Back Pain : How is non-specific back pain diagnosed?

How is non-specific back pain diagnosed?
Most people who develop low back pain that comes on suddenly (acutely) have non-specific low back pain. If there are no other associated symptoms and the pain is not too bad, many people are confident to just "get on with it" and treat it themselves - and indeed most get better quickly. However, if in doubt, see your doctor for a check-over and advice.

A doctor will usually want to ask questions about your symptoms, and examine you. Basically, the symptoms are usually as described above, with no other worrying symptoms to suggest anything serious or another cause of back pain (such as the ones listed below). The examination by a doctor will not detect anything to suggest a more serious cause of back pain. Therefore, a doctor can usually be confident from his or her assessment that you have non-specific back pain.

As a general guide, if any of the following occur then it may not be non-specific low back pain, and there may be a more serious underlying cause. But note: the vast majority of people with low back pain do not have any of the following symptoms or features. They are included here for completeness, and as an aid to what to look out for and to tell your doctor should they occur.

Pain that develops gradually, and slowly gets worse and worse over days or weeks.
Constant back pain that is not eased by lying down or resting.
Pain that travels to the chest, or is higher in the back behind the chest.
Weakness of any muscles in a leg or foot.
Numbness (lack of feeling) in any part of your bottom or leg.
If you have taken steroid tablets for more than a few months.
Symptoms that may indicate an inflammatory (arthritis) cause such as ankylosing spondylitis. The main ones are:
Pain which is worse in the second half of the night or after waking.
Stiffness, in addition to pain, of the back muscles in the morning after getting up from bed that lasts more than 30 minutes.
The pain is eased (and not made worse) by activity.
Symptoms that may indicate cauda equina syndrome. The main ones are, in addition to back pain:
Numbness around the anus (the saddle area).
Bladder symptoms such as loss of bladder sensation; loss of bladder control, incontinence, loss of sensation when passing urine.
Incontinence of faeces.
Symptoms that may indicate a fracture in the spine The main ones are:
Back pain following major trauma such as a road accident or fall from a height.
Back pain following minor trauma in people with osteoporosis.
Symptoms that may indicate infection or spread of cancer affecting the spine. The main ones are:
Onset of pain in a person over 50 years, or under 20 years, of age.
Pain that remains when lying down; aching night-time pain disturbing sleep.
Symptoms or problems in addition to pain such as:
If you have or have had a cancer of any part of the body.
General symptoms, such as fever, unexplained weight loss, etc.
If you inject street drugs.
If you have a poor immune system. For example, if you are on chemotherapy or have HIV/AIDS.