Synonyms: Lumbago, Acute Lumbalgia, Lumbar Syndrome, Lumbar Paralysis.
General information
By a Lumbago, in the vernacular as lumbago known, one understands suddenly occurring, violent back pain in the area of the lumbar spine. Usually the pain occurs after jerky, everyday movements such as bending or lifting heavy objects and can sometimes be so severe that the person affected can hardly move at all. The cause of lumbago is often a harmless blockage of the vertebral bodies or pulled muscles, but serious conditions such as a herniated disc of the lower back can also cause the symptoms of lumbago.
Frequency: widespread disease back pain
Back pain is the second most common reason why patients visit a doctor’s office. About 80% of Germans have back pain once in their life, about 70% even once a year. The most common age group affected is between 50 and 70 years of age, but schoolchildren and young people are increasingly complaining about back problems.
Causes and triggers
Often the appearance of a lumbago is based on a weakened back musculature. The reason for this can be incorrect strain due to sitting incorrectly or for too long as well as lack of movement. If the wrong movement is made, a deep back muscle is easily pulled, which then tenses and hardens reflexively and can thus block a vertebral body.
Blockages can also occur in the sacroiliac joint (sacroiliac joint). Because of the pain, affected persons usually automatically assume a relieving posture, which further increases the muscle tension. Therefore, patients should move again as soon as possible after a lumbago.
A herniated disc (prolapse) or a bulging disc (protrusion) can also manifest itself through the symptoms of a lumbago. However, this is often accompanied by sensory disturbances or paralysis in the legs or feet. In rare cases, an inflammation or a tumor in the spinal column can also cause severe back pain as in the case of a lumbago.
A lumbago usually manifests itself as a stabbing, drilling or pulling pain in the lower back, which occurs suddenly and is usually accompanied by a restriction of movement. The pain may radiate into the chest or thigh up to the knee, but this does not necessarily mean that the sciatic nerve or any other nerve is involved. The entire back muscles are often tense, hardened and sensitive to pressure.
Numbness, tingling or muscle weakness, on the other hand, usually only occur when an intervertebral disc, the cause of the complaints, presses on a nerve. After a specific questioning of the complaints and the medical history (anamnesis), the doctor will perform a physical examination to check the mobility of the vertebral joints and the sacroiliac joint. Neurological tests are performed to rule out nerve involvement such as a herniated disc or nerve entrapment: In these tests, the physician checks whether the patient feels touches on both legs and feet equally strongly and tests the strength of the flexor and extensor muscles and reflexes.
The so-called Lasègue test is a groundbreaking test for the diagnosis of sciatica (pain originating from the sciatic nerve). For this test, the doctor slowly lifts the stretched leg of the patient lying flat on his back, thereby stretching the sciatic nerve. If pain is already present when the leg is lifted less than 45°, the Lasègue test is considered positive.
This may indicate irritation of the nerve root due to a herniated disc, inflammation of the nerve or pinching of the sciatic nerve. In this case, an MRI is performed if necessary to rule out a herniated disc. If a herniated disc is suspected, it is also important to know whether the patient can control urine and stool.
If there is a functional disorder of the bladder or anal sphincter muscle, this indicates damage to the nerves of the lower spinal cord (cauda syndrome), which must be treated surgically immediately. Otherwise, there is a possible risk of a permanent disorder of urinary and fecal continence. In the case of a simple lumbago, warm baths, heat pads or infrared radiation can help to relax the muscles.
Stair positioning can also help to relieve pain: In a supine position, the lower legs are placed at right angles on a padded elevation, while the head and neck rest on a flat cushion.If a blockage in the vertebral or sacroiliac joints is behind the symptoms, a “settling” (deblocking) by an orthopedist or chiropractor can work wonders. Massages, general physiotherapy or manual therapy also usually lead to an improvement of the symptoms of lumbago. If the pain is severe, temporary anti-inflammatory painkillers (NSAIDs) such as ibuprofen or diclofenac can be taken.
Although they do not have a causative effect against lumbago, they can enable early appropriate movement, which usually promotes recovery. If the back muscles are very tense, the doctor can prescribe muscle-relaxing medication (muscle relaxants) such as Sirdalud®. This active ingredient belongs to the group of benzodiazepines and is particularly suitable for evening use because of its calming effect.
Injections of anti-inflammatory drugs such as cortisone or local anesthetics into the back muscles are also administered to the lumbago. The advantage of this is that the active ingredients only work where necessary and do not burden the entire body. If a herniated disc is the cause of the discomfort, surgery may be necessary under certain circumstances.
As a rule, the symptoms of an uncomplicated lumbago improve relatively quickly with appropriate treatment. The acute pain usually subsides within a few days, after which those affected often have mild symptoms for one to two weeks. If a herniated disc is the cause, however, a long-term therapy and possibly an operation is usually necessary.
If the lumbago is the result of incorrect loading or weak back muscles, a recurrence should be actively counteracted. Affected persons should consider the following: Once the symptoms of acute lumbago have subsided, special spinal gymnastics or targeted back training helps to build up the weakened back muscles. A strong back is less susceptible to lumbago.
Overweight should be reduced if possible to relieve the back. An ergonomically designed workplace with an individually adapted desk and office chair prevents tension and back pain.
- Once the symptoms of an acute lumbago have subsided, special spinal gymnastics or targeted back training helps to build up the weakened back muscles. A strong back is less susceptible to lumbago.
- Overweight should be reduced if possible to relieve the back.
- An ergonomically designed workplace with an individually adapted desk and office chair prevents tension and back pain.
- When lifting heavy objects you should kneel down and use the power from your legs instead of bending down with a round back.
