Does unspecific low back pain really exist?

Abstract

Only 20 % of low back pain or sciatica is of a specific origin. These specific pain conditions include tumours, spondylitis, rheumatic and metabolic diseases as well as radicular syndromes. By far the most pain from discs, facet and sacroiliac joints, ligaments and muscles must be considered as unspecific, because no anamnestic information or clinical signs exist (radiological changes included) to assign pain to structural or functional correlates. In addition, the therapeutic consequences from the assignment of structural changes to pain remain unclear. In acute pain situations the specificity of the pain is not important because of the fast relief of the disease, in chronic pain situations, fear avoidance beliefs and pain behaviour seem to be much more important than structural and functional changes.