Simple or Non-specific Lower Back Pain - One of the Most Common Causes of Lower Back Pain

Current clinical guidelines (see ref below) group lower back pain into three main types. These three main causes are:

1. Serious spinal problems (<1%)
2. Nerve root irritations (<5%)
3. Simple or non-specific pain (approx 95%)

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For more details on all three take a look at this page which is about these causes of spinal pain and looks at them in more detail.

Simple back pain is the most common type of low back problem and confusingly there are lots of terms used to describe it, these include:

• Facet syndrome
• Mechanical/postural back pain
• Back muscle pain
• Back Muscle spasm
• Back ache
• Lumbago
• Lumbar strain

What are the symptoms of simple lower back pain?

I see many people with this problem, in fact this condition makes up the bulk of my caseload. Commonly the pain is felt in the centre of the low back area and can spread out to the tops of the buttocks or thighs. About 70% of people with simple low back pain have pain referred to the buttocks and thighs. It is often described as a dull, aching pain that is hard to pin point. Usually the back pain is worse than the leg or buttock pain ( this differs from sciatica)

 

This body chart shows the normal pattern of non-specific lower back pain. Notice how it can spread across the buttocks toward the hips.

What makes it feel worse?

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It is frequently 'activity dependent' which means it often worsens as you do a particular activity, such as sitting for example. It is often a bit better in the mornings (unless sleep postures / mattress are a problem) and after rest - many people complain that it gets worse as the day goes on (again this differs from a disc bulge where often the symptoms are usually worse after rest).

How does it start?

There is no absolute pattern, it can start gradually for no apparent reason, or more suddenly after changes in activity levels or an obvious injury. These case studies show some of the different ways that this problem can start.

How does it behave ?

It often comes and goes to start with. It can start with a single episode of pain, often 2-5 days in duration. It often returns (estimates suggest that up to 75% of people who have had this once will get it again). The number of days of pain may increase and the time between the episodes may decrease. Eventually,some people with this problem feel pain most of the time.

Which treatment is best for this problem

What causes the pain in simple back pain?

Some case studies showing how simple back pain starts.

Lower Back Pain Toolkit Home Page

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References

(1) Prodigy Guidelines

23-May-2011