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Nonspecific Back Pain

Definition

Nonspecific back pain refers to pain in the back that is not caused by a diagnosed disorder, such as a muscle strain or ruptured disc.

What is going on in the body?

Nearly everyone has back pain at some time in life. 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.
Back pain can occur in the neck, upper back and shoulders, the lower back, or in all of these locations. Often nonspecific 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.

Risks

What are the causes and risks of the condition?

The exact cause of back pain may be hard to find. Pain can come from muscles, ligaments, nerves, discs, or bones. People who are inactive are especially at risk because their muscles lack conditioning. They are likely to be strained when they are suddenly put to use.
Other risk factors include the following:
  • advancing age
  • frequent or heavy lifting
  • overweight or obesity
  • poor posture
  • repetitive movements, including twisting
  • smoking

Prevention

What can be done to prevent the condition?

Many times, nonspecific back pain can be prevented. Some helpful steps include:

  • Exercising regularly.
  • Following ergonomic principles in setting up workstations.
  • Practicing good posture.
  • Stretching muscles before exercise.
  • Taking frequent breaks from prolonged sitting or standing.
  • Using good lifting techniques.

Diagnosed

How is the condition diagnosed?

Diagnosis of nonspecific back pain begins with a medical history and physical exam. The healthcare professional may order tests, including:
  • a CT scan
  • an MRI
  • X-rays

Long Term Effects

What are the long-term effects of the condition?

Nonspecific back pain can interfere with personal and work activities.

Other Risks

What are the risks to others?

Nonspecific back pain is not contagious and poses no risk to others.

Treatments

What are the treatments for the condition?

Nonspecific 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, whereas in fact, the opposite is true. In general, it is best to begin moving and doing normal activities within a few days, because too much rest can cause more back pain in the long run because the muscles become weakened.
Other treatments for back pain include:
  • antidepressants
  • corticosteroid injections
  • heat or ice
  • mild exercise that does not stress the back
  • muscle relaxants to relieve muscle spasms
  • acetaminophen (i.e., Tylenol)
  • nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (i.e., Advil, Motrin)
  • prescription pain medicines for severe pain
  • stress management
Occasionally, physical therapy or chiropractic can be ordered to reduce pain and improve function.

Side Effects

What are the side effects of the treatments?

NSAIDs may cause stomach upset or allergic reactions. Other medicines may cause drowsiness, constipation, or allergic reactions.

After Treatment

What happens after treatment for the condition?

Generally, a person can expect to recover reasonably quickly from nonspecific back pain. Learning about the back and how to prevent reinjury is important.

Monitor

How is the condition monitored?

People with nonspecific back pain can expect to feel better within a few days to a few weeks. If healing does not occur within this time, or if any new or worsening symptoms occur, a healthcare professional should be consulted.

Sources

Clinical Practice Guidelines, Acute Low Back Problems in Adults, US Department of Health and Human Services, Agency for Health Care Policy and Research, Number 14, 1994

Back Pain, National Institutes of Health, National Institute of Neurological Disorders and Stroke, Patient Handout, 1997

Fact Sheet on Back Pain, American College of Rheumatology, [hyperLink url="http://wwww.rheumatology.org/" linkTitle="www.rheumatology.org"]www.rheumatology.org[/hyperLink]

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