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Nonspecific back pain

Contents of this page:


Skeletal spine
Skeletal spine
Vertebra, cervical (neck)
Vertebra, cervical (neck)
Vertebra, lumbar (low back)
Vertebra, lumbar (low back)
Vertebra, thoracic (mid back)
Vertebra, thoracic (mid back)
Spinal stenosis
Spinal stenosis
Spine supporting structures
Spine supporting structures

Alternative Names    Return to top

Back pain - nonspecific

Definition    Return to top

Nonspecific back pain refers to pain in the back due to an unknown cause.

See also: Low back pain

Causes    Return to top

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 can not 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. .

Symptoms    Return to top

Exams and Tests    Return to top

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.

Treatment    Return to top

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.

Outlook (Prognosis)    Return to top

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.

Possible Complications    Return to top

Chronic pain can develop which can be debilitating and keep people out of work.

When to Contact a Medical Professional    Return to top

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    Return to top

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.

References    Return to top

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.

Update Date: 5/12/2008

Updated by: Thomas N. Joseph, MD, Private Practice specializing in Orthopaedics, subspecialty Foot and Ankle, Camden Bone & Joint, Camden, SC. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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