Lumbago (Lower back pain)

Lumbago – lower back pain – is not a specific disease but rather a complaint that may be caused by a large number of underlying problems of varying levels of seriousness. It often comes on quickly and without warning. It can hurt a lot and the only thing you want is to lie down. But the best way to get rid of the lumbago is actually to move. Usually, lumbago goes away by itself within a few weeks.

Causes

The majority of LBP does not have a clear cause but is believed to be the result of non-serious muscle or skeletal issues such as sprains or strains. Obesity, smoking, weight gain during pregnancy, stress, poor physical condition, poor posture and poor sleeping position may also contribute to low back pain. Physical causes may include osteoarthritis, degeneration of the discs between the vertebrae or a spinal disc herniation, broken vertebra(e) (such as from osteoporosis) or, rarely, an infection or tumor of the spine.

Symptoms

Lumbago often comes without warning, for example when lifting heavy objects or turning suddenly.

Common symptoms are:

pain in the lower back
stiffness in the back.

Often the pain sits on one side of the back. Sometimes the pain radiates down the body. Lumbago can hurt a lot in the first few days, but the pain then subsides.

Prevention and protection

Exercise appears to be useful for preventing low back pain. Exercise is also probably effective in preventing recurrences in those with pain that has lasted more than six weeks. Medium-firm mattresses are more beneficial for chronic pain than firm mattresses. Shoe insoles do not help prevent low back pain.

Treatment

Management of low back pain depends on which of the three general categories is the cause: mechanical problems, non-mechanical problems, or referred pain.

For acute pain that is causing only mild to moderate problems, the goals are to restore normal function, return the individual to work, and minimize pain. The condition is normally not serious, resolves without much being done, and recovery is helped by attempting to return to normal activities as soon as possible within the limits of pain.

For those with sub-chronic or chronic low back pain, multidisciplinary treatment programs may help. Initial management with non–medication based treatments is recommended, with NSAIDs used if these are not sufficiently effective. Non–medication based treatments include superficial heat, massage, acupuncture, or spinal manipulation. Acetaminophen and systemic steroids are not recommended as both medications are not effective at improving pain outcomes in acute or subacute low back pain.

Surgery may be useful in those with a herniated disc that is causing significant pain radiating into the leg, significant leg weakness, bladder problems, or loss of bowel control. It may also be useful in those with spinal stenosis.