Lumbago

Martina Feichter studied biology with an elective subject pharmacy in Innsbruck and also immersed herself in the world of medicinal plants. From there it was not far to other medical topics that still captivate her to this day. She trained as a journalist at the Axel Springer Academy in Hamburg and has been working for since 2007 - first as an editor and since 2012 as a freelance writer.

More about the experts All content is checked by medical journalists.

Lumbago (lumbago, lumbalgia) is what doctors call acute low back pain. The trigger is usually an unfavorable or unfamiliar movement of the trunk. Lumbago is generally harmless and will get better on its own. Read more about the topic here: How does lumbago develop? What to do about the pain When is it advisable to see a doctor in the case of lumbago?

Brief overview

What is lumbago? Acute shooting pain in the lower back, usually triggered by an abrupt, unfamiliar or awkward movement (such as bending over, lifting, rotating the trunk, etc.).
Symptoms: acute pain in the area of the lower lumbar vertebrae and above the sacrum (in the middle or to the side of it), often also when walking and standing. The mobility of the lumbar spine is limited due to pain. Sometimes the pain radiates (into the leg, for example).
Examinations: A detailed discussion with the patient (anamnesis) and a physical examination are usually sufficient for the doctor to clarify. Further examinations (X-ray, MRI, laboratory tests, etc.) are only necessary if serious or organ-related causes of acute lower back pain are suspected.
Treatment: warmth, short-term step storage, but no bed rest! Instead, light exercise and maintain everyday activities, possibly with the help of pain relievers (such as ibuprofen or diclofenac).
Forecast: Lumbago is usually harmless and disappears on its own after a short time.

Lumbago: Description & Symptoms

The colloquial term lumbago refers to acute shooting pain in the lumbar region. The technical term for this acute low back pain is lumbago or lumbago (the expression "acute lumbago" is nonsensical).

Lower back pain is a common ailment. According to the German back pain study 2003/2006, up to 85 percent of the population will experience lower back pain at least once in their life.

Local lumbar syndrome

The term "local lumbar syndrome" includes all disease states that:

are due to degenerative (wear-related) and functional disorders in the lumbar spine and
the symptoms of which remain limited to the lumbar region.

This includes all transitions between simple lumbago, which sets in acutely and disappears just as quickly, to chronically recurring (recurrent) lower back pain.

Lumbago: symptoms

The pain from lumbago is mainly in the lower lumbar region and above the sacrum - either in the middle or a little to the side of it. They can also radiate to other parts of the body (especially the leg) as if a nerve root in the lumbar area was irritated (pseudoradicular pain).

The pain limits the mobility of the lumbar spine: Many of those affected can no longer bend down. Walking and standing can also be almost impossible due to pain. If you press or knock on the spinous processes of the vertebrae, it hurts.

Lumbago: treatment

Heat helps against the pain of lumbago: it stimulates blood circulation, relaxes the muscles and can thus alleviate the pain. For example, warming pads (such as warm patches, warm mud packs, hot water bottles, grain pillows) and red light radiation are recommended.

If the pain worsens during the heat treatment, you should stop using it and seek advice from a doctor - there may be something other than lumbago behind the symptoms.

Short-term pain relief can often also be achieved with the stepped position: The patient lies on his back. The legs are bent at right angles at the hips and knees, for example by placing the lower legs on a chair or stool of the appropriate height. This position takes pressure off the spine and muscles in the lower back.

In addition, lumbago sufferers should not lie in bed and move as little as possible. Experts strongly advise against this! Because bed rest and inactivity are not helpful. They can even do harm by making the pain worse and delaying healing. Instead, patients should keep their normal everyday activities as good as possible - with the help of pain medication if necessary.

Painkillers from the group of non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or diclofenac are particularly recommended for lumbago drug treatment. They are taken, for example, as a tablet or capsule. However, sometimes because of their potential side effects (such as severe heart failure), NSAIDs should not be used. In addition, there are people who cannot tolerate NSAIDs. In such cases, the doctor may prescribe an alternative pain reliever, such as metamizole.

In general, lumbago patients should only use pain relievers when absolutely necessary. In addition, the medication should only be taken for a short time and in the lowest possible dose.

Lumbago: duration

In addition, no further measures are generally necessary in the case of lumbago: the symptoms usually subside on their own after a short time. As uncomfortable as acute low back pain is - you should just be patient with uncomplicated lumbago.

Prevent lumbago

If you often get lumbago, you should stretch your back extensively after sitting still for a long time and before lifting and carrying heavy loads. In this way he is carefully prepared for future stresses. In addition, those affected should make sure to always keep warm and avoid cold and wet (especially in the back area).

People with poorly developed back muscles are particularly likely to get lumbago. Exercises to strengthen the core muscles can therefore have a preventative effect. A doctor, sports medicine specialist or physiotherapist can show patients suitable exercises. A back school may be useful.

Lumbago: causes and possible diseases

Lumbago is usually caused by an abrupt, awkward or unfamiliar movement of the trunk. For example, when lifting an object with the back bent, acute pain can "shoot" into the back. A rotation or a stretching of the trunk in combination with a rotation can also be a trigger. Such movements can lead to minimal shifts or "blockages" of the vertebral joints, which cause the lumbago symptoms. Sudden compression or strain of the vertebral joints as well as muscular tension can also be behind this.

Occasionally, the acute lower back pain is due to a protrusion of the intervertebral disc or a herniated disc (prolapse) in the lumbar spine.

Some patients attribute their lumbago to the effects of cold and wet.

Sometimes acute lower back pain turns out to be pain radiating from diseased internal organs (such as the kidneys).

Lumbago: when do you need to see a doctor?

Lumbago does not necessarily require medical attention - it is usually harmless and goes away on its own. However, you should see a doctor in the following cases:

The lower back pain persists or worsens.
Other symptoms join the pain (such as numbness or paralysis).

Lumbago: what does the doctor do?

In the case of lumbago or unexplained lower back pain, the doctor will first talk to the patient in detail in order to collect their medical history (anamnesis). Possible questions are, for example:

Where exactly are you in pain?
How long has the pain existed?
Was there a specific trigger for the complaints?
Is the pain localized or does it radiate to other parts of the body (such as the leg)?
What is the time course of the pain (during the day, at night)?
Do you have any other complaints (such as sensory disturbances in your legs, problems with emptying your bladder, etc.)?
Have you had lower back pain in the past?
Do you have any mental illness (such as depression)? Do you have stress, anxiety or do you often feel tense / overworked?

The psychological state of the patient is important because under certain circumstances it can encourage the back pain to become chronic (chronification). This applies to depression, stress and anxiety, for example. Even with patients who encounter their complaints with helplessness and hopelessness, who perceive their own situation as catastrophic and / or take excessive care, the pain very easily becomes chronic. These unfavorable risk factors for the chronification of back pain are called "yellow flags". In order to record them, the doctor can also ask the patient to fill out an appropriate questionnaire.

Physical examination

After the conversation, the doctor will examine the patient. The aim is to rule out potentially dangerous conditions such as herniated discs as the cause of the pain. The doctor examines the shape and posture of the back, checks the mobility of the spine and feels the back muscles for painful areas and tension.

If the lower back pain radiates into the leg, nerve roots in the lumbar vertebrae could be narrowed (compressed), for example due to a herniated disc. The doctor can check this with various tests. He controls the feeling (sensitivity) in the affected leg (by stroking the skin), as well as the muscle strength and the reflexes.

Further investigations only in certain cases

An anamnesis discussion and physical examination are sufficient to clarify acute lower back pain. Sometimes, however, there are indications of a serious or organ-related cause for the symptoms. In addition to a herniated disc, these can also be diseases of internal organs: Here, pain can radiate from the organs into the lumbar vertebrae and initially be mistaken for harmless lumbago. This can be the case with urinary stones (urolithiasis), inflammation of the gallbladder (cholecystitis), inflammation of the pancreas (pancreatitis), kidney tumors or endometriosis.

If such diseases are suspected, further examinations are necessary. These include, for example, blood and urine tests as well as imaging procedures such as x-rays, magnetic resonance imaging (magnetic resonance imaging, MRT) or computed tomography (CT).

Imaging tests are also recommended if severe low back pain persists or worsens for more than four to six weeks despite proper treatment.

In older patients with suspected or known osteoporosis, a more detailed investigation is always advisable. The alleged lumbago could turn out to be a vertebral fracture (vertebral fracture).

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