Nonspecific back pain refers to pain in the back due to an unknown cause.
See also: Low back pain
Back pain - nonspecific
Causes, incidence, and risk factors:
Back pain is one of the most common complaints treated by physicians. Nearly four out of five people will have back pain at some time in their life. Most of the time, the exact cause of the pain cannot be found.
Back pain can develop in association with a number of causes, including muscle strain , injury to the back, overuse, muscle disorders, pressure on a nerve root, poor posture, and many others. Pregnant women, smokers, construction workers, and people who do repetitive lifting all have increased risk of back pain.
- Low back pain
- Pain in any part of the back
- Pain may radiate to the buttocks or upper legs
Signs and tests:
A physical examination focused on the back, the abdomen, and the extremities may confirm back pain or muscle spasm , but the examination does not reveal a specific cause (such as a herniated disk) or any neurological problem (such as weakness or change in sensation).
X-rays of the spine are usually normal. Further work-up may include a CT scan or MRI of the spine.
Most nonspecific back pain is probably caused by muscle strain. It usually responds to 2 - 5 days of rest and pain medications such as nonsteroidal anti-inflammatory drugs (NSAIDS), which includes ibuprofen and naproxen, followed by gradual return to activities. Medications may be needed to reduce muscle spasms.
Physical therapy is often prescribed so the patient follows proper body mechanics (such as good posture and lifting correctly) and to improve strength and flexibility in the spine, abdomen, and legs.
Surgery is not useful for the treatment of nonspecific back pain.
Most cases of nonspecific back pain go away on their own or respond to treatment. It is helpful to sleep on a firm mattress, with a board under the mattress, or even on the floor. Heat or ice applied to the affected area may provide some relief.
Chronic pain can develop, which can be debilitating and keep people out of work.
Calling your health care provider:
Call for an appointment with your health care provider if there is significant pain that persists beyond a week.
Call your health care provider if you have been diagnosed with nonspecific back pain and the pain changes in intensity or quality. This is particularly important if the pain travels down the legs below the knee (suggesting pressure on the nerves as they leave the spinal cord), or if there is weakness or numbness in a leg.
If you develop progressive weakness, urinary incontinence , or bowel incontinence , or if you have numbness in your groin or anal region, you should get to an emergency room or call the local emergency number (such as 911).
Prevention is very important, given the tremendous number of people who suffer from this problem. Maintain your weight in a healthy range and keep the back muscles strong and flexible to help prevent back problems.
Good posture and correct technique when lifting heavy objects (lifting with legs, keeping back straight) or carrying heavy objects (keep object close to body) are also beneficial.
Smeets RJ, Vlaeyen JW, Hidding A, et al. Chronic low back pain: physical training, graded activity with problem solving training, or both? The one-year post-treatment results of a randomized controlled trial. Pain. 2008;134(3):263-276.
Urquhart DM, Hoving JL, Assendelft WW, et al. Antidepressants for non-specific low back pain. Cochrane Database Syst Rev. 2008;(1):CD001703.
Chou R, Huffman LH. Medications for acute and chronic low back pain: a review of the evidence for an American Pain Society/American College of Physicians clinical practice guideline. Ann Intern Med. 2007;147(7):505-514.
Chou R, Huffman LH. Nonpharmacologic therapies for acute and chronic low back pain: a review of the evidence for an American Pain Society/American College of Physicians clinical practice guideline. Ann Intern Med. 147(7):492-504.
Chou R, Qaseem A, et al. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann Intern Med. 2007;147(7):478-491.