Lower Back Pain: Causes, Treatment & Help

Lower back pain is very common and is usually harmless. They usually do not last longer than six weeks. However, in persistent cases, the doctor should definitely be consulted.

What is lower back pain?

Sudden onset of lower back pain is colloquially referred to as lumbago. Other names include low back pain or lumbago. Sudden onset lower back pain is colloquially referred to as lumbago. Other names are low back pain or lumbago. If the legs are also affected, it is also called sciatica. In most cases, the acute pain disappears within six weeks. However, they do not always occur acutely. There are also chronic forms of low back pain, but these can often become more severe at certain intervals. Since the pain may almost lead to immobility in the acute phase, a serious cause is often suspected. However, this is only true in rare cases. In most cases, they have a harmless cause. The connection between signs of wear and tear in the lower spine and low back pain is also not always clear. Many sufferers experience severe pain without any visible changes, while patients with a highly stressed lower spine often do not experience low back pain.

Causes

The causes of lower back pain are usually harmless. Often it is just muscle tension pressing on the nerves. There is often the idea that there is a herniated disc. However, this is rarely the case. In the case of a herniated disc, there is a leakage of gelatinous mass from the core of the disc. This gelatinous mass can press on the nerves. However, even a herniated disc can be painless if the nerves are not irritated in the process. The herniated disc can be promoted by wear and tear of the spine. However, sometimes it occurs without any visible cause. Much greater significance for pain in the lower back have, as already mentioned, the muscle tension. Muscle tension is caused by uneven use of the back muscles, postural errors or psychological problems. In rare cases, the causes of low back pain are much more serious. These include severe wear and tear of the spine, osteoporosis, scoliosis (spinal curvature), inflammatory processes in the spine (rheumatic or infectious causes) or even malignant tumors. In some other conditions, such as kidney dysfunction or gastrointestinal problems, pain may also radiate to the lower back.

Diseases with this symptom

  • Herniated disc
  • Gastrointestinal diseases
  • Sciatica
  • Osteoporosis
  • Tumor
  • Sacroiliac joint syndrome
  • Scoliosis
  • Kidney weakness
  • Lumbago

Diagnosis and course

In the case of sudden onset of pain in the lower back, the doctor should be consulted. Most often, he will determine its cause through a patient interview and physical examinations. In the vast majority of cases, muscle tension is present. The pain quickly disappears. Imaging procedures are not necessary in these cases. Since they are mostly X-ray examinations or computer tomographies, their too frequent use is even harmful due to X-ray radiation. These diagnostic methods should be reserved for persistent cases of low back pain. If the pain is still unchanged after six weeks or if paralysis is added to the acute pain, imaging methods such as CT or MRI must be consulted for diagnosis. In rare cases with unusual and severe courses, laboratory tests for blood and urine are also performed. Here, possible causative agents of infections or inflammatory markers and indications of diseases such as autoimmune disorders, cancer or kidney disease causing lower back pain can be found.

Complications

Lower back pain can be associated with several complications. Because of the pain sensations, the muscles may become tense, which makes the pain worse. If the cause of the pain is a herniated disc, then the complication can be sensory deafness, numbness, and paralysis.The muscles, which are often cramped due to the pain, often exacerbate the pain and discomfort, as they can be accompanied by incorrect loading of the joints and a protective posture. A further complication is the possible chronification of the pain. In this case, the body develops a so-called pain memory and the pain continues to be present even after the actual cause has been eliminated. This is then also referred to as chronic pain. If the pain in the lower back is caused by a herniated disc, this can increase in size as the disease progresses. In this case, the pressure on the nerves in the spinal canal is increased further and further and, in extreme cases, the affected nerve root may die and the blood supply to the nerve is interrupted. The muscles controlled by the affected nerve become paralyzed, which is irreversible if the nerve root dies. This can also affect the muscles of the bladder and bowel, leading to incontinence.

When should you see a doctor?

As soon as paralysis symptoms and uncontrolled discharge of stool and urine occur, a specialist must be consulted. The paralysis may affect only one leg, the lower abdomen, or the hands and arms. The respiratory center may also be affected. The specialist is usually an orthopedic surgeon. He or she will determine whether the lower back pain can be treated as an outpatient or inpatient. In addition, neurologists and neurosurgeons may also be the right contact. However, this does not necessarily mean that those affected have to undergo surgery. Sudden pain triggered by a wrong movement or carrying a heavy load can often be treated by other measures. Heat is one of them, and together with painkilling and anti-inflammatory drugs, there is usually improvement in the symptoms soon. When visiting the family doctor, he will also administer an intramuscular injection in acute cases. Self-treatment with medication may only last a few days. If there is no relief, it is mandatory to see a doctor.

Treatment and therapy

As a rule, the treatment of lower back pain is uncomplicated, since the discomfort is usually caused by muscle tension. In this regard, everyone can contribute to recovery themselves. Prolonged bed rest should be avoided, because it makes the muscle tension even worse. Daily physical exercise is important. This helps the muscles to relax again. The best types of exercise are walking, swimming or cycling. In the beginning, however, a painkiller should always be taken as well, so that the back pain does not become imprinted in the pain memory. Otherwise, it could become chronic without the presence of a visible cause. However, since painkillers often cause side effects, it should be clarified with a doctor which analgesic should be used and in which dose. Furthermore, heat treatment of the back also relieves the tension. There are many causes of muscle tension. Besides a lack of exercise, stressful situations and psychological problems can also lead to it. In addition to exercise therapy, it can therefore sometimes also be useful to make use of psychotherapy. The same treatment methods are usually used for a herniated disc as well. Only if the herniated disc already leads to symptoms of paralysis, increased pain at night, progressive nerve loss or even urinary and fecal problems, emergency surgery is often necessary. Other therapies have also proven effective in treating back pain. For example, treatments such as massage, physiotherapy, back exercises via back schools or acupuncture lead to impressive successes for back health. Surgery should only be performed in exceptional cases. According to previous experience, surgeries for normal back problems have not brought long-term success.

Prevention

There are many ways to prevent lower back pain. The most important is to strengthen the back through physical exercise. Sports activities such as swimming, walking or cycling strengthen the back muscles. Lack of exercise is absolutely counterproductive. Furthermore, posture errors such as one-sided strain on the back, carrying objects with a bent back or remaining in the same position for long periods of time should be avoided. When sitting for a long time, the back relaxes by leaning back regularly.Excess weight is harmful to the back and should be reduced if present. Learning relaxation methods also contributes to a healthy back without pain.

What you can do yourself

Various self-help methods can be used for lower back pain. Exercise is important. A walk in nature is considered pleasant by many sufferers. The muscles in the lower back region are gently massaged and the vertebral joints are moved. The movement may hurt at first, but after a warm-up period, the pain usually subsides. Heat often helps with lower back pain. It promotes blood circulation and loosens the muscles. It is helpful to place a warmed grain pillow or hot water bottle on the affected area. The temperature should not be too high to avoid burns. A warming full bath also provides relaxation and pain relief. In principle, the painful lower back should be kept warm during all everyday movements. Back-friendly footwear, a suitable mattress, a healthy diet and a healthy posture are also recommended. Patients with lower back pain should pay special attention to their movement patterns. When standing up or sitting down, the pelvis should always be aligned. The abdominal and pelvic floor muscles should be tensed in advance. Those affected should consciously support themselves with their legs and arms. In addition, people with lower back pain should never remain in the same position for more than 30 seconds. Muscles should be tensed and relaxed while consciously taking a breath.