Low back pain refers to pain in the area between your lowest ribs (around your waist) and your bottom. Acute refers to pain that started recently. Non-specific means the cause of the pain is not serious or trigged from arthritis, infection or sciatica (an irritated nerve in your back). It also means that it is not possible to find a specific source of the pain (eg, joint, muscle, ligament, disc). Most low back pain is non-specific. Even the best imaging techniques cannot identify what is causing your back pain. The good news is that imaging is not required for you to manage the problem effectively.
What causes acute non-specific low back pain?
Studies have identified some risk factors for acute non-specific low back pain. Lifting heavy loads at work and repeated lifting at work, as well as lifestyle factors such as smoking, obesity and depressive symptoms, can increase your risk of experiencing low back pain. However, these factors only increase your risk of experiencing low back pain by a small amount.
How do I know if I have non-specific low back pain?
Your physiotherapist is trained to distinguish between serious and non-serious causes of low back pain. They will do this by asking you a series of questions about your pain and examining your back. Imaging is not needed to diagnose acute non-specific low back pain. It can be tempting for clinicians to make an educated guess about which back structure is responsible for the pain. Many patients and clinicians find ‘non-specific’ hard to accept. However, specific diagnoses, for example, disc injury, joint problem or muscle strain for low back pain are not well supported by scientific evidence and are not needed to manage your pain.
How can physiotherapy help with acute non-specific low back pain?
A physiotherapist can help confirm that you have non-specific low back pain and rule out other conditions that require additional testing and treatment. Once a diagnosis of non-specific low back pain is confirmed, they can give you some advice about recovery time, what you can do and how your physiotherapist can offer to help speed up recovery. This will usually involve a combination of physiotherapy treatment and some things that you can do at home. Physiotherapy treatment might include hands-on therapy, education, exercises or a combination of these. Many people with acute non-specific low back pain require minimal physiotherapy treatment. Techniques to help you manage at home might include advice on how to stay active, how to manage the pain at home and at work, and how to return to your normal activity levels.
How effective is physiotherapy for acute non-specific low back pain?
Many studies have looked at the effectiveness of physiotherapy treatments for people with acute non-specific low back pain. There is some evidence that hands-on treatment can reduce pain in the short term. The good news is that most people recover quickly from acute non-specific low back pain. It may be surprising but exercise, whether it is back-specific (muscle stretches, tummy exercises, repeated back movements) or general (walking, cycling, swimming), does not seem to reduce pain in the short term for people with acute non-specific low back pain. While specific exercises are not useful for relieving pain, returning to the normal physical activities you do around the house and at work is very important. Your physiotherapist can give you advice about how best to do this in a sensible way.
What can I do at home?
Resting in bed for long periods is generally discouraged. Staying active, and using heat and simple medications (eg, ibuprofen such as Nurofen or a diclofenac such as Voltaren) for pain relief can be helpful. Most people can safely return to work even if the pain has not yet gone away.
How long until I feel better?
Most people recover very quickly from low back pain, with much reduced pain within two weeks. Your physiotherapist might use a short questionnaire to help determine whether you should expect your recovery to be fast or slow. Some tools such as the STarT Back Tool and MyBack are available online for you to fill out yourself. You can use this information to help decide on a management plan that is right for you. The results of these questionnaires are good things to discuss with your physiotherapist.