What is acute nonspecific back pain?
Nonspecific back pain refers to pain that is not associated with any radicular signs and evolves in the setting of a nonserious event and in the absence of warning signs such as fever or weight loss.
The pain may be either nonmechanical (i.e., movement of the spinal segment does not provoke pain) or mechanical from disc disease, arthropathy, muscle or joint strain.
The back pain may be referred pain such as menstrual-related back pain, constipation, or a disorder of the urinary tract.
How is acute nonspecific back pain treated?
The first duty is to make sure that a serious underlying pathology is not the cause of back pain.
Thus, the history and physical examination findings are key. If a serious event such as either a major fall or motor vehicle accident has occurred, imaging is needed.
If there is weight loss, fever, or neurologic deficits, the underlying pathology is no longer in the realm of benign nonspecific back pain, and imaging is mandatory.
Acute, nonspecific back pain is treated conservatively with over-the-counter analgesics, muscle relaxants if there is muscle spasm, gentle back exercises, and as close to normal activity as the pain allows.
If the back pain persists beyond 4 to 6 weeks, then diagnostic studies become warranted, and a change of therapeutic plan is in order.