Physio Network [Physio Discussed] Is non-specific low back pain a diagnosis? with Dr Mark Laslett and Greg Lehman
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Jun 11, 2025 In this engaging conversation, Dr. Mark Laslett, a musculoskeletal physiotherapy specialist from New Zealand, and Greg Lehman, a physiotherapist and chiropractor with a biopsychosocial approach, tackle the contentious issue of non-specific low back pain. They debate whether it qualifies as a real diagnosis and discuss its implications for patient treatment. Their dialogue brings to light the current research gaps, challenges in diagnostic accuracy, and the need for individualized care strategies, making a compelling case for a reexamination of traditional approaches.
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Non-Specific Pain Isn't Diagnosis
- Non-specific low back pain is not a diagnosis but a symptom presentation and should not be used as a diagnosis in science or treatment.
- Diagnosis involves identifying the source, cause, and influential factors of nociception, beyond just where the pain originates.
Accuracy of Clinical Low Back Pain Tests
- Clinical tests can predict sources like sacroiliac joint pain and discogenic pain with about 77-80% accuracy.
- However, some subsets of patients do not present with typical signs, making diagnosis in the clinic uncertain for them.
Give Patients Rational Explanations
- Ask patients what they want from their consultation; many seek an explanation for their pain.
- Provide rational explanations and guidance on management even when a precise cure is not possible, to help patients manage pain better.