Lumbago or sciatica is a sudden and usually sharp pain in the lower back, i.e. the lumbar spine. Doctors call this lumbago.
What is lumbago?
Lumbago is a lower back pain that usually occurs without warning. Affected patients can hardly move or stretch and adopt a kind of relieving posture. Patients are often only able to move in a curved manner. The result is usually that the entire back musculature tenses up, which leads to further pain.
Since the pain from lumbago is very severe, most sufferers suspect a herniated disc. However, this can only be diagnosed in very few cases – as a precaution, however, you should definitely consult a doctor if you experience severe back pain.
It is not uncommon for people who suffer from lumbago to have back pain on a regular basis. Incidentally, a herniated disc can be distinguished from lumbago by the fact that the pain often radiates into the legs – lumbago usually only affects the lower back.
The trigger for lumbago is usually just a small careless movement, such as wrong turning, lifting or bending over. Often, lumbago is also caused by incorrect straightening up during sports.
These incorrect movements pull muscles or block vertebrae – resulting in quite severe pain. There are countless nerves and nerve fibers in the area of the joints – these are the main triggers for the very severe pain.
Only in very rare cases is narrowing of the spine due to tumors the cause of lumbago.
Symptoms, Ailments & Signs
Lumbago usually comes on suddenly and causes severe, stabbing back pain almost immediately. 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. As the disease progresses, the lumbar spine may become rigid due to pain.
Those affected then adopt a relieving posture with a straight lumbar spine or a bent back. Pressure on the spinous processes of the lumbar vertebrae causes severe pain that only subsides slowly. People who suffer from lumbago are usually no longer able to move or stretch. Even the smallest movements cause severe pain.
This causes the back muscles to tense up and the person concerned instinctively bends forward. This relieving posture leads to an increase in pain and thereby intensifies the lumbago. In some cases, severe pain can also lead to gastrointestinal problems. Nausea and vomiting are typical, occasionally accompanied by stomach cramps.
Lumbago usually lasts for a few days and then subsides on its own, provided the patient rests sufficiently. If the causes are not treated, it can always come back to lumbago.
course of the disease
The good news for all patients with lumbago: with the right treatment, it usually goes away on its own after a few days. However, if the pain does not go away on its own within three days, you should see a doctor; he will prescribe the appropriate medication or administer injections. However, patients who regularly suffer from lumbago should consult a doctor, as this may be a harbinger of a herniated disc.
Complications from lumbago are very rare. However, it is quite possible that the sciatica syndrome harbors unpleasant surprises or that it becomes chronic. One of the most common complications of lumbago is recurrence.
The symptoms can recur after a pain-free break of several months. If there are about six months between the low back pain, it is usually another lumbago. Sometimes this is caused by a serious cause. This can be osteoporosis (bone loss) or spondylolisthesis (spinal slippage).
In some cases, the low back pain does not go away completely. Instead, their intensity increases at repeated intervals. If this condition lasts longer than twelve weeks, the lower back pain is said to become chronic. In this case, the pain has developed into an independent disease. However, it is important to rule out other possible causes such as Bechterew’s disease.
Complications set in for some patients in the early stages of lumbago. The pain continues unabated or radiates down the leg or foot. Some sufferers also suffer from sensory disturbances such as numbness or tingling, weakened muscles or paralysis of the foot. Most of these complications are caused by herniated discs. But slipped vertebrae, vertebral fractures, neuropathies of the spinal cord nerves and pathological changes in the spinal canal can also be responsible for the symptoms.
When should you go to the doctor?
Normally, lumbago occurs suddenly and unexpectedly. Shooting pain sets in from twisting movements or lifting objects, leading to collapse. The patient suffers immensely from the severe pain and inability to move. A doctor must be consulted immediately because the person affected no longer has any movement control over their body due to the spontaneous paralysis. Even the slightest attempt to move causes significant pain. Moving is only possible with effort and the support of another person. The symptoms of paralysis often put those affected in fear and panic. A doctor can provide quick relief from the symptoms.
In particularly serious cases, an ambulance must be called and the instructions of the rescue personnel must be followed until they arrive. The patient should not take medication without consulting a doctor. There may be side effects that need to be clarified in advance. The person affected should always remain calm and breathe evenly in the event of lumbago. In many cases, this results in very slow locomotion. Under these conditions, the patient can at least bring his body into a position that he perceives as more comfortable and relieving. On the way to a doctor further shocks are to be avoided.
Treatment & 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 whether the pain radiates into the legs, whether there are sensory disturbances or signs of paralysis or even problems with urination.
Now the mobility and reflexes of the patient are examined. X -ray, ultrasound and blood tests as well as computed tomography are frequently used methods to finally diagnose lumbago accurately.
Treatment generally depends on the underlying cause. In the case of a blocked vertebral body, for example, the only thing that usually helps is setting it in place – this should only be performed by an experienced orthopaedist. Normally, however, painkillers are completely sufficient for lumbago; Heat is also very good for the back. Absolute bed rest is hardly necessary for lumbago, you should only take it easy in the first few days. After that, exercise is an absolute must to get the back muscles going again. Diclofenac is one of the most commonly prescribed pain relievers for lumbago, and it comes in pill form.
Often, however, the doctor also injects an anti-inflammatory drug directly into the back muscles. Physiotherapy, massages and back school can be used to help with lumbago. If, in turn, a herniated disc is the trigger for lumbago, often only an operation can help.
Outlook & Forecast
Lumbago goes away on its own after a few days. If the condition is treated early, it subsides almost painlessly within one to three days, although slight back pain can persist for some time afterwards. In addition, there is a risk of poor posture as a result of lumbago. Especially with chronic complaints there is a risk of unnatural posture of the back or head, which can lead to premature joint wear, tension and other health problems.
These risks can be avoided if the sufferers take advantage of physiotherapy in addition to the treatment of the actual back problem. Patients with chronic back pain sometimes suffer from several cases of lumbago in a row. Recurring complaints are an enormous burden for those affected, who often suffer from chronic pain as well. 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 eliminates possible triggers, the risk of further symptoms is relatively low. Life expectancy is not reduced by lumbago.
In order to prevent back pain in general and lumbago in particular, it is crucial to strengthen the back muscles. The right mattress also works wonders – it should be adapted to your body weight. Especially in occupations with predominantly sedentary work, it is important to create a sporting balance. Swimming and cycling are particularly back-friendly sports.
Immediately after the lumbago, the affected person should take it easy. It is important to give the back and especially the intervertebral discs enough time to recover. Any pain and cramps can be treated with the help of home remedies such as pain-relieving teas, massages or hot baths. In the case of severe symptoms, preparations from the pharmacy can help. Acute pain is relieved with special back bandages.
In addition, the sufferer may need to use crutches to take the strain off their back during the recovery period. Follow-up care always includes regular follow-up checks by a chiropractor or orthopedist. The condition should subside within a few days to weeks. The cause must then be determined so that lumbago does not occur again.
If there is a vertebral joint blockage, a physiotherapist must be consulted. The specialist can put the joint back in place manually, thereby relieving the pain. Acupuncture and alternative measures can also be part of the follow-up care insofar as the condition is chronic. The follow-up examinations should be carried out at least every two weeks.
If the trend is positive, the intervals can be extended. Chronically ill people need to stay in constant contact with an orthopedist. Part of the aftercare is also the prevention of another lumbago. This is achieved by using a special bed, back-friendly shoes and comparable measures.
You can do that yourself
A doctor does not always have to be consulted for lumbago. The symptoms can often be reduced by simple measures and home remedies.
In the case of acute lumbago, the strain should be stopped immediately. However, sitting or lying down for long periods of time is not recommended as it can lead to further tightening of the muscles. Gentle exercise and regular relaxation are better. If you still have to sit, you should use a stool or exercise ball. Light stretching exercises are also helpful. An effective workout: lie carefully on the floor and stretch out your arms and legs. This relieves the nerves and relaxes the muscles.
Heat treatments, hot showers or massages help against the pain. A so-called Schlenzbad, in which the temperature is gradually increased, has also proven itself. Essential oils are recommended to support this. Pine, spruce, mint or lavender, for example, can be used in the form of massages and rubs and promise a rapid improvement in symptoms. Teas, such as those made with birch leaves, elderberry or lime blossom, also have a pain-relieving effect. If the symptoms do not decrease with the measures mentioned, a visit to the doctor is recommended.