Lumbago: causes, symptoms and treatment

Lumbago is a sudden, strong pain in the lower back, commonly known as a locked or seized lower back. It appears suddenly, most often after an abrupt movement, bending or lifting, and limits movement so much that a person can barely change position. Although it looks frightening and disabling, lumbago is in most cases the result of tension and spasm of muscles and ligaments, not serious damage, and with proper therapy it settles within a few days to a couple of weeks. It is one of the most common reasons people seek help from a physiotherapist.

Symptoms of lumbago

The main symptom of lumbago is a sharp pain in the lower back that comes on suddenly. It is recognized by:

• a sudden, sharp pain in the lower back, often exactly at the moment of a certain movement,
• increased pain when bending, standing up, coughing and sneezing,
• cramped, hard muscles on one or both sides of the spine,
• limited mobility and a forced, hunched body position,
• a feeling of a block in the lower back, as if something is stuck.

With ordinary lumbago the pain stays in the back. If the pain spreads down the leg, accompanied by numbness or weakness, it may indicate pressure on a nerve and requires a more careful assessment, since such a condition is treated differently.

Causes and risk factors

Lumbago is most often caused by sudden overload or an incorrect movement. The most important causes and risk factors are:

• lifting a load with a bent back instead of from the knees,
• an abrupt or twisted movement of the trunk,
• long sitting and poor posture,
• weak trunk muscles and poor physical fitness,
• degenerative changes of the discs and vertebrae, as well as cold and draught.

How the diagnosis is made

The diagnosis is made by examination and assessment of spinal mobility and muscle spasm. It is most important to distinguish ordinary lumbago from a condition with pressure on a nerve, since they are treated differently. Imaging is done only if the symptoms last longer, recur or are accompanied by signs that require further work up, such as pain spreading into the leg or weakness.

Treatment of lumbago

Treatment of lumbago at the Dynamic Fizio center takes place in two phases. In the acute phase the goal is to quickly reduce pain and spasm with physical therapy, and then recurrence is prevented by strengthening the muscles. We use:

• tecar therapy and electrotherapy to quickly reduce pain and relax the spasm,
• manual techniques and mobilization to restore mobility,
• kinesitherapy and exercises to strengthen the trunk muscles and stabilize the spine,
• training in correct lifting of loads and body posture.

What to do when the pain strikes

In the first days you should not rest completely. Light movement within limits that the pain allows is recommended, avoiding long lying down, and positions that unload the back, such as lying on the back with bent knees. Complete rest longer than a day or two actually slows recovery and further weakens the muscles.

How treatment works at our center

Treatment starts with a free first examination, where we assess spinal mobility, the strength of the muscle spasm and rule out signs that would indicate pressure on a nerve. In the acute phase the goal is to quickly reduce pain and spasm, so devices and gentle manual techniques are used, and as soon as the pain eases, exercises for strengthening and stabilizing the spine are introduced. A key part of treatment is also training in correct movement, since this prevents a new attack.

Frequently asked questions

How long does lumbago last? In most people acute lumbago settles within a few days to two or three weeks, especially with therapy and light movement.

Should I move or must I lie down? Light movement is recommended. Long lying down does not speed recovery, it slows it.

How do I prevent it from returning? With regular exercises to strengthen the trunk muscles, correct lifting of loads from the knees and avoiding long sitting in the same position.

Can I keep working? Lighter activities are desirable within limits that the pain allows, while heavy lifting and abrupt movements should be temporarily avoided.

Is lumbago the same as sciatica? No. With lumbago the pain stays in the back, while with sciatica it spreads down the leg along the nerve, so an exam is important to tell them apart.

When must I see a doctor urgently? If, along with back pain, you have leg weakness, numbness in the groin area or loss of bladder control, urgent assessment is needed.

Does massage help with lumbago? Gentle manual techniques can relax the cramped muscles and ease pain, but they work best together with devices and stabilization exercises, as part of a complete plan.

Does a firm mattress help? A mattress that is too firm or too soft can worsen the complaints. A medium firm mattress that supports the natural curves of the spine is recommended.

If a locked lower back has caught you, book a free first examination at 060/134-3303.