However, low back pain is a symptom, not a disease, and it may have many causes. While some low back pain may have a detectable cause such as a herniated disc or stenosis, the most common form of low back pain is non-specific in nature, meaning there is no discernible structural cause.
Causes of Non-Specific LBP
Most non-specific LBP is made worse by certain motions, postures or loads, which may lend insight into the individual, there is no single treatment that can be broadly applied.
Some things that may contribute to chronic non-specific LBP include:
Poor postural habits
Inefficient movement mechanics
Imbalanced muscle tension
Ergonomically inefficient work station
Weak core and low back muscles
Sedentary lifestyle
Excess body weight
Overall physical deconditioning
Excessive muscle loading with inadequate recovery time
In rare cases, non-specific LBP can be caused by hyperalgesia, a heightened state of sensitivity where the pain threshold of the Central Nervous System (CNS) is lowered, and a certain level of pain is maintained, even after the initial injury or cause of pain has healed.
Diagnosis
In cases of non-specific LBP, imaging with MRI is useless, since there are no structural anomalies to MRI as a diagnosis of exclusion aimed at ruling out more serious underlying conditions.
Unwarranted use of MRI unnecessarily subjects patients to further spinal degeneration.
An effective diagnosis depends on multiple facto resolution. This may include:
computerized gait analysis
thorough postural analysis
assessment of strength and range of motion
review of daily activities and lifestyle factors
comprehensive health history review,
other diagnostic approaches geared to getting at the source of pain
Treatment for Non-Specific LBP
Treatment for LBP should be individualized, and may involve a combination of strategies. Some possible treatment approaches include:
physical therapy
therapeutic massage
chiropractic manipulation
therapeutic Pilates exercises
acupuncture
extracorporeal shock wave therapy (ESWT)
computerized gait retraining
alternative therapies such at Vojta, DNS, Redcord therapy, and more
Back Pain Treatment in NYC
NYDNRehab is the place to ensure you receive the very best treatment available for your back pain.
At NYDNRehab, we are dedicated to your active lifestyle.
Follow me:
About the Author
Dr. Lev Kalika is a world-recognized expert in musculoskeletal ultrasonography, with 20+ years of clinical experience in advanced rehabilitative medicine. In addition to operating his clinical practice in Manhattan, he regularly publishes peer-reviewed research on ultrasound-guided therapies and procedures.
Dr. Kalika is an esteemed member of the International Society for Medical Shockwave Treatment ((SMST), and the only clinician in New York certified by the ISMST to perform extracorporeal shockwave therapy. He is also an active member of the American Institute of Ultrasound in Medicine (AIUM), and has developed his own unique approach to dynamic functional and fascial ultrasonography.
In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.
Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.
The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.
Dynamic ultrasonography examination demonstrating the full thickness tear and already occurring muscle atrophy due to misdiagnosis and not referring the patient to proper diagnostic workup
Demonstration of how very small muscle defect is made and revealed to be a complete tear with muscle contraction under diagnostic sonography (not possible with MRI)
Complete tear of rectus femoris with large hematoma (blood)
Separation of muscle ends due to tear elicited on dynamic sonography examination
Request Telehealth 
