Non-specific LBP

• Non-specific LBP - how do we go from back pain to diagnosing it as non-specific:

  1. History / MOI
  2. Red Flags, Special questions, Past Medical History, Drug History, Social History
  3. Exclude other common pathologies / need for onward referral?
  4. considerations:
  5. Could it be secondary to a “common pathology”?
  6. Could it be secondary to a known traumatic injury?
  7. Could it be acute or chronic?
  8. Could it be due to psychosocial factors?

  
• Non-specific LBP:

  • Unknown origin
  • Non-specific pathology
  • Unlikely to be sinister or progressive
  • With or without referred pain/signs/symptoms
  • Last for long periods (persistent)
• Non-specific LBP - What do we think causes it?

  • Normal part of aging and degeneration?
  • Muscle imbalances?
  • Sedentary lifestyle?
  • Psychosocial factors (explain 30 - 45% of chronic LBP)
• Psychosocial Considerations - Patient factors will influence response to treatment:

  • Behaviours
  • Thoughts
  • Feelings
  • Social factors
  • Lifestyle
  • Stress
• Non-specific LBP - How do we deal with LBP?

  • Identify any pain, signs or symptoms to manage
  • Create a problem list, and treat the symptoms
  • Set goals
  • Education
  • Joint decision making
  • Involve the patient