

  • Lumbar sprain or strain (obesity, prolonged sitting or standing, etc).

  • Postural strain.

  • Occupational (manual jobs).

What Are The Features of Non-Specific Low Back Pain?

Characteristic features of non-specific low back pain include:

  • A recognizable, identifiable pathology (such as an infection, fracture, autoimmune or inflammatory disorder, etc.) cannot explain the cause of low-back pain.

  • Both sexes and all age groups can be equally affected by non-specific low back pain but the impact on quality of life is much higher in older age groups.

  • In most cases, the outcome of acute spells is obscured by frequent relapses.

  • Recurrence is one of the major characteristics of non-specific low back pain, as demonstrated by large-scale studies. 

  • Increased lumbar spine motility is a common clinical finding in non-specific low back pain.

  • Most of these episodes are self-limiting and are not associated with serious diseases. However, it is important for the physician to recognise and distinguish red flags such as the age of onset (less than 20 and greater than 55), history of trauma, unexplained weight loss, and any other neurologic symptoms associated with it.

How is Non-Specific Low Back Pain Managed?

The physiotherapy management of non-specific low back pain includes:

1. Therapeutic Modalities to Reduce Pain

  • Thermal therapy.

  • Therapeutic ultrasound.

  • High-intensity laser therapy.

  • Combo therapy.

  • Super inductive system.

2. Aerobic Exercises

Ideally, this should comprise up to a maximum of eight sessions over a period of up to 12 weeks. The exercise programme may include elements such as:

  • Treadmill running.

  • Cycling.

  • Swimming.

  • Elliptical training.

  • Rowing.

3. Muscle Strengthening 

  • Core strengthening exercises such as planks, side planks, partial crunches, reverse crunches, abdominal hollowing, etc.

  • Gluteal strengthening exercises such as clamps, quadruped kickbacks, standing hip abduction, bridging, progressive resistive exercises with loop band and theraband, etc.

  • Lower back muscle strengthening exercises such as spinal extension, quadruped arm/leg raise, quadruped kickbacks, supine pelvic tilt, prone lying leg raises, etc.

4. Stretching

  • Child’s pose, head to toe, forward fold, chest to knee, sitting twists, piriformis muscle stretch, hamstring stretching (long seated forward bend), pigeon stretch, cobra stretch, etc.

5. Motor Control Training

  • Contraction of transversus abdominis muscle: Pull your belly in and up at the navel without moving the rib cage, pelvis or spine. 

  • Contraction of the multifidus muscle: Standing with a forward stride. Move one foot forward while standing. Put your weight on your front leg and then your back leg alternately. Also, you can modify this activity with a theraband tied around your knee and perform this task against the theraband resistance for multifidus strengthening.

6. McKenzie Therapy

  • Patients with non-specific low back pain can benefit from this classification-based treatment. The therapy consists of three parts - evaluation, treatment, and prevention. The exercises in the treatment are guided by the direction of pain (flexion, extension, lateral bending, and rotation) with the aim to reduce pain.

7. Manual Therapies

  • Spinal manipulation and mobilisation.

  • Soft tissue mobilisation (massage).

Up to nine sessions of manual therapy over a period of 12 weeks is recommended to reap the maximum benefits of this treatment modality. Alternatively one could also try guided pilates, dry needling and dry/wet cupping therapy to ease the pain.

If you feel like you suffer from low-back pain without any particular reason, consult your doctor for prompt diagnosis and management of the condition. 

Disclaimer: This article is written by the Practitioner for informational and educational purposes only. The content presented on this page should not be considered as a substitute for medical expertise. Please "DO NOT SELF-MEDICATE" and seek professional help regarding any health conditions or concerns. Practo will not be responsible for any act or omission arising from the interpretation of the content present on this page.