About Lumbago (Lower Back Pain)
Lumbago can have various underlying causes. Some common causes include:
- Muscular strain or sprain: Overexertion or improper lifting techniques can lead to muscle strain or sprain in the lower back.
- Herniated disc: When the soft inner portion of a spinal disc protrudes through the outer layer, it can compress nearby nerves and cause pain.
- Degenerative disc disease: As discs in the spine age, they can lose their cushioning ability, leading to pain and stiffness.
- Spinal stenosis: Narrowing of the spinal canal can put pressure on the spinal cord and nerves, causing pain.
- Osteoarthritis: The breakdown of cartilage in the joints of the spine can result in inflammation and pain.
- Oncologic process: Lumbago may be a symptom of some cancers. However, cancer patients will often experience other symptoms in addition to lower back pain.
Non-modifiable risk factors for lumbago, which are factors that cannot be controlled to reduce the risk of developing the condition, include:
- Age: The risk of developing lumbago increases with age.
- Gender: Men and women have similar rates of lumbago, but women may be more prone to certain types of back pain.
- Family history: Having a family history of back pain or spinal conditions may increase the risk.
Modifiable risk factors for lumbago, which are factors that can be controlled to reduce the risk of developing the condition, include:
- Obesity: Excess weight puts additional stress on the spine and can contribute to back pain.
- Poor posture: Maintaining proper posture while sitting and standing can help prevent strain on the back.
- Lack of exercise: Regular physical activity helps strengthen the muscles supporting the spine and reduces the risk of back pain.
- Smoking: Smoking can impair blood flow to spinal tissues, leading to degeneration and increased risk of back pain.
Remember, these are general risk factors and individual experiences may vary. It's always a good idea to consult with a healthcare professional for personalized advice.
The most common early symptoms of lumbago include:
- Pain and stiffness in the lower back
- Pain that worsens with rest and during the night
- Pain that improves with movement
- Fatigue, feeling tired and lacking energy
As lumbago progresses or becomes more severe, other common symptoms may occur, such as:
- Radiating pain down the buttocks, hip, groin, or leg (referred to as sciatica)
- Weakness in the affected area
- Loss of reflexes
- Numbness or tingling sensation
- Difficulty walking
It's important to note that everyone's experience with lumbago can vary. Some individuals may have mild pain that comes and goes, while others may experience severe and prolonged pain. Additionally, lumbago can affect other parts of the body as well. If you are experiencing symptoms of lumbago, it is recommended to consult with a healthcare professional for an accurate diagnosis and appropriate treatment.
To diagnose lumbago, doctors typically perform a physical examination and review your medical history. However, if further tests are needed to determine the cause or severity of lumbago, additional examinations, tests, and procedures may be recommended. These can include:
- X-ray: Provides detailed images of the bones in your lower back.
- Computed tomography (CT) scan: Produces cross-sectional images of your spine to identify any structural abnormalities.
- Magnetic resonance imaging (MRI) scan: Uses magnetic fields and radio waves to create detailed images of the soft tissues in your back.
- Electromyogram (EMG): Measures the electrical activity in your muscles and nerves to assess muscle and nerve function.
- Radionuclide bone scan: Evaluates blood flow and cell activity in the bones.
Additional tests to determine the stage or severity of lumbago:
- Muscle function testing: Assesses the strength and function of specific muscles in your lower back.
- Deep reflex testing: Checks your reflexes in response to certain stimuli.
- Sensation testing: Evaluates your ability to feel different sensations in specific areas of your lower back.
- Lasegues sign test: Involves raising your leg straight while lying down to assess for pain or discomfort.
It's important to consult with a healthcare professional for an accurate diagnosis and appropriate treatment.
The goals of treatment for lumbago are to alleviate pain, improve functionality, and enhance the quality of life. Here are the recommended treatments and how they work to achieve these goals:
- Medications:
- Analgesics (pain relievers), NSAIDs (nonsteroidal anti-inflammatory drugs), opioids, and gabapentin can be prescribed to alleviate pain symptoms and improve quality of life. These medications work by reducing inflammation, blocking pain signals, and modifying nerve activity.
- Because of its potential for dependence and addiction, opioids are often prescribed for short-term use only, rather than as a long-term solution for lower back pain. Talk to your doctor about other medication alternatives for long-term pain management.
- Therapies: Physical therapy regimens can help restore functionality and alleviate pain. Rehabilitation training focuses on improving blood circulation, strengthening muscle groups in the lumbar spine, and correcting movement patterns. This helps repair the physiological structure of the lumbar vertebrae and achieve normal physiological function.
- Alternative therapies: Alternative therapies, such as acupuncture and massages, may help with muscle relaxation and stress relief, that could help ease lower back pain symptoms.
- Therapeutic procedures:
- Neuraxial steroid injections: These are injections of anti-inflammatory steroids into the space around the spinal cord (epidural space) to reduce inflammation and pain.
- Trigger point injections: These involve injecting a small amount of anesthetic or steroids directly into muscle knots (trigger points) that cause pain.
- Surgery may be considered for certain severe cases of lumbago. Surgery relieves pressure on the spinal cord and nerve roots by removing part of the vertebrae, including the facet joints and lamina (bony areas of the spine). This helps reduce nerve pressure and improves movement in the lower limbs. However, guidelines for surgery are still being developed due to the complexity of the condition.
- Self-care and health behavior changes: Making lifestyle modifications can also contribute to the treatment of lumbago. This may include maintaining a healthy weight, practicing proper body mechanics during activities, engaging in regular exercise to strengthen core muscles, and avoiding prolonged sitting or standing.
Remember to consult with your healthcare professional before starting any medication or treatment. Medication dosing may be affected by many factors. Check with your health care professional about dosing for your individual situation. Side effects can occur. Check with your health care professional or read the information provided with your medication for side effect information.