What Causes Non-Specific Low Back Pain and How is It Diagnosed?

What Causes Non-Specific Low Back Pain and How is It Diagnosed? Blog

 

Chronic low back pain (LBP) can range from a mild annoyance to a debilitating pain that keeps you off your feet. LBP is one of the primary complaints that sends Americans to the doctor and keeps them home from work.

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 its root cause. Because LBP is specific to 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 be found. Yet patients suffering from non-specific LBP are often subjected to MRI as a diagnosis of exclusion aimed at ruling out more serious underlying conditions.

Unwarranted use of MRI unnecessarily subjects patients to ionizing radiation, which is especially harmful for younger women of childbearing age. Some studies suggest that patients who undergo MRI are more likely to receive surgical interventions that do not resolve LBP, and which can lead to further spinal degeneration.

An effective diagnosis depends on multiple factors, and your back pain specialist should be willing to explore all pathways that lead to 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 go for back pain in NYC. Our back pain specialists have access to the most cutting edge technologies for diagnosis and treatment, all under one roof. Our team of professionals work together to ensure you receive the very best treatment available for your back pain.

At NYDNRehab, we are dedicated to getting at the source of your back problem, not just treating the symptoms. Our skilled therapists know how to accurately assess and diagnose your back pain, and create individualized solutions for treatment. With the latest technologies and methods at our fingertips, NYDNRehab is fully equipped to treat your back pain at its source, so you can return to your active lifestyle.

 

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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)

image

Complete tear of rectus femoris
with large hematoma (blood)

image

Separation of muscle ends due to tear elicited
on dynamic sonography examination

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