What's your opinion of non-specific low back pain? Dr Stuart McGill

The niggling lower back twinge or pain is often difficult for many health professionals to not only diagnose, but to also recommend an exercise regime that will help alleviate the pain and get to the root cause of the issue.

These types of back pain issues are sometimes referred to as non specific low back pain, but what does that term actually mean? In order to try and find an answer, the question was posed to Dr Stuart McGill, who has some very interesting views and rejects the “non specific” part of this description.

He says, ”If you have ever been told that you have non specific low back pain, then it is my opinion that there is no such thing, that is, unless you have already undergone a thorough assessment, that has involved provocative testing. By provocative testing, I really mean testing that involves the finding of motions, postures and loads that have actually caused the pain and contribute to make it feel worse. Once a good part of the cause has been identified, that immediately gives us a very solid clue as to how to proceed with the treatment.”

So, what actually causes back pain? Well, that’s another question for Dr McGill who says, “I wish I had a simple answer for that question, and some would simply say, “We don’t really know”, however, by saying “We don’t really know”, is an easy way of ducking the question and I take the opposite view in that we DO know the precise causes of back pain, providing we can examine the individual. By looking at the individual, for example, someone with a disc bulge posterior lateral on the left hand side, with a focal distribution, which may sound like mumbo-jumbo, but allows us to know, via replication, that the patient was repetitively flexing forward and bending to the right, over and over again, causing the pain to develop.”

Dr McGill is suggesting that it is possible to get to the bottom of non-specific low back pain and that quite often, patients with non-specific back pain are those who have repetitive movement patterns, especially patterns that are non-optimal for their body. Looking at these movement patterns and also the injury history of the patient can help the issue to be pinpointed precisely.

Diagnosis of the causes of non-specific back pain via a thorough examination is fundamental to being able to advise a patient as to what they can and cannot do during their exercise and training regimes. To find out more about a getting a Low Back Pain Assessment click here