Understanding Low Back Pain (LBP): A Comprehensive Guide

If you’ve been dealing with low back pain (LBP) for weeks, months, or even years—you’re not alone. But here’s the truth most people don’t hear:

Naming your diagnosis is not the same as solving your pain.

Many individuals are told they have disc bulges, arthritis, “wear and tear,” or nonspecific back pain. More often than not, they receive a generic sheet of exercises—or worse, they’re advised to rest and take painkillers—and are quickly sent on their way.

Yet, the pain continues to return.

That's because low back pain isn’t a one-size-fits-all issue. It has subtypes, patterns, and root causes that need to be identified before any lasting solutions can be found.

What Are LBP Classification Models?

Classification models are clinical systems that break back pain into distinct subgroups. Rather than treating everyone the same, these models enable clinicians to pinpoint common movement or pain patterns. This targeted approach allows for more effective treatment.

At The Back Specialists, we utilize a modern, evidence-informed classification system that groups back pain into four primary subtypes:

• Mobility Dysfunction

• Direction Specific Exercise

• Stabilization / Motor Control Deficits

• Nociplastic Pain

  
  

Each of these subgroups represents a completely different type of back pain, requiring its own tailored approach.

Let’s delve deeper into each subtype.

Understanding the Subtypes of Low Back Pain

1. Mobility Dysfunction

In this category, the issue isn’t about a “weak core” or alarming scan results—it’s a loss of movement.

People experiencing mobility dysfunction often feel:

• Stiffness in one or several directions (e.g., bending, twisting)

• A sensation of being locked up in the hips, lower back, or mid-back

• An inability to move freely or a constant feeling of tightness

  
  

These individuals typically stretch daily yet seem to find only temporary relief.

The Fix

Our focus is on enhancing joint mobility, soft tissue flexibility, and breathing patterns that influence spinal movement. It’s not merely about stretching more; it’s about unlocking the specific areas restricting your body from moving freely.

2. Direction Specific Exercise

This subtype is one of the most misunderstood and mistreated types of back pain.

Individuals in this group frequently report:

• Pain that intensifies with some movements while easing with others

• For instance, pain may worsen with sitting but improve with walking, or it may get worse when bending but better when arching the back

  
  

This subgroup often includes people with disc irritation, sciatic pain, or nerve tension—but not exclusively.

The Fix

We identify your directional preference (e.g., flexion, extension, or lateral shift) and design a movement program that consistently loads your spine in the direction that reduces your symptoms. Many patients experience significant symptom relief, often during their very first visit.

3. Stabilization / Motor Control Deficits

This category is not focused on stiffness; it’s about control.

Individuals in this group often:

• Feel “wobbly” or unstable in the lower back

• Find certain movements (like lifting, twisting, or changing direction) painful or unsafe

• Have a history of frequent, seemingly random back flare-ups

  
  

What’s happening here is that their deeper stabilizing muscles—like the transverse abdominis, multifidus, diaphragm, and pelvic floor—aren’t functioning in harmony. This can lead to excessive or uncontrolled movements of the spine, resulting in irritation and flare-ups.

The Fix

We retrain deep core activation and motor control, often starting with breathwork and low-load exercises before advancing to more challenging tasks. This subgroup benefits from structured and progressive rehabilitation.

4. Nociplastic Pain

This group often falls through the cracks.

Individuals experiencing nociplastic pain may:

• Have persistent pain that doesn’t follow a clear mechanical pattern

• Have visited multiple healthcare providers without receiving satisfactory answers

• Feel overwhelmed, misunderstood, and unsure of where to turn next

  
  

In cases of nociplastic pain, the nervous system has become sensitized. The problem isn’t necessarily in the tissues anymore; it's rooted in how the body processes danger and threat signals.

This doesn't mean the pain isn't real—it absolutely is. However, the treatment must also involve the brain and nervous system, in addition to the muscles and joints.

The Fix

We employ pain science education, graded movement exposure, and strategies to calm the nervous system, all while focusing on what makes you feel secure. This compassionate, evidence-based approach is empowering and transformative.

Why This Model Works (When Other Treatments Don’t)

Many people fail to achieve lasting relief because they receive treatments that don’t correspond with their specific subgroup.

Here’s an example:

• Someone with motor control deficits may be instructed to stretch more (which can worsen their condition).

• A person with a direction-specific issue might be prescribed general Pilates (which could irritate the wrong movements).

• An individual with nociplastic pain could be told, “Your scan is fine—just move on.”

  
  

These mismatched treatments lead to frustration, fear, and feelings of being “just broken.”

But remember: you’re not broken. You simply haven’t been assessed properly using the right framework.

How We Use This at The Back Specialists

Every client at The Back Specialists begins with a detailed movement assessment to identify their specific subgroup.

We utilize tests from:

• The Selective Functional Movement Assessment (SFMA)

• Movement Impairment Syndromes (Shirley Sahrmann)

• McGill’s Flexion/Extension/Rotation categorization

• Breathing and bracing strategies from DNS (Dynamic Neuromuscular Stabilisation)

  
  

We then clearly explain your findings so you comprehend what’s going on, why it’s happening, and how we can address it together.

From this point, we create a personalized plan tailored to your individual needs, avoiding a one-size-fits-all routine.

Ready to Get Clarity on Your Pain?

If you’ve attempted various remedies—stretching, strengthening, resting, icing, or pushing through your back pain—without any lasting change, it’s time for a different approach.

Our €39 Mini-Assessment provides you with:

• A full classification of your pain pattern

• Clear next steps

• A take-home Movement Clarity Report

• Expert guidance from specialists who treat the root cause—rather than just the symptoms

  
  

There’s no guesswork. No fluff. Just a precise plan designed for your unique body.

You’re not broken. You just haven’t been accurately seen.

Take the first step today and finally gain the clarity your back has been demanding.

The Back Specialists – We don’t do generic. We do precision care for lasting change.