If you go to your doctor with a painful lower back, there’s around an 85-90% chance that you will be diagnosed with “non-specific low back pain” (NSLBP). In some ways that would be a good thing. Let me elaborate…
- Around 1% of lower back pain is due to “serious underlying disease.
- Around 10-13% is due to nerve impingement, usually involving disc problems.
That leaves the rest, which a lot of scientists can’t find an obvious reason for – hence the tag “non-specific”. So, as I said, that’s a good thing. Ideally you don’t want low back pain due to “serious underlying disease” or due to nerve impingement. The downside is that medical science (and therefore your doctor), only has fairly blunt tools in the fight against NSLBP.
Fortunately there are groups of scientific researchers who maintain that the tag “non-specific” is due to lack of imagination and appropriate in-depth investigation. A luminary within this field is Dr Stuart McGill, of Waterloo University in Ontario, Canada; his research has demonstrated that mechanical load causes different “tissues” (ligaments, muscles, discs, bones etc) to fail at different degrees of load (and then become inflamed, which often leads to pain). Further, he and other researchers – by injecting anaesthetic into specific tissues – have identified various sources of pain. So, it’s not really “non-specific” at all; it’s just difficult for many people to pin down because they don’t have the skills/knowledge to ask the right questions. Happily, as osteopaths, we specialise in identifying (without the need for anaesthetic injections) which tissues are causing which pains. We probably don’t always get this right straight away, but by a process of elimination can quickly determine where things have gone wrong.
If you don’t ask the right questions, you’re not likely to get very useful answers… “non-specific”? – phaa!!