Low Back Pain is a Benign and Self Limiting Condition.The term 'non-specific back pain' is a slightly misleading term. Low back pain (LBP) may come and go but the reasons for the persisting back pain are still present, causing the client to be constantly susceptible. The longer this situation remains the more likely it will continue and an acute more debilitating episode is on the way.
In the meantime, the body develops physical compensations, often unnoticed, until they themselves become a painful problem, exacerbating your condition leading to seemingly unrelated musculoskeletal pain elsewhere. This is not a benign situation, this is a very active patient situation. The 10% of patients in acute pain ( just hurt themselves, very painful) are much more likely to receive an accurate, specific diagnosis. The other 90% are generally thought of as all having the ‘same back problem’ and this back pain will gradually disappear. What is now known is that the pain does come back again and all these patients do not respond to a general care plan, which implies that there condition is individual and not benign. Careful assessment of the client with functional tests can subdivide this homogenous group allowing for more personalised care. Most acute episodes tend to improve rapidly, and if left alone can run an intermittent chronic course with intermittent acute flare ups. Often the acute episode can last up to 3 months , without treatment (not 6 weeks as is often reported). The ‘flare ups’ are mild to moderately activity limiting and painful and can come and go for months.
The natural history of LBP can be summarised
· No evidence saying that 90% of back pain episodes resolve spontaneously in 1 month
· Return to work does not equate to recovery as often chronic patients move in and out of jobs or return to less demanding employment
· Patients may stop seeing there GP, but this does not mean they are better
Assessing the individual client and finding what activities aggravates and generates their pain the most, allows for more accurate treatment and appropriate rehabilitation activity and advice.