Pain felt in the back that arises due to strain on muscles, joints, nerves or bones is known as back pain. Most of us experience back pain at some point in our lives. Clinicians most commonly classify back pain by the duration of the pain. Accordingly, it may be classified as either:
Acute back pain (short term) is an episode of pain that is short term and does not last more than four weeks. Most acute back pains are caused by a sudden injury to muscles or ligaments supporting the back. Many episodes subside automatically given adequate rest and precautions.
Chronic back pain (long term), is pain that extends beyond the expected period of healing. Clinically it is defined as back pain that lasts for 3 months or more. It often progresses gradually and the cause is difficult to determine in the vast majority of cases. Chronic back pain has the potential to cause serious disability in leading a normal productive life and an accurate diagnosis is critical to ensuring effective treatment that gets the patient back to a functional, pain-free state.
The American College of Physician recommends that Clinicians involved in the diagnosis and treatment of back pain, should attempt to classify chronic back pain into three categories:
Non-specific low back pain: Back pain for which the clinician cannot identify the exact underlying cause is termed as non-specific back pain. At least 85% back pain cases are clinically classified as ‘non- specific in nature. MRl’s and other imaging tests fail to help the clinician arrive at a precise diagnosis, and therefore majority of back pain patients continue to suffer without an effective treatment.
Low back pain associated with radiculopathy or spinal stenosis:
Radiculopathy and spinal stenosis are specific causes of back pain that may be identified through a complete physical evaluation of the spine and imaging tests like MRI. However, these two specific causes arc estimated to cause not more than 8% to 15% of all back pain cases. Standard treatment for such cases can range from guided medical movements to medication.
Other forms of specific low back pain:
These comprise causes like tumour, cancer, and disorders of certain organs not associated with the spine. These cases are estimated to comprise not more than 2% of all back pain cases.
Thus, not more than 2 out of 10 people suffering from chronic back pain are able to know the specific cause.