Learn about lumbago symptoms, diagnosis, causes and treatment options for back pain relief. Find ways to manage lumbago and improve your quality of life.

Lumbago

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Ismail Munir

Overview

Lumbago, also known as low back pain, is a common musculoskeletal disorder characterized by discomfort or pain in the lumbar region of the spine. 
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Lumbago or lower back pain is a common condition that can be caused by many different injuries, conditions, or diseases, most often related to muscles or tendons in the back. Pain can range from mild to severe and can make it difficult or impossible to perform daily activities. Treatment usually includes rest, pain relievers, physical therapy, and in some cases, surgery. Certain risk factors, such as age, weight, overall health, occupation, and structural problems, can increase the likelihood of developing lower back pain.

Around four out of five people experience lower back pain at some point in their lives<a href="#">[1]</a>. It is the most common cause of absence from work and the most common disability worldwide<a href="#accordion">[2]</a>. 
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Lumbago or low back pain is based on the duration of symptoms, and it can be classified into three types: acute, subacute, and chronic:

<ul>
	<li>Acute Lumbago: This type of low back pain typically lasts for up to six weeks and is usually caused by sudden injury or trauma to the lower back. Acute lumbago is often characterized by sharp, intense pain and limited mobility. 
	&nbsp;</li>
	<li>Sub-acute Lumbago: Subacute lumbago is a type of low back pain that lasts from six weeks to three months. It is often associated with the healing phase of an acute injury or with a chronic condition that is worsening. 
	&nbsp;</li>
	<li>Chronic Lumbago: Chronic lumbago is a type of low back pain that persists for more than three months. It is often associated with degenerative changes in the spine, such as <a href="https://merisehat.pk/disease/herniated-disc">herniated discs</a>, spinal stenosis, or arthritis. Chronic lumbago is usually characterized by a dull, persistent ache that can be accompanied by intermittent flare-ups of acute pain. 
	&nbsp;</li>
</ul>

Signs and Symptoms

Symptoms of lower back pain can occur suddenly or gradually, with or without a known cause. This type of pain can range from sharp and stabbing to dull and achy, and it may radiate to other areas of the body, such as the legs. Here are some common symptoms of lower back pain: 
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Pain: Pain can occur suddenly or gradually and may be sharp or dull. It may be felt in the lower back, bottom, or legs, and can worsen with certain movements or positions.

Stiffness: People may experience stiffness in the lower back, making it difficult to move or straighten up. A decreased range of motion and difficulty standing from a seated position are common symptoms.

Posture Problems: Many people with lower back pain have difficulty standing up straight and may appear bent or crooked. Their lower back may look flat instead of curved.

Muscle Spasms: After a strain, the muscles in the lower back may spasm or contract uncontrollably. This can cause extreme pain and make it difficult to stand, walk, or move. 
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Note: If you experience any of these symptoms, it is important to seek medical attention to determine the underlying cause of your lumbago and develop an appropriate treatment plan. 
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Causes

Lower back pain can be caused by a variety of underlying conditions, including<a href="#accordion">[2]</a>: 
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<ul>
	<li>Muscle Sprains Or Strains</li>
</ul>

Excessive exercise or physical activity, particularly on weekends after a sedentary work week, is a frequent cause of lower back pain resulting from strained muscles. This is particularly relevant for individuals who engage in high-intensity workouts or certain sports, such as golf. 
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<ul>
	<li>Herniated Disc</li>
</ul>

A herniated disc, also known as a slipped or ruptured disc, occurs when the cushion between the spinal vertebrae extends outside its usual position, pushing against the spinal cord or nerve roots. Trauma and degenerative changes over time can cause a herniated disc, and without treatment, pain can last up to six weeks. 
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<ul>
	<li>Sciatica</li>
</ul>

If a herniated disc presses on the sciatic nerve, it can cause sciatica. This results in back pain that radiates to the leg or foot. 
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<ul>
	<li><a href="https://merisehat.pk/disease/spinal-stenosis">Spinal Stenosis</a></li>
</ul>

Spinal stenosis is caused by the narrowing of the spaces in the spine, putting pressure on the spinal cord and spinal nerves. This is commonly associated with the degeneration of the discs between the vertebrae, causing compression of the nerve roots or spinal cord by bony spurs or soft tissues such as discs. Symptoms include numbness, weakness, and cramping, which worsens when standing or walking. 
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<ul>
	<li>Unusual Spine Curvatures</li>
</ul>

Conditions such as scoliosis, lordosis, and kyphosis can cause unusual curvatures in the spine, which are usually present at birth and first diagnosed during childhood or adolescence. These curvatures can cause pain and poor posture, as they place pressure on the muscles, tendons, ligaments, and vertebrae. Some people may not have any symptoms. 
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<ul>
	<li>Other Conditions</li>
</ul>

Several other conditions can cause lower back pain, accompanied by additional symptoms. These include <a href="https://merisehat.pk/disease/arthritis">arthritis</a>, fibromyalgia, spondylitis, spondylosis, kidney and bladder problems, pregnancy, endometriosis, <a href="https://merisehat.pk/disease/ovarian-cyst">ovarian cysts</a>, uterine <a href="https://merisehat.pk/disease/fibroids">fibroids</a>, spinal cord misalignment, spinal infections, and cancer of the spinal cord. 
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Diagnosis

There are no specific screening tests for lumbago. Doctors often rely on the patient&rsquo;s clinical history to reach a diagnosis. 

The healthcare provider will inquire about the patient&#39;s symptoms and perform a physical examination to assess the condition of their back: 
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Imaging Studies: To identify any broken bones or other damage, the doctor may order imaging studies such as Spine X-ray, MRI, CT scan, or Electromyography (EMG).

Spine X-ray: It uses radiation to create images of bones.

MRI: It uses a magnet and radio waves to produce images of bones, muscles, tendons, and other soft tissues.

CT Scan: It employs X-rays and computer technology to create 3D images of bones and soft tissues.

Electromyography (EMG): It tests nerves and muscles and detects neuropathy, which may cause numbness or tingling in the legs.

Blood And Urine Tests: Depending on the cause of the pain, the provider may also order blood or urine tests to detect genetic markers for certain conditions that cause back pain or to check for kidney stones. 
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Treatment

Lumbago, or low back pain, can be treated in various ways depending on the cause and severity of the pain. Here are some common treatments: 
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Medications: Over-the-counter pain relievers such as acetaminophen, ibuprofen, and naproxen can help to reduce pain and inflammation. If the pain is severe, prescription-strength painkillers may be prescribed. Muscle relaxants can also be prescribed to help ease muscle spasms that may be contributing to the pain. 
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Physical Therapy: Physical therapy can help relieve low back pain, especially if it is caused by muscle or ligament strain. The therapist may use a combination of exercises, stretches, and massage to reduce pain and improve flexibility and strength. They may also teach people techniques for proper posture and body mechanics to prevent future injuries. 
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Heat Or Cold Therapy: Applying heat or cold to the affected area can help to reduce pain and inflammation. Cold therapy is usually recommended in the first few days of pain, while heat therapy is used after the initial swelling has subsided. 
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Injection Therapy: Corticosteroid injections can reduce inflammation and pain in the affected area. These injections are usually given directly into the affected joint or muscle. 
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Surgery: Surgery is usually only recommended in severe cases where conservative treatments have failed. The most common surgical procedures for low back pain include laminectomy, discectomy, and spinal fusion. 
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Alternative Therapies: Some people find relief from low back pain through alternative therapies such as chiropractic care, acupuncture, or massage therapy. While these therapies may not be backed by scientific evidence, some people find them helpful. 
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Note: The treatment for lumbago should be individualized based on the cause and severity of the pain. It&#39;s best to consult with a healthcare professional to determine the best course of treatment for you. 
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Lumbago, or low back pain, can have several complications, including: 
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Chronic Pain: If the underlying cause of the low back pain is not treated properly, it can lead to chronic pain, which can be difficult to manage and may require long-term treatment.

Limited Mobility: Severe low back pain can make it difficult to move or perform everyday activities, leading to limited mobility.

<a href="https://merisehat.pk/disease/depression">Depression </a>And <a href="https://merisehat.pk/disease/anxiety">Anxiety</a>: Chronic pain can lead to depression and anxiety, as constant pain and limited mobility can affect a person&#39;s overall quality of life.

Sleep Disturbances: Pain can interfere with a person&#39;s ability to sleep, leading to sleep disturbances and fatigue.

Dependency On Pain Medication: If the pain is not managed properly, a person may become dependent on pain medication, which can lead to addiction and other health problems.

Loss Of Work Productivity: Chronic low back pain can make it difficult for a person to work or perform daily tasks, leading to a loss of work productivity and income. 
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The following are the possible risk factors<a href="#accordion">[3]</a>: 
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Age: Low back pain is more likely to occur in individuals aged between 30 to 50 years and may increase with advancing age.

Fitness Level: Physically unfit Individuals are at higher risk of developing low back pain as their muscles may not provide adequate support to the spine.

Weight: Being overweight, obese, or experiencing rapid weight gain can increase stress on the back, leading to pain.

Genetics: Some forms of back pain, such as ankylosing spondylitis, are influenced by genetic factors.

Occupation: Jobs that involve heavy lifting, pushing, pulling, twisting, or vibrating the spine can cause back injuries. Additionally, sitting for extended periods with poor posture or inadequate back support can also lead to low back pain.

Mental Health: Anxiety, depression, and mood disorders can impact an individual&#39;s perception of their back pain. Additionally, stress can cause muscle tension that contributes to low back pain.

Smoking: Smoking can restrict blood flow and oxygen supply to the spinal discs, leading to faster degeneration and increasing the risk of low back pain.

Backpack Overload In Children: Overloading a backpack with school books and supplies can strain the muscles in the back and cause fatigue, leading to low back pain. 
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The following measures can help reduce the risk of lumbago:<a href="#accordion">[3]</a> 
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<ol>
	<li>&nbsp;Avoiding jerky or strenuous movements that can strain the back.</li>
	<li>&nbsp;Exercising regularly. It is important to consult a doctor for age-appropriate, low-impact exercises that strengthen the lower back and abdominal muscles.</li>
	<li>&nbsp;Maintaining a healthy weight and following a nutritious diet that promotes bone growth.</li>
	<li>&nbsp;Using ergonomically designed furniture and equipment at home and work.</li>
	<li>&nbsp;Changing sitting positions frequently, taking breaks to walk or stretch, and using a low stool or stack of books to support the feet while sitting for long periods.</li>
	<li>&nbsp;Wearing comfortable, low-heeled shoes.</li>
	<li>&nbsp;Sleeping on a firm surface in a fetal position with the knees drawn up to reduce spinal curvature and relieve pressure on the spine.</li>
	<li>&nbsp;When lifting objects, one should use the proper technique by bending at the knees, keeping a straight back, and holding objects close to the body.</li>
	<li>&nbsp;Quitting smoking increases blood flow to the lower spine and reduces the risk of spinal disc degeneration and <a href="https://merisehat.pk/disease/osteoporosis-80">osteoporosis</a>. 
	&nbsp;</li>
</ol>

Key Points

<ul>
	<li>Lumbago, also known as low back pain, is a common musculoskeletal condition that affects the lower part of the back. It can be acute or chronic and can have various causes such as muscle strain, herniated disc, spinal stenosis, or degenerative disc disease.</li>
	<li>Acute lumbago usually lasts less than six weeks, while chronic lumbago can persist for more than three months. Acute lumbago is usually self-limiting and resolves without specific treatment, while chronic lumbago often requires a multidisciplinary approach.</li>
	<li>Symptoms of lumbago can include pain, stiffness, limited range of motion, and difficulty standing or sitting. Pain may be localized in the lower back or radiate down to the legs.</li>
	<li>Risk factors for lumbago include age, sedentary lifestyle, poor posture, obesity, and smoking. Other factors such as genetics, occupational hazards, and psychological stress may also contribute to causing lumbago.</li>
	<li>Diagnosis of lumbago is usually based on clinical evaluation, medical history, and imaging studies, such as X-rays or MRIs. Blood tests may be done to rule out underlying conditions such as infection or inflammatory disease.</li>
	<li>Treatment for lumbago depends on the underlying cause and the severity of symptoms. Conservative measures such as rest, ice, heat, and pain medications may be recommended for acute lumbago. Physical therapy, exercise, and spinal manipulation may also be helpful.</li>
	<li>Surgery may be considered for chronic lumbago if other treatments have failed, or if there is a specific structural abnormality such as herniated disc or spinal stenosis that requires surgical intervention.</li>
	<li>Prevention of lumbago includes maintaining a healthy weight, regular exercise, good posture, and avoiding prolonged sitting or standing. Ergonomic adjustments in the workplace or home environment may also help prevent lumbago.</li>
	<li>The prognosis of lumbago is generally good, as most cases improve with conservative treatment. However, chronic lumbago may have a significant impact on quality of life and may require ongoing management.</li>
	<li>Complications of lumbago are rare but may include nerve compression, spinal cord injury, or loss of bladder or bowel control. These complications require urgent medical attention and may require surgery. 
	&nbsp;</li>
</ul>

[1] Low back pain: Causes, diagnosis &amp; treatments. Cleveland Clinic.

[2] Martel J. What you should know about lower back pain. Healthline.

[3] Back pain. National Institute of Neurological Disorders and Stroke.

[4] Geneen LJ, Moore RA, Clarke C, Martin D, Colvin LA, Smith BH. Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews. Cochrane Database Syst Rev. 2017;4(4):CD011279. Published 2017 Apr 24. doi:10.1002/14651858.CD011279.pub3