Non-specific low back pain

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Low back pain often refers to pain in the lumbosacral area from the 12th ribs to the iliac crest, and sometimes the buttocks and gluteal folds.
‘Non-specific’ back pain has traditionally described pain not attributable to an underlying cause. It may also be referred to as ‘mechanical’, ‘musculoskeletal’, or ‘simple’ low back pain.

Low back pain (LBP) can be a dull ache or sharp pain. It can also cause pain to radiate into other areas of the body, especially the legs.
LBP can restrict a person’s movement, which can affect their work, school and community engagement. It can also cause problems with sleep, low mood and distress.
LBP can be acute (lasting under 6 weeks), sub-acute (6–12 weeks) or chronic (over 12 weeks).
People with LBP may also experience spine-related leg pain (see separate section). This is often described as a dull sensation or a sharp, electric shock feeling. Numbness or tingling and weakness in some muscles may be experienced with the leg pain.

Low back pain is now the leading cause of disability worldwide.
Non-specific low back pain may account for 90-95% of cases of low back pain presenting to primary care.
In 2015, the global point prevalence of activity-limiting low back pain was 7.3%.

Low back pain may result from a dynamic interaction between social, psychological, and biological factors.

Risk factors for the development of non-specific low back pain include:

Risk factors for the development of chronic pain and disability include:

Pain lasting longer than 12 weeks.
High baseline pain intensity and disability.
Anxiety and/or depression.
Stressful life events including previous or current physical or emotional trauma.
Previous or current substance misuse.
Perceived risk of persistent pain.
Maladaptive coping strategies and 'fear avoidance' (avoidance of work, movement, or other activities due to fear of exacerbating pain or damaging the back), or negative beliefs about pain and activity.
Pain coping characterised by excessively negative thoughts about pain and the future ('catastrophizing').
Past history of other chronic pain syndrome(s).

Non-specific low back pain is a self-limiting condition for the majority of people affected, and usually resolves within a few weeks.
People who have had low back pain often have episodes of recurrence and may develop repeated 'acute on chronic' symptoms.
Most episodes of low back pain are short-lasting with little or no consequence, but recurrent episodes are common and low back pain is increasingly understood as a long-lasting condition with a variable course rather than episodes of unrelated occurrences.