Overview: What is lumbago?
The stabbing pain shoots without warning into the back, usually in the lumbar vertebrae. Sometimes those affected are no longer able to stand up completely, and it is only with difficulty that they manage to stand upright again. But even though lumbago, as it is technically known, can cause very severe pain, the intervertebral discs or the sciatic nerve only play a role in the rarest of cases.
As a rule, it is an acute onset of muscle tension that affects neighboring structures. Lumbago often disappears on its own, and with the right treatment it is even safer. Lumbago is therefore generally harmless.
Lumbago: causes and risk factors
In most cases, the trigger for lumbago is an everyday movement, perhaps just performed a little differently than usual. The stabbing pain can therefore simply start when you get out of bed, a chair or the couch. Bending or twisting movements, lifting or stretching can also be triggers. Draughts can also cause lumbago.
Each of these external influences can cause the muscles in the lumbar vertebrae to tense up. This tension can in turn affect other nearby tissues and structures. For example, vertebral joints can become minimally displaced or blocked. The sacroiliac joint, i.e. the sacroiliac joint, is also at risk. However, it is very rare for a herniated or bulging disc to occur. Involvement of the sciatic nerve (lumboischialgia) is also the exception rather than the rule.
Tension, displacement or blockage irritates the nerves in the spine. This leads to the severe pain that is typical of lumbago.
In any case, an important risk factor for lumbago is when a lack of sport and exercise weakens the back. Weak back and abdominal muscles are prone to tension and are less resilient. However, if the muscles are well developed and strong, they act like a supporting corset for the spine.
Symptoms: Pain and stiff back
The sudden onset of acute, burning to sharp pain is the most important sign of lumbago. Because the tension irritates the nerves in the spine as described, the pain usually remains localized and does not radiate, as is the case with sciatica. The other symptoms of lumbago:
- Spine becomes stiff, the pain prevents movement in the affected area (mostly lumbar spine and sacrum), bending down or even stretching properly is hardly possible anymore
- Back muscles are hardened
- Slight pressure on the spinous processes of the vertebrae hurts. The spinous processes are the parts of the vertebral bodies that are clearly visible in the middle of the back as small elevations and describe the course of the spine.
Any movement that could lead to further pain is avoided. This results in a relieving posture, which in turn can lead to tension. Muscles, tendons and joints suffer as a result, and further back problems are caused by the relieving posture, creating a vicious circle.
Lumbago: Diagnosis with us
The severe pain and restricted movement are usually reason enough to consult an orthopaedic specialist. You should always seek medical advice promptly if one or more of the following symptoms occur. They may indicate involvement of the intervertebral discs or nerve damage:
- Tingling or numbness in the legs
- Symptoms of paralysis in the legs
- Urinary and bowel dysfunction
We will take a detailed medical history and ask about the characteristics of the complaints, additional health problems, when and where the pain occurred, possible triggers and also stress.
This is followed by a physical examination. First, we examine the spine and back muscles to see if there is any tension or pressure pain. In addition, the primary aim is to rule out potentially dangerous causes of the complaints. These include a herniated disc with the risk of nerve damage, or a vertebral body fracture in osteoporosis. We therefore also check the nerve reflexes, sensitivity, motor skills and strength in the legs
Weitere Untersuchungsoptionen betreffen die Bildgebung, also Röntgen, dabei auch 3D-Röntgen, Computertomografie, Kernspintomografie und Magnetresonanztomografie.
Lumbago: prevention, early detection, prognosis
Strong back and abdominal muscles and daily exercise can possibly prevent lumbago. You should therefore regularly do special gymnastics and exercises for these muscle groups. Other important preventive measures:
- If you have to sit a lot: stand up from time to time and stretch extensively. Walk a few steps, preferably up and down a flight of stairs.
- Avoid lifting or carrying heavy loads – and if you do, please follow the instructions for back-friendly lifting and carrying.
- Keep your back warm and avoid draughts.
- After swimming, please take off your swimwear, rub yourself down and put on dry clothes to avoid hypothermia in the lumbar vertebrae.
Early detection, as with other back diseases, is hardly possible with lumbago. This is because it always occurs suddenly and is an acute complaint that is not apparent beforehand.
Progression and prognosis (lumbago)
Although there are hardly any early warning signs of lumbago, the prognosis for lumbago is very good. Ultimately, lumbago is harmless unless it is associated with intervertebral disc problems or sciatica.
The symptoms of lumbago often disappear by themselves overnight or after a few days. If this is not the case, there are effective therapies. As a rule, pain and blockages disappear after a few weeks.
Lumbago: Treatment means heat, exercise and medication
If severe pain occurs, rapid intervention is called for. Here are some initial measures that you can simply try out:
- Showering: Warm water is usually good for you. Direct the shower jet over the painful areas, i.e. the lower back and lumbar vertebrae. This relaxes hardened muscles.
- Stepped positioning: This relaxes the back muscles and relieves pressure on the spine. Please lie on your back and use a small pillow to support your neck. Bend your legs and place your lower legs on a sitting cube or chair; your lower legs and thighs and your thighs and hips should each form a 90-degree angle.
- Lying on your side: Lie relaxed on one side. The head is supported by the hands on the side. The lower leg is stretched out without being strained, the upper leg should be positioned slightly bent over the other – so that the bent knee reaches the floor. This pose gently stretches the entire lower back. Please change sides after a while.