Lumbago is a term which is not used much nowadays and refers to moderate severe and disabling low back pain, usually of acute or recent onset and often secondary to disc problems in the back. It can be chronic if it persists for three months or longer.
The causes of lower back pain or lumbago are often not clear, with a definite cause identified only rarely. Much back pain is thought to be related to disc problems but pain can be caused from the joints, muscles, ligaments or nerves. A minority of cases are caused by serious underlying conditions such as tumours or infections.
Lumbago symptoms typically include pain the the back which can refer to the buttocks, backs of thighs or round to the groin. Spinal movements are limited, particularly bending forwards which increases the pressures in the spine. The back muscles may be over contracted in muscle spasm and may force an abnormal posture to one side.
Sciatica symptoms are different, with severe pain in the buttock, leg and foot which is very clearly defined by the patient. Sciatica treatment by a physiotherapist can be helpful although a sciatica cure may have to wait until nature settles the nerve down and the pain subsides. Sciatica stretches are often recommended and may be unhelpful due to stretching the already inflamed nerve. Sciatica – pregnancy may also be a problem along with the sacroiliac and low back pains typically suffered. Further information is available at sciatica Emedicine.
Important issues with low back pain are the symptoms and signs which warn of a serious medical condition, known as red flags. Your doctor or physiotherapist will question you about these at your first attendance to screen you for underlying illnesses or conditions. Indications that all is not right include loss of weight, disturbance of bladder or bowel function, loss of feeling around the groin and genitals and numbness or loss of power in the legs. If you have any of these symptoms you should consult your doctor or other medical authority immediately.
Back Pain Relief for Acute Back Pain
Acute back pain is worrying if the pain is very severe but this does not reflect the seriousness of the underlying problem - most back pain is caused by a strain or sprain to one of the spinal structures. The back pain will settle down with time and you should return to normal activity.
Back Pain Relief for Chronic Back Pain
Chronic back pain is longer lasting, for example over three months and perhaps for much longer, and is rarely cured completely. It can be managed well or it can take over someone's life and make everything much more difficult for them.
Diagnosing Low Back Pain
This is a difficult matter and many people with back pain will never get a moderately clear diagnosis as to why they have their pain. X-rays are not routinely helpful in identifying causative problems in the spinal anatomy.
Spinal surgeons diagnose back pain by thinking of three categories:
Physiotherapists, osteopaths and chiropractors make detailed examinations to form therapeutic diagnoses so that they can plan treatments. There appears to be no scientific evidence however to back up the usefulness of these examination tests in terms of outcome.
The Treatment of Lumbago
Research work has shown that for acute back pain the following treatments are:
While for chronic back pain the following treatments are:
References from the Cochrane Library
van Duijvenbode I, Jellema P, van Poppel M, van Tulder MW. Lumbar supports for prevention and treatment of low back pain. Cochrane Database of Systematic Reviews 2008, Issue 2. Art. No.: CD001823. DOI: 10.1002/14651858.CD001823.pub3.
Furlan AD, van Tulder MW, Cherkin D, Tsukayama H, Lao L, Koes BW, Berman BM. Acupuncture and dry-needling for low back pain. Cochrane Database of Systematic Reviews 2005, Issue 1. Art. No.: CD001351. DOI: 10.1002/14651858.CD001351.pub2
Hayden J, van Tulder MW, Malmivaara A, Koes BW. Exercise therapy for treatment of non-specific low back pain. Cochrane Database of Systematic Reviews 2005, Issue 3. Art. No.: CD000335. DOI: 10.1002/14651858.CD000335.pub2.
Engers AJ, Jellema P, Wensing M, van der Windt DAWM, Grol R, van Tulder MW. Individual patient education for low back pain. Cochrane Database of Systematic Reviews 2008, Issue 1. Art. No.: CD004057. DOI: 10.1002/14651858.CD004057.pub3.
Henschke N, Ostelo RWJG, van Tulder MW, Vlaeyen JWS, Morley S, Assendelft WJJ, Main CJ. Behavioural treatment for chronic low-back pain. Cochrane Database of Systematic Reviews 2010, Issue 7. Art. No.: CD002014. DOI: 10.1002/14651858.CD002014.pub3.
Dahm KT, Brurberg KG, Jamtvedt G, Hagen KB. Advice to rest in bed versus advice to stay active for acute low-back pain and sciatica. Cochrane Database of Systematic Reviews 2010, Issue 6. Art. No.: CD007612. DOI: 10.1002/14651858.CD007612.pub2.
Heymans MW, van Tulder MW, Esmail R, Bombardier C, Koes BW. Back schools for non-specific low-back pain.. Cochrane Database of Systematic Reviews 2004, Issue 4. Art. No.: CD000261. DOI: 10.1002/14651858.CD000261.pub2.
Assendelft WJJ, Morton SC, Yu EI, Suttorp MJ, Shekelle PG. Spinal manipulative therapy for low-back pain. Cochrane Database of Systematic Reviews 2004, Issue 1. Art. No.: CD000447. DOI: 10.1002/14651858.CD000447.pub2.