October 24, 2025, 7:13 pm | Read time: 5 minutes
Going to the doctor with back pain and returning home without a diagnosis: For 80 to 90 percent of patients suffering from back pain, this is the reality. Back pain without an identifiable cause and diagnosis is referred to as nonspecific back pain and is a source of uncertainty for many affected individuals. Therefore, it is worth taking a closer look: How can nonspecific back pain arise, be healed, and be prevented?
Back pain is among the most common causes of work incapacity and use of the health care system.1 Nonspecific back pain is particularly distressing because conventional clinical methods cannot pinpoint a precise cause. This, of course, complicates targeted treatment. However, not all nonspecific back pain is the same. The suffering of those affected varies in terms of cause, duration, progression, and severity.
Overview
Distinguishing Chronic vs. Episodic Pain
Back pain is considered chronic if it lasts longer than three months.
Acute back pain occurs for the first time or reappears after six months of being pain-free and lasts a maximum of six weeks.
Subacute back pain lasts longer than six weeks but does not yet meet the criteria for chronicity.
What Can Cause Nonspecific Back Pain?
The reasons for the occurrence of nonspecific back pain are often diverse. They can be attributed to a complex mix of psychological, social, and biophysical factors.
A study in the form of a meta-analysis examined the results of 54 longitudinal studies. It concluded that work-related psychosocial factors, such as workplace conflicts, unsatisfactory work, or high stress, can trigger back pain. Back pain is not only influenced by ergonomic errors, such as poor posture, but also by psychosocial influences like low professional recognition. In addition to psychological stress as a risk factor, long-term sitting, lack of exercise, obesity, smoking, and poor diet can be causes and/or maintenance factors.2
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What to Do About Nonspecific Back Pain?
Since nonspecific back pain often lacks a precise diagnosis and corresponding recommendations for action, those affected are often overwhelmed. They face the crucial question: What now?
A large portion of those affected tend to move less and avoid physical activities.3 However, the opposite is recommended. Light physical activities, such as walking, can help strengthen the back muscles and promote recovery. The National Care Guideline also recommends maintaining physical activities as much as possible for nonspecific back pain.4
Over-the-counter pain relievers like ibuprofen can also be taken on medical advice to relieve acute pain and prevent reduced movement. Visiting a physical therapist can also be beneficial to receive individual exercises and techniques for pain relief and muscle strengthening.
Additionally, the workplace should be as ergonomic as possible. An ergonomic chair and the correct screen height can relieve back pain. The use of heat or cold packs can also help alleviate pain. Heat relaxes the muscles, while cold can reduce inflammation.
Since stress—due to psychological burdens, psychosocial conflicts, or professional demands—often promotes nonspecific back pain, it is advisable to also consider psychosomatic components in the treatment of back pain.
Expert Dr. Hartmut Bork recommends in his book “Nonspecific Back Pain” a combination of sports or exercise therapy measures and behavioral therapy for chronic back pain. Behavioral therapy helps identify stressors and develop strategies to reduce psychological burdens. This, in turn, makes a demonstrable contribution to promoting recovery from back pain.
Additionally, relaxation exercises such as yoga, tai chi, meditation, and progressive muscle relaxation can help relieve tension.
Preventing Back Pain
The prevalence of chronic back pain can vary depending on the study and research design. However, it can be assumed that about 20 to 30 percent of acute back pain becomes chronic. Therefore, it is advisable to prevent the occurrence of back pain prophylactically.
In a 2017 study, researchers concluded that participating in sports and other leisure activities reduces the risk of frequently occurring or chronic lower back pain. Regular physical activity is an effective prophylaxis against back pain, as it helps strengthen the back muscles, increase spinal flexibility, and improve circulation. Psychosocial risk factors such as stress can also be counteracted through exercise and the increased release of endorphins from sports. The results of the study included 36 prospective cohort studies with a total of 158,475 participants in the meta-analyses.5