Lumbago is an umbrella term that is used to refer to pain in the lower back, below the rib cage. The pain can be anywhere between mild and severe and it can have a range of underlying causes.It also affects people of all ages.
Although the term lumbago has largely fallen into disuse, lower back pain is still a major economic factor in most developed countries. It accounts for a large proportion of missed work days among North American adults, for example. This means that, when the costs of treatment are factored into the equation, it has a significant economic cost to most developed countries.
Lumbago pain can be either acute or chronic. Acute pain is usually an indicator of a soft tissue injury and normally goes away after a week or two of self care at home. However, a chronic low back pain can be due to more long term problems such as a herniated disc or other spinal problems.
Causes Of Lumbago
Since the term lumbago refers to a type of pain rather than an injury, it can have several possible causes. Some of the more common ones are:
A lower back strain or sprain as a result of lifting heavy loads, possibly using incorrect technique;
Poor posture, in which you are sitting or standing with your shoulders hunched forward instead of being held back and straight. This can leave your lower back bearing too much of the weight of your upper body. This in turn can cause pain due to over stressing of the soft tissues of the lower back.
A herniated disc, when the rubbery discs between the vertebrae of your spine become damaged. This can cause the soft center of one of more discs to push through the tough exterior and possibly press against the nerves adjacent to the spine. When this happens, the nerve damage can cause pain that radiates away from your lower back and into your buttocks or legs, for example;
Osteoarthritis or spondylosis, two forms of arthritis that can directly attack the spine;
Rheumatoid arthritis, an autoimmune form of arthritis in which the body’s immune response can start to attack the bones and soft tissues of the lower back;
Osteoporosis, a disease that cause brittle bones and can increase the likelihood of a spinal compression fracture;
Scoliosis, an unusual curvature of the spine in either direction;
Spinal stenosis, in which the spinal canal narrows and eventually compresses the cord that runs through it. This may also cause nerve damage due to compression of the nerves next to the spinal cord;
Tumours of the spine or elsewhere in the lower back;
It is important to note that the causes can range from acute conditions that can be treated conservatively at home through to potentially life threatening diseases that require surgery.
Symptoms Of Lumbago
As mentioned above, the symptoms of lumbago can vary widely. However, generally speaking, they include the following:
Pain & swelling in the lower back. It may be a dull aching pain or a sharp stabbing one;
The pain may radiate into the buttocks area or even into the legs. If this happens, it is an indicator that nerve damage may be a factor;
The pain may be aggravated by bending, twisting, running or in some cases just by standing up;
Some lumbago patients may experience occasional muscle spasms. This is a possible indicator of a lower back muscle strain;
In addition to pain, you may feel a tingling or “pins and needles” sensation in your buttocks or legs. This is another possible indication of the involvement of nerve damage.
If you experience some or all of these symptoms, you should seek medical advice as a matter of urgency. This is especially the case if you are also experiencing loss of bowel or bladder control or weakness or numbness in the legs. These are warning signs of a serious underlying medical condition.
Lumbago Diagnosis & Treatment
To ascertain the cause of your lumbago, your doctor will review your medical history and perform a physical examination of your lumbar region. He or she will want to know more about the type of low back pain you are experiencing, how it started and what makes it worse.
Unless there are “red flags” indicating something more serious than a soft tissue injury, your doctor will likely prescribe a period of self care at home. This will include:
Reduced physical activity and avoidance of heavy lifting or other back stressing duties;
Icing your back until the pain and swelling have gone down. A cold compress may alternatively be used. Apply it for periods of 20 minutes or so and at intervals of 2-3 hours;
Use of a heating pad or hot compress o improve blood flow once any swelling has started to recede;
Wearing a lower back brace to provide additional support to your lower back, if your lumbago is the result of muscle or ligament damage;
Physical therapy to strengthen and/or stretch the lower back muscles. This will improve their capability to withstand your regular activities.
Although he or she will likely advise reducing your physical activity for a period, you should avoid complete bed rest. It will likely cause atrophy (weakening) of your lower back muscles and increase the likelihood of another injury.
If your lumbago does not respond to this conservativeapproach, other possibilities can be tried, including:
Non Steroidal Anti inflammatory Drugs (NSAIDs);
Spinal manipulation by a chiropractor;
Various types of surgery. Your doctors can discuss these options with you in greater detail.