Non-specific low back pain: Symptoms, causes, and best treatments

Non-specific low back pain is:

• when your back hurts
• without having a significant injury.

In other words, when a doctor looks at a scan of your back, they can't see any apparent reason for why your back is hurting.

Non-specific lower back pain means that your pain is not caused by a significant injury to any of the structures in your spine.

This type of diagnosis can cause frustration. We tend to feel that if our back hurts a lot or continuously, it must mean something serious is wrong.

• Good evidence suggests the intensity of lower back pain doesn't correlate (match) with the structural changes in back scans.
• People with similar scan findings often have entirely different pain pictures. Some experience severe pain, while others have mild or no pain at all.
• We now understand that pain is simply the body's alarm system, and your alarm system can sometimes become oversensitive, causing pain even without significant injury.

Evidence-based rehab plans for lower back pain

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Symptoms of non-specific low back pain

Even though non-specific low back pain is not considered serious, it can cause severe pain and significantly impact your quality of life.

Common symptoms include pain that:

• You can feel across your whole lower back, or more on one side, or refers to your buttocks
• Varies from dull and aching to sharp or stabbing
• Worsens when you move into or out of certain positions
• Changes in intensity with different activities (but you may be aware of it all day)
• Worsens or improves with exercise
• Is affected by your stress levels

Non-specific low back pain symptoms can either improve or worsen with exercise. Often, it's the type of exercise that makes the difference.

The best treatment for non-specific low back pain

Studies show that the most effective treatment plans for non-specific low back pain are ones that are tailored to your specific situation and include a combination of the following:

1. Relative rest

Relative rest aims to help settle your pain while promoting recovery.

• It's about modifying or taking a break from aggravating activities or movements
• and striking the right balance between rest and exercise.

Movement is important - it helps feed your back joints and improve circulation and is one of the best ways to decrease pain.

Relative rest works because it helps keep your back well-nourished while temporarily reducing the activities that irritate it.

Relative rest means that, instead of stopping all activity, you just adapt it to a level that doesn't cause you pain, e.g., you walk more slowly, shorter distances, or on more even terrain.

How to strike a balance between rest and activity:

1. Observe how different movements and activities affect your pain.
2. Continue all activities that don't significantly impact your pain.
3. It's usually OK to experience a slight increase in discomfort while doing something (up to 3/10) as long as it settles down quickly and doesn't cause a significant increase in your pain during the following 24 hours.
4. If an activity causes a significant increase in your pain, see if you can adapt it so your back tolerates it better, e.g., doing less of it or performing it differently.
5. Only temporarily stop movements and activities that continue to significantly aggravate your pain despite adapting them.

Take a look at our article about running with lower back pain to see an example of how to apply the concept of relative rest to sport.

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2. Changing unhelpful habits

Our bodies like variety. Repeat any movement too often or hold any position for too long, and it will likely cause pain and discomfort.

A common reason for lower back pain is sitting too long in the same position regardless of how "good" your posture is.

Some unhelpful habits include:

• Sitting for long periods without back support - Tires your back muscles, causing them to spasm and hurt
• Sitting for too long without a break - Lack of movement leads to reduced circulation, in turn leading to fewer nutrients and less oxygen reaching your back muscles and joints.
• Staying in a position even though it feels uncomfortable.

Find more advice on how to adapt sitting when you have lower back pain here.

3. A tailored exercise program

An individualized program combining graded lower back, core, and whole-body exercises to help strengthen your back muscles, improve your balance, and increase your general fitness can help.

Experts recommend choosing exercises and activities you enjoy and will stick to for positive long-term success is best.

Don't like Pilates and Yoga? No problem! Many different types of exercise have been shown to help with back pain. Choose something you enjoy.

What's more, there isn't any one type of exercise that seems to be superior. Studies have found lots of different types of exercise can reduce or prevent lower back pain, including:

• Walking
• Stretches
• Yoga
• Pilates
• Gym workouts
• Thai chi
• etc.

If you like running sports, check out the lower back pain rehab plan in the Exakt Health app.

The app is designed for runners and guides you step by step through the rehab process, making it easy to pitch your exercise level correctly.

It uses your feedback after workouts to set your training intensity to suit your back's strength and adjusts your program as you recover.

Start your back pain rehab today!

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4. Learning about pain

Evidence indicates stress and anxiety are pain triggers and can make your pain feel worse. So, part of learning about pain is knowing how to manage stress and anxiety and finding ways to improve your overall mental well-being.

Some strategies that can help include:

• Speaking to someone about sources of stress in your private life or at work
• Improving your quality and duration of sleep
• Achieving a better work-life balance
• Getting regular exercise
• Avoiding or reducing nicotine and alcohol intake
• Working with a doctor or physical therapist you trust can help if you're worried about your injury and its impact on your future quality of life and earnings.

A bad night's sleep can increase your back pain.

Other treatments may also help reduce low back pain symptoms. Some may be worth considering, and others are best avoided.

Other treatments to consider

When treating lower back pain, some modalities can help relax your muscles and reduce your pain in the short term.

However, their effects are usually short-lived, and they do not prevent future injury. These include:

• Massage
• Heat therapy (heat packs, warm baths, steam baths, sauna)
• Medication for lower back pain (prescribed by a doctor)
• Acupuncture
• TENS

Massage can provide short-term pain relief. But to get rid of your back pain permanently, you must address the cause.

Treatments to avoid

• Complete rest: It can make you feel stiffer and more uncomfortable in the long run - research shows people do better when they stay active during recovery.
• Ultrasound therapy: The current research does not support it; other pain relief treatments are more effective for lower back pain.

Preventing lower back pain

Once your pain subsides and you resume your usual activities, there are a few steps you can take to reduce the risk of future low back pain episodes:

• Keep active, avoiding long periods of inactivity during the day
• Maintain good back muscle strength and joint mobility
• Stay fit with regular aerobic exercise
• Avoid sudden increases in training volume or intensity
• Monitor your fatigue levels
• Take care of your mental well-being

If you're a runner, recover smarter and bounce back stronger with the Exakt Health app. Download it now and unlock access to effective rehab plans proven to help you regain strength, flexibility, and confidence after a range of running injuries, including lower back pain.

Evidence-based Rehab and Prehab plans for runners

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