Lumbago: Causes, Symptoms & Treatment

Lumbago or sciatica syndrome is a sudden and usually stabbing pain in the lower back, that is, the lumbar spine. This is called lumbago by medical professionals.

What is lumbago?

Under the colloquial term lumbago, medically referred to as lumbago or ischialgia, occurs a sudden, stabbing and persistent pain, especially in the lumbar region, with subsequent movement restrictions. Lumbago is a pain in the lower back that usually occurs without warning. Affected patients can hardly move or stretch and adopt a kind of protective posture. Often, patients can only move around hunched over. The consequence is usually that the entire back musculature tenses up, which results in further pain. Since the pain of lumbago is very severe, most sufferers suspect a herniated disc. However, this can only be diagnosed in the fewest cases – as a precaution, however, one should definitely consult a doctor in case of severe pain in the back. It is not uncommon for people who suffer from lumbago to have regular back pain. Incidentally, a slipped disc can be easily distinguished from lumbago by the fact that in the latter the pain often radiates into the legs – in the case of lumbago, only the lower back is usually affected.

Causes

The trigger for lumbago is usually just a small careless movement, such as by turning, lifting or bending incorrectly. Often, lumbago is also caused by incorrect straightening during sports. These incorrect movements cause muscles to be pulled or vertebrae to be blocked – resulting in pain that is nevertheless quite severe. In the area of the joints there are countless nerves and nerve fibers – these are the main trigger for the very strong pain. Only in very rare cases are narrowings of the spine due to tumors the cause of lumbago.

Symptoms, complaints and signs

As a rule, lumbago occurs suddenly and almost immediately causes severe, stabbing back pain. The pain occurs in the lower back or in the area of the lumbar spine and becomes stronger or weaker depending on the body position. In the course of the disease, pain-induced numbness of the lumbar spine may occur. As a result, the affected person adopts a protective posture with the lumbar spine stretched straight or the back bent. When pressure is exerted on the spinous processes of the lumbar vertebrae, severe pain occurs that subsides only slowly. People who suffer from lumbago are usually unable to move and stretch. Even the smallest movements cause severe pain. As a result, the back muscles tense up and the affected person instinctively bends forward. This protective posture leads to an increase in pain and thus intensifies the lumbago. In some cases, severe pain can also lead to gastrointestinal complaints. Nausea and vomiting are typical, occasionally accompanied by stomach cramps. Lumbago usually persists for a few days and then subsides on its own, provided the patient takes sufficient rest. If the causes are not treated, lumbago may recur again and again.

Course of the disease

The good news for all patients with lumbago: it usually disappears on its own after a few days with the right therapy. However, if the pain has not disappeared on its own within three days, a doctor should be consulted; he or she will prescribe the appropriate medication or administer injections. However, patients who regularly suffer from lumbago should see a doctor, as it may be a precursor to a herniated disc.

Complications

Complications very rarely occur with lumbago. However, it is quite possible for sciatica to carry unpleasant surprises or for it to become chronic. Among the most common complications of lumbago are relapses. Thus, the complaints may recur after a pain-free break of several months. If there are about six months between the low back pain, it is usually another case of lumbago. Sometimes this is caused by a serious cause. This may be osteoporosis (bone loss) or spondylolisthesis (slipped vertebrae).In some cases, low back pain does not completely subside. Instead, its intensity increases at repeated intervals. If this condition lasts longer than twelve weeks, it is referred to as chronic low back pain. In this case, the pain has developed into a disease in its own right. However, it is important to rule out other possible causes such as ankylosing spondylitis. In some patients, complications set in even in the early stages of lumbago. For example, the pain continues unabated or radiates into the leg or foot. Some patients also suffer from sensory disturbances such as numbness or tingling, weakened muscles or paralysis of the foot. The reason for these complications is mostly herniated discs. However, spondylolisthesis, vertebral fractures, neuropathies of the spinal cord nerves and pathological changes in the spinal canal can also be responsible for the complaints.

When should you go to the doctor?

Lumbago usually occurs suddenly and unexpectedly. Twisting movements or lifting objects cause a stabbing pain to set in, which leads to a collapse. The affected person suffers immensely from the severe pain and an inability to move. A doctor must be consulted immediately, as the affected person no longer has control of movement over his body due to spontaneous paralysis. Even the smallest attempts at movement result in considerable pain. Only with effort and the support of another person is it possible to move. The paralysis symptoms often put the affected person in fear and panic. A doctor can bring about rapid relief of the symptoms. In particularly severe cases, an emergency physician should be called and the instructions of the rescue personnel should be followed until the physician arrives. The patient should not take medication without consulting a medical professional. Side effects may occur, which must be clarified in advance. The patient should always remain calm and breathe steadily when suffering from lumbago. In many cases, this allows the patient to move very slowly. At least under these conditions, the patient can move his body into a position that he perceives as more comfortable and relieving. Further jarring should be avoided on the way to a doctor.

Treatment and therapy

In order to treat lumbago specifically and effectively, the doctor must first know exactly when it occurred. Most patients can also describe this quite clearly. It is also important for the doctor to know whether the pain radiates into the legs, whether sensory disturbances or paralysis symptoms or even problems with urination are added. The patient’s mobility and reflexes are then examined. X-ray, ultrasound and blood tests as well as computer tomography are frequently used procedures to finally diagnose lumbago accurately. Treatment generally depends on the underlying cause. In the case of a blocked vertebral body, for example, the only way to help is usually to set it – this should only be done by an experienced orthopedist. Normally, however, painkilling medication is quite sufficient for lumbago; heat is also very good for the back. Absolute bed rest is hardly necessary in case of lumbago, only in the first days one should take it easy. After that, however, exercise is an absolute must in order to get the muscles of the back going again. Diclofenac is one of the most commonly prescribed painkillers for lumbago, which is administered in the form of tablets. Often, however, the doctor also injects an anti-inflammatory drug directly into the muscles of the back. Physiotherapy, massages and back training can be used as a supportive measure for lumbago. If, in turn, a herniated disc is the trigger for the lumbago, often only surgery helps.

Outlook and prognosis

Lumbago disappears on its own after a few days. If the condition is treated early, it subsides almost painlessly within one to three days, although mild back pain may persist for some time afterwards. In addition, there is a risk of poor posture developing as a result of lumbago. Especially with chronic complaints, there is a risk of unnatural postures of the back or head, which can lead to premature joint wear, tension and other health problems.If sufferers take advantage of physiotherapy to accompany treatment of the actual back condition, these risks can be avoided. Patients with a chronic back condition sometimes suffer several witch hazes in succession. Recurrent complaints are an enormous burden for the affected person, who often suffers from chronic pain concomitantly. A recurring sciatica syndrome indicates a herniated disc, which is associated with severe physical limitations for those affected. In principle, however, the prognosis for lumbago is positive. If the condition is quickly clarified and treated, and the patient also eliminates possible triggers, the risk of further complaints is relatively low. Life expectancy is not reduced by lumbago.

Prevention

To prevent back pain in general and lumbago in particular, it is quite crucial to strengthen the back muscles. The right mattress also works wonders – this should be adapted to the body weight. Especially in professions with predominantly sedentary work, it is important to create a sporting balance. Particularly back-friendly sports are swimming and cycling.

Aftercare

Immediately after lumbago, the affected person should take it easy. It is important to give the back and especially the intervertebral discs sufficient time to recover. Any pain and cramps can be treated with the help of home remedies such as painkilling teas, massages or hot baths. In the case of severe discomfort, preparations from the pharmacy can help. Acute pain is relieved with special back bandages. In addition, the affected person may need to use crutches to relieve the back during the recovery phase. Follow-up care in any case includes regular progress monitoring by the chiropractor or orthopedist. The condition should subside within a few days to weeks. The cause must then be determined so that lumbago does not recur. If there is a vertebral joint blockage, a physical therapist must be consulted. The specialist can manually realign the joint and thereby relieve the pain. Acupuncture and alternative measures may also be part of the aftercare, insofar as it is a chronic condition. Follow-up examinations should occur at least every two weeks. If the course is positive, the intervals can be extended. Chronically ill patients must remain in permanent contact with an orthopedist. Part of the follow-up care is also the prevention of further lumbago. This is achieved through the use of a special bed, back-friendly shoes and comparable measures.

What you can do yourself

A doctor does not always have to be consulted for lumbago. Often, the discomfort can be reduced by simple measures and home remedies. In the case of acute lumbago, the load should be stopped immediately. However, prolonged sitting or lying down is not recommended, as this can lead to further hardening of the muscles. Gentle exercise and regular relaxation are better. Those who still have to sit should use a stool or exercise ball. Light stretching exercises are also helpful. An effective workout: carefully lie on the floor and stretch out your arms and legs for a long time. This relieves the nerves and loosens the muscles. Heat applications, hot showers or massages help against the pain. A so-called Schlenz bath, in which the temperature is gradually increased, has also proven effective. In addition, essential oils are recommended. Pine, spruce, mint or lavender, for example, can be used in the form of massages and rubs and promise a rapid improvement in the symptoms. Teas, for example with birch leaves, elderberry or linden blossoms, also have a pain-relieving effect. If the symptoms do not subside with the above measures, a visit to the doctor is recommended.