Lumbago is an acute low back pain that occurs as a result of a wrong movement most often caused by a microtrauma that affects an intervertebral disc and makes it impossible for the patient to perform bending movements of the torso.
Ignored and not treated properly, the lumbago crisis may worsen and the patient may remain immobilized for a longer period of time.
Low back pain can be classified according to duration into: acute (pain lasts less than 6 weeks), subacute (6 to 12 weeks) or chronic (over 12 weeks).
Lumbago can be caused by problems with the disc, joints, muscles and ligaments or most often, a combination of them. Usually low back pain can be the result of trauma or acute injury, incorrect posture or the accumulation of stress, resulting in the spine.
The most prone to lumbago are obese and sedentary patients and, frequently, workers who lift heavy objects. It was found that there is a relationship between height over 1.81 meters and back pain. Risk factors for the development of low back pain are both individual and occupational.
Individual factors include:
- age over 45 years;
- anthropometric factors (anatomy and structure of the spine);
- spinal static disorders and mobility;
- integrity and development of paravertebral muscle mass;
- psycho-social factors (depression, anxiety, stress);
Occupational factors include:
- hard physical work that mainly requires lifting weights;
- the vibrations to which construction workers are subjected (eg those who use the pickhammer);
- maintaining the same position for a long time (prolonged orthostatism or office work for several consecutive hours).
The pain sets in after movements that involve lifting, twisting and bending. The description of symptoms can range from sensitivity at some point to irradiated pain. The pain may or may not get worse due to certain movements, such as lifting a leg, or in certain positions, such as sitting or standing. It is possible for pain to radiate along the legs, known as sciatica.
Signs, in short:
- analgesic position of the body with the torso bent to one side and forward;
- limitation of movements (stiffness);
- pain or burning in the back or neck;
- difficulties in changing posture;
- difficulty lifting from a sitting position;
- bending difficulties.
a. Physical therapy
In the first stage, physiotherapy aims to reduce pain and contracture and muscle rebalancing. Subsequently, the physiotherapist will focus on toning the lumbo-abdomino-pelvic muscles and reintegrating the spine into activity as well as readjustment to exercise.
Physical therapy has a fundamental role in achieving the objectives set:
- maintaining the mobility of the spine;
- correcting vicious positions;
- restoring muscle strength and endurance;
- restoring movement coordination;
- regaining the functionality of the affected region.
b. Manual therapy
Manual therapy (manipulation / mobilization of the spine) is often used to relieve symptoms and manage this condition in the acute stage. The exercise program will be designed to help restore muscle strength and re-educate accurate movement patterns. Some activities, such as Pilates or yoga, are helpful for long-term back care.
c. Surgical treatment for lumbago
Drug treatment involves reducing the triggers of pain, inflammation, muscle contractions. Surgical treatment takes place only as a last resort. Different treatment options will sometimes fail, the pain becoming progressively more severe and surgery is needed to correct the source of the pain.
The nature of each procedure will vary depending on the extent of the pain and the part of the body involved.
The types of surgical treatment are: microdiscectomy, percutaneous discectomy, laminectomy, foraminotomy and artificial disc implantation.
Surgical treatment is used in the following situations:
- Persistence of pain symptoms and impairment of the patient’s quality of life despite correctly applied drug treatment.
- Progressive development of neurological phenomena consisting of paresis, paralysis or urinary incontinence
- The ponytail system appeared by compressing the lumbosacral nerve roots
- Newly installed paretic sciatica
- Spinal stenosis, high-grade spondylolisthesis