Non-Specific Low Back Pain

By: Michael Lam, MPT IMS

What is non-specific low back pain and why do I have it?

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Low back pain generally falls into two categories: Acute & Chronic.

Acute low back pain usually stems from some sort of recent traumatic event, or a series of repetitive micro traumas to the low back that happen over time. Chronic low back pain is loosely defined as pain that persists greater than 3-6 months.
Non-specific low back pain is defined as "low back pain not attributable to a recognizable, known specific pathology e.g. osteoporosis“ (1).

Why am I getting low back pain?

Well, chances are that if your low back pain occurred while lifting incorrectly, it’s likely acute. If it’s pain that has been a long-standing issue (e.g. “I’ve always had a bad back, but didn’t really do much for it when I was younger because I could get by”), then it’s likely a chronic issue. 

The literature has shown that the longer your low back pain persists, your deep core stabilizers, namely your transverse abdominis, begin to alter in terms of their firing (2), muscle tone/thickness and movement (3). At a younger age, we tend to be more active, stronger, and have better ways to compensate for the pain so we can continue with our daily activities (sports, work etc). At a certain point in time, those compensatory strategies begin to break down and that is likely why the intensity of the low back pain may spike.

So what can you do about low back pain?

You’ve probably tried a lot of painkillers, muscle relaxants and other pharmaceuticals but have found that they, only temporarily numb/alleviate the pain for several hours before its return. Studies have found the best way to manage low back pain is to retrain and jump-start your deep core muscles/stabilizers. Not just your abs though, the muscles more directly linked to your low back pain – the transverse abdominis. (4,5,6). In a study, working on stabilization exercises was found to decrease pain and levels of disability over a number of weeks.

So what now?

If you’re reading this and fed up with your low back pain, pop by and talk to one of our physiotherapists to see how he/she can help decrease your pain and improve your overall quality of life.

(References:

  1. Balagué, Federico, et al. "Non-specific low back pain." The Lancet 379.9814 (2012): 482-491. Level of evidence 1A
  2. HodgesPW, Changes in motor planning of feedforward postural responses of the trunk muscles in low back pain. Exp Brain Res 2001;141:261–6.
  3. HidesJ, StantonW, FrekeM, et al.  MRI study of the size, symmetry and function of the trunk muscles among elite cricketers with and without low back pain. Br J Sports Med 2008;42:809–13
  4. Ferreira PH, Ferreira ML, Maher CG, et al, Changes in recruitment of transversus abdominis correlate with disability in people with chronic low back pain, British Journal of Sports Medicine  Published Online First: 26 May 2009. doi: 10.1136/bjsm.2009.061515
  5. Yen-Hua Chen, Huei-Ming Chai, Yio-Wha Shau, Chung-Li Wang, Shwu-Fen Wang, Increased sliding of transverse abdominis during contraction after myofascial release in patients with chronic low back pain, Manual Therapy, Volume 23, 2016, Pages 69-75, ISSN 1356-689X, http://dx.doi.org/10.1016/j.math.2015.10.004. (http://www.sciencedirect.com/science/article/pii/S1356689X15001940)
  6. Hosseinifar, M., Akbari, M., Behtash, H., Amiri, M., & Sarrafzadeh, J. (2013). The effects of stabilization and mckenzie exercises on transverse abdominis and multifidus muscle thickness, pain, and disability: A randomized controlled trial in NonSpecific chronic low back pain. Journal of Physical Therapy Science, 25(12), 1541-1545. doi:10.1589/jpts.25.1541)