Introduction
The lumbar spine syndrome is a clinical picture whose symptom complex primarily describes back pain in the area of the lumbar spine (lumbar spine) as the leading symptom. Since it is a so-called lumbar spine “syndrome”, it describes various signs of the disease that result from different causes. For example, in the lumbar spine syndrome, one can suffer from back pain in the lumbar spine on the one hand, and on the other hand complain of abdominal pain or pain radiating to the lower extremities.
Common symptoms of a lumbar spine syndrome
The most common symptoms of a lumbar spine syndrome are as follows: The classification of symptoms in a lumbar spine syndrome can also be divided into radicular, i.e. symptoms originating from the nerve roots, and pseudo-radicular symptoms, whereby the latter does not originate from the roots themselves and therefore usually does not lead to radiating pain or motor deficits.
- Back pain
- Sensations like numbness or tingling
- Tensions
- Stomach pain or digestive problems
- Radiating pain
- Motor failures
Pain in the lumbar spine is a very common phenomenon in the population. It is assumed that about 80% of adults have suffered from it once or several times in their lives.
It is one of the most common causes of incapacity to work and significantly increases the number of days of absence due to illness. Men and women are affected equally often. The pain is felt differently by many patients – from sharp, suddenly occurring pain that makes movement impossible to chronic, rather dull pain sensations, everything is described.
Also the beginning of the pain can look very different. In one case the trigger can be a wrong movement or trauma and the pain can start acutely. In the other case a permanent bad posture or age-related changes in the spine can cause a creeping onset.
Acute pain is defined as lasting up to 4 weeks, subacute pain varies within a period of 4-12 weeks and chronic pain is defined as pain that lasts longer than 12 weeks. The characteristics of the pain vary depending on where the pain originates: bony and muscular structures can trigger the back pain, but also ligaments, tendons or nerve irritation. With regard to the nerves, the lumbar spinal syndrome can be classified into radicular and pseudoradicular pain.
Generally speaking, the pain localization in lumbar spine syndrome is related to the lower back, i.e. the lumbar spine, and results from blockages, irritation or tension. Rarely does pain radiate into the legs. The character of the pain can vary between dull, pulling, non-piercing and very strong intensities.
Depending on the trigger, the pain can be sudden and of short duration, but can also become chronic. The temporal course of the pain thus depends on the cause. The intensity of the pain can be negatively influenced by loading the lumbar spine.
An increase in pressure due to a violent cough, sneezing or pressing can also increase the pain. Many patients are not aware of the fact that abdominal and back pain can be related. However, it is also possible, especially in the presence of a lumbar spine syndrome, that abdominal pain may occur in addition to the characteristic back pain.
The reason for this can be, for example, that patients suffering from lumbar spine syndrome adopt a relieving posture in order to minimize the pain and relieve the back. In addition to tension in the back, this also results in problems in the muscular apparatus of the abdomen and trunk. The muscles can be unphysiologically shortened or stretched by the incorrect posture and cause pain as a result.
This means that back pain can often cause abdominal pain. In addition to superficial, purely muscular abdominal pain, however, abdominal pain with organic causes must also be considered. Due to the incorrect posture, various organs in the abdominal cavity become constricted or distorted, so that the pain emanates from the irritated organs.
Depending on the position of the organ, the pain may radiate to the abdomen, but also to the back. Clearly defined clinical pictures such as herniated discs and scoliosis, a disease in which the spine is deformed, can cause this described phenomenon. If the pain is localized especially in the lower abdominal area, one should always think of a so-called “spondylolisthesis” of the lumbar vertebrae.The slipping positional change of the vertebral bodies influences muscle and ligament structures of the spine to a high degree.
The pain is often projected into the abdominal region via the muscle apparatus. The causality chain of pain can also be reversed, i.e. pain radiating from the abdomen to the back. This can falsely give rise to the suspicion of suffering from a lumbar spinal syndrome, even though the back pain is organic in nature.
An example of this is inflammation of the pancreas, whose location in the abdominal cavity is relatively close to the spinal column. Pain due to so-called pancreatitis (inflammation of the pancreas) can therefore move to the back. Irritable bowel syndrome, for example, can cause the symptom triad of nausea, back and abdominal pain.
As soon as back and abdominal pain occur simultaneously, not only the back but also the abdomen (the stomach) should be examined in addition to the diagnosis of a lumbar spine syndrome. The spinal column is the bony carapace of the spinal cord from which the nerve fibers originate, which organize themselves together in bundles and then emerge as nerves and supply the individual areas of the body. If changes occur in the spinal column, whether it is only a temporary tension of a muscle or a swelling due to an inflammation, this can irritate the nerves in their course.
The patient can then feel this, for example, through tingling, numbness, signs of paralysis or pain. Of course, such neurological symptoms can also occur in a harmless way, such as an unfavorable sleeping position. Basically, such sensory disturbances, which do not exist for a short time, should always be clarified by a doctor.
For example, problems with urination or difficulties in holding urine or stool can also occur. These are clear warnings that should be taken to hospital quickly so that further diagnostic tests can be carried out as soon as possible. In addition to back pain, patients with a lumbar spine syndrome often suffer from sensations such as numbness or tingling in the back and extremities.
In most cases, back pain is accompanied by a relieving posture, which in turn provokes tension in the back muscles and restricts movement. As already mentioned, the radiation of pain is not particularly characteristic, since the pain is mostly locally limited to the lumbar spine. Exceptions or variations are described in the following sections “abdominal pain”, “radical” and “pseudo-radicular”.
In general, the lumbar spine is very susceptible to injury or discomfort compared to the other spinal column sections. This is due to the fact that the lumbar vertebrae in particular are subject to a great deal of pressure due to their position at the end of the spine. After all, the lumbar spine has to bear the weight of our entire trunk. A slipped disc is therefore a typical clinical picture and occurs mainly in the lumbar spine area.
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