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non-specific back pain

Alternative Names
back pain

Non-specific back pain symptoms occur mostly in the back. Symptoms are not related to nerve problems or a serious underlying condition.

What is going on in the body?
Nearly everyone has back pain at some time. About 20% of people have some form of back pain each year. Back pain is the most common cause of disability for people under the age of 45. In most cases, herniated discs, fractures, or other structural problems are not the cause of the pain. Back pain can be in different locations. Pain can be in the neck, upper back and shoulders, and the lower back. Often non-specific back pain results from stresses on the muscles and ligaments that support the spine. Sometimes it is hard to find the cause of the pain.

What are the signs and symptoms of the condition?
Back pain can be unbearable. It can also be just a nagging annoyance. Medical treatment is necessary if the person has a loss of bowel or bladder control or numbness that goes into the legs. A doctor should be seen if the pain is severe, lasts more than a few days, or keeps a person from daily activities.

Specific symptoms include:
  • pain in the lower or upper back
  • pain that radiates to the thighs, buttocks, or arms
  • muscle spasms
The back also may be sore to the touch.

What are the causes and risks of the condition?
Back pain is usually a result of a strain to the muscles or ligaments. People who are inactive are especially at risk. Inactive people are not conditioned. They are prone to strains when they use their back. People who smoke, are older, have poor posture, or who do a lot of lifting or repetitive movement are also prone to back pain. The exact cause of back pain may be hard to find. Pain can come from muscles, ligaments, nerves, discs, or bones.

Some causes of non-specific include:
  • muscle or ligament strain
  • degeneration of vertebrae
  • overuse
  • poor posture
  • injuries to the back
  • inactive lifestyle
  • disease, such as tumour, spondylitis, or osteoporosis
  • slips and falls
What can be done to prevent the condition?
Back pain and injury can be prevented. Regular exercise and stretching muscles before playing sports or being active can help. Careful lifting and good posture help protect the back. People who sit or stand a lot should take frequent breaks. Work surfaces and materials should be at a comfortable height and position. Mattresses may be soft or hard as long as they are comfortable. Good stress management skills help keep tension from gathering in the back. Smokers have a higher incidence of back pain, possibly because smokers tend to be more inactive. People can learn to protect their backs in every-day activities and strengthen them with exercise.

How is the condition diagnosed?
The doctor will take a careful medical history. Physical and neurological examinations diagnose the condition. A medical history helps the doctor find any serious underlying conditions. These include fractures, tumours, infection, and specific syndromes that affect the back. The physical examination looks carefully at the muscles and the bones in the back. The doctor will also examine reflexes, legs, and feet. Sometime X-rays are needed. Rarely, CT scans or MRI scans, two special types of X-rays, are taken of the back. These are done to rule out other causes of back pain, such as a herniated disc or fracture.

What are the long-term effects of the condition?
Sometimes non-specific back pain can lead to chronic pain.

What are the risks to others?
There is no risk to others.

What are the treatments for the condition?
Non-specific back pain usually goes away in a few days to a few weeks. Treatment usually includes resting the back for just a few days. Many people think that back pain means spending a long time in bed. The opposite is true. In general, it is best to begin moving and doing normal activities within a few days. Too much rest can cause the back to hurt more because muscles become weakened. Nonsteroidal, anti-inflammatory drugs, or NSAIDS, are commonly prescribed. Other medications may include analgesia, muscle relaxants, antidepressants, or steroid injections. There are also treatments that can help relieve discomfort and decrease the amount of time spent away from normal activities. These include using ice, heat, stress management techniques, and exercise that does not stress the back. Sometimes a person will be helped with physiotherapy, spinal manipulation, or other applied therapy. Generally, a person can expect to recover fairly quickly from non-specific back pain.

Treatments include:
  • rest for 4 days or less
  • analgesics, muscle relaxants, antidepressants, or steroid injections
  • heat, ice, and exercise that does not stress the back
What are the side effects of the treatments?
NSAIDS can upset the stomach. Other drugs may also cause stomach upset, drowsiness, and other symptoms, depending on the drug and dose.

What happens after treatment for the condition?
Learning about the back and how to prevent re-injury is important. Learning how to protect and strengthen the back is an important part of the total treatment.

How is the condition monitored?
People with non-specific back pain can expect to feel better within a few days to a few weeks. If healing does not occur within this time, a doctor will look for other causes of the pain. If pain radiates or there is numbness, tingling, weakening, loss of bowel or bladder control, fever, or re-injury, the doctor should be notified.

Author: Terry Mason, MPH
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Potential conflict of interest information for reviewers available on request

This website and article is not a substitute for independent professional advice. Nothing contained in this website is intended to be used as medical advice and it is not intended to be used to diagnose, treat, cure or prevent any disease, nor should it be used for therapeutic purposes or as a substitute for your own health professional's advice.  All Health and any associated parties do not accept any liability for any injury, loss or damage incurred by use of or reliance on the information.


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