Okay! what's the value of calling it non- specific back pain?

keeping PT simple.

Last week, I discussed the rationale behind labeling low back pain as non-specific back pain. As I highlighted, the term "non-specific" indicates our inability to find specific pathoanatomical structure responsible for causing low back pain.

What’s the value of knowing we don’t know the pathoanatomical structures of low back pain?

I believe it frees physiotherapists from attributing low back pain primarily to a specific issue within or around the spine, allowing them to adopt a holistic perspective on the condition.

• It reduces noicebo: I have “observed” so it’s true pathologies, like reduction of joint space, degeneration have spawned advises like: don’t bend, don’t drive, don’t lift weight and much more. However, these recommendations are not only incorrect but also contribute to increased pain, hindered recovery, long-term disability, and an increased risk of chronic pain development.

• Reduction in imaging and harm from it: Understanding that there is no specific structural issue to be found in the back can reduce the need for imaging tests such as MRI and X-rays. Think of all the benefit.

• Increase time in learning things which matter: We all learn complicated ways of manually assessing whether the issues is in the L2 or L4 or sacral joint. I know i spent some months on those- seems those are not needed. So no need to learn and waste time rather we can use that time to learn, proper science from neurobiology to EBM. Please note many studies have showed manipulation of specific joint is as good as manipulating any joint in the region.

• Traction, which is based on the idea of increasing the joint space, - now you know why it is a comedy treatment.

• All exercise program are same, so keep it simple. Any exercise program can be effective; there's no need to attend specialized courses to target specific muscles. Therefore, it's not worth wasting time and money on such courses. Instead, plan a sensible exercise routine that is just as beneficial as any program like McKenzie or motor control exercises.

So, many treatments and ideas which are not scientific can be removed from our repertoire.

What changed by knowing low back pain is non specific:

Its helps in looking at Low back pain holistically. It means don’t just look at the muscles and joints around the region of pain. Look at the mind and body. Assess and treat psycho-social components of pain is the vital part of treatment of low back pain (well all the diseases).

For instance, providing reassurance that back pain is not a complicated disease, nothing wrong with your back and encouraging activity can significantly aid in recovering from back pain.

Summary:

As the disease is non specific, reassure your patient it will be over soon, if they be active and do exercises.