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Writer's pictureErnesto De La Cruz Valdes

"Understanding the Difference: Specific vs. Nonspecific Low Back Pain"



Lower Back Pain
Back Pain

Specific low back pain is due to a known cause;


-Infection (tuberculosis, discitis)

-Tumor (metastasis)

-Degenerative process (osteoporosis, spinal stenosis)

-FractureStructural deformity (scoliosis, Scheuermann's disease)

-Inflammatory disorder (AD, psoriatic arthritis)

-Root syndromeCauda equina syndrome


Nonspecific low back painIt is defined as low back pain not attributable to a specific known pathology and is classified according to its duration;

-If the pain started less than 6 weeks ago, it is called acute low back pain.

-If the pain started between 6 and 12 weeks it is called subacute low back pain.

-If the pain persists for 12 weeks or more it is called chronic low back pain.


As usual;

-90% of people with low back pain recover in 3-4 months without treatment.

-70% of people with low back pain recover in 1 month without treatment.

-50% of people with low back pain recover in 2 weeks without treatment.

-The remaining 5% to 10% do not respond to conservative interventions.

-The final 5% are the most complex cases which do not improve gradually.


Nonspecific low back pain is usually caused by:


-Trauma

-Lumbar sprain or strain

-Postural tension


Treatment of nonspecific low back pain


The most recent guidelines proposed by the National Institute for Health and Care Excellence UK (NICE) do not recommend analgesia or imaging investigations, unless these imply a change in the intervention. The guidelines to follow recommended by NICE are;


-Advise and recommend physical activity to the patient, thus focusing on non-pharmacological treatment since this involves a high risk and little benefit for the patient.

-Inform and educate the patient about their condition Take into account the treatment preferences proposed by the patient

-Advise and inform the patient on how to control pain individually.


The NICE guidelines highlight the importance of educating the patient about their condition, as well as staying physically active and continuing, as much as possible, with day-to-day activities.

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