Lumbago, also known as lower back pain, is one of the most common conditions affecting the world's population. This term refers to pain that is located in the lower back and can vary in intensity, from mild discomfort to acute pain that can disable the sufferer. Below, we will explore in depth the causes, symptoms, diagnostic methods, and treatment options for low back pain.
Causes of Lumbago
Mechanical Causes
Muscle and Ligament Injuries:
Efforts and Stretching: Activities such as lifting heavy objects, sudden movements or poor posture can cause muscle strains and ligament sprains.
Muscle Overload: Excessive use of the back muscles can lead to inflammation and pain.
Structural Problems:
Herniated Disc: Intervertebral discs can shift or rupture, putting pressure on nearby nerves and causing pain.
Disc Degeneration: With age, intervertebral discs can degenerate, reducing their ability to absorb impacts and causing pain.
Spinal Stenosis: Narrowing of the spinal canal can compress the nerves and cause lower back pain.
Vertebral Misalignment:
Scoliosis and Lordosis: Abnormal curvatures of the spine can contribute to low back pain by altering weight distribution and back mechanics.
Non-Mechanical Causes
Inflammatory Diseases:
Arthritis: Osteoarthritis and rheumatoid arthritis can cause inflammation in the joints of the spine.
Ankylosing Spondylitis: An inflammatory disease that affects the joints of the spine, causing stiffness and pain.
Infections:
Osteomyelitis: An infection in the bones of the spine can be a rare but serious cause of low back pain.
Disc Space Infection: Infection of the intervertebral discs can also cause low back pain.
Systemic Diseases:
Fibromyalgia: A disorder that causes widespread musculoskeletal pain, including the lower back region.
Cancer: Tumors in or near the spine can cause low back pain.
Risk factor's
Age : Aging is a significant risk factor due to natural degeneration of discs and joints.
Sedentary Lifestyle: Lack of physical activity can weaken back muscles and increase the risk of low back pain.
Obesity : Excess weight adds pressure on the spine and can contribute to lower back pain.
Smoking : Smoking can reduce blood flow to the spine and accelerate disc degeneration.
Symptoms of Lumbago
Pain
The main symptom of low back pain is pain in the lower back, which can be:
Acute : Severe pain that comes on suddenly, usually due to an injury.
Chronic : Pain that persists for more than three months, often related to degenerative conditions.
Other Associated Symptoms
Stiffness : Difficulty moving, especially after sitting or standing for long periods.
Muscle Spasms: Involuntary contractions of the back muscles.
Radiating Pain: Pain can spread to the buttocks, legs and, in severe cases, the feet, especially if there is nerve compression.
Warning Signs
While most cases of low back pain are benign, certain symptoms may indicate a more serious condition:
Loss of Bladder or Bowel Control: This may be a sign of cauda equina syndrome, a medical emergency.
Loss of Sensation or Weakness : Especially in the legs, which could indicate significant nerve damage.
Intense and Persistent Pain: That does not improve with rest or basic treatment.
Fever : Along with back pain, it may suggest an infection.
Diagnosis of Lumbago
Clinic history
A complete evaluation of the medical history is essential to identify possible underlying causes. This includes:
Description of Pain: Intensity, duration, location and triggering factors.
Injury History: Any recent trauma or injury to the back.
Associated Symptoms: Presence of other symptoms such as fever, weight loss or changes in intestinal or bladder function.
Physical exam
A detailed physical examination can help determine the cause of low back pain:
Visual Inspection: To detect any structural anomaly or asymmetry.
Palpation : To identify specific areas of pain or muscle spasm.
Mobility Tests: Evaluate the flexibility and range of motion of the spine.
Neurological Tests: Evaluate muscle strength, reflexes and sensitivity in the lower extremities.
Imaging Tests
X-rays : Used to detect bone problems such as fractures, arthritis or scoliosis.
Magnetic Resonance Imaging (MRI): Provides detailed images of soft tissues, including discs, muscles and nerves. It is useful in diagnosing herniated discs and spinal stenosis.
Computed Tomography (CT): Provides more detailed images of the bones and can help identify hidden fractures or degenerative changes.
Bone scan: Used in cases of suspected infections or tumors.
Lab tests
Blood Tests: To detect infections, inflammatory diseases or systemic conditions.
Fluid Cultures: If a spinal infection is suspected, cerebrospinal fluid cultures may be performed.
Lumbago Treatment
Non-Pharmacological Treatments
Relative Rest: Avoid activities that worsen pain, but maintain some mobility to prevent stiffness.
Physiotherapy : Specific exercises to strengthen back muscles and improve flexibility. Techniques such as therapeutic massage, electrotherapy and hydrotherapy can also be beneficial.
Application of Heat and Cold: Hot compresses can help relax muscles, while cold compresses can reduce inflammation.
Education and Ergonomics: Instruction on proper posture, lifting techniques, and ergonomic adjustments in the workplace.
Pharmacological Treatments
Over-the-counter pain relievers:
Paracetamol: Used to relieve mild to moderate pain.
Nonsteroidal Anti-Inflammatories (NSAIDs): Such as ibuprofen or naproxen, which reduce inflammation and pain.
Prescription drugs:
Muscle Relaxants: To treat severe muscle spasms.
Opioids : Used in cases of intense acute pain, but they should be administered with caution due to the risk of dependence.
Antidepressants and Anticonvulsants: In cases of chronic pain, these medications can help modify the perception of pain.
Medical Interventions
Corticosteroid Injections : To reduce inflammation around the nerve roots.
Nerve Blocks : Injections to temporarily interrupt the transmission of pain.
Alternative therapies:
Acupuncture : May provide pain relief in some cases.
Chiropractic : Manipulation of the spine to improve function and reduce pain.
Surgical Treatments
Microdiscectomy: Removal of the herniated part of the disc that is pressing on the nerve.
Laminectomy : Removal of part of the vertebra to relieve pressure on the spinal cord or nerves.
Vertebral Fusion: Union of two or more vertebrae to stabilize the spine.
Lumbago Prevention
Healthy life style
Regular Exercise: Stay active with exercises that strengthen your back muscles and improve flexibility, such as yoga, swimming, and Pilates.
Healthy Weight: Maintain an adequate weight to reduce the load on the spine.
Ergonomics: Adopt correct posture when sitting, standing and lifting heavy objects.
Education and Awareness
Health Education : Educational programs on the prevention of low back pain in the workplace and in daily life.
Stress Management: Stress management techniques, such as meditation and cognitive behavioral therapy, to reduce muscle tension and the risk of low back pain.
Evaluation and Monitoring
Regular Evaluations: Periodic consultations with health professionals to monitor and manage any spinal problems.
Rehabilitation Programs: Personalized programs for the recovery and prevention of recurrences of low back pain.
Lumbago is a common condition that can significantly affect the quality of life of those who suffer from it. Although the causes can be varied, from muscle injuries to inflammatory diseases or structural problems, an accurate diagnosis is crucial to implement adequate treatment. With a combination of lifestyle changes, medical treatment, and in some cases, surgical intervention, most people can find relief and improve function. Prevention, through proper posture, regular exercise and stress management, plays a key role in reducing the risk of developing low back pain.