Lumbago, Acute Lower Back Pain—What to Do When You Have Lumbago?

Lumbago (ICD code: M54.5) is the term used to describe acute back pain, primarily in the lower back, the lumbar region. The lumbar region takes its name from the Latin word “lumbus,” which means “loin.”

Lumbago is often viewed as a distinct condition and a synonym for back pain. In fact, this painful phenomenon is a protective reflex of the body involving the muscles. The back muscles spasm to support the spine.

For those affected, lumbago is a warning sign. They should work to improve their personal back health in the future.

Everyday movements—such as lifting objects—are often the trigger for lumbago © Antonioguillem | AdobeStock

Lumbago is characterized primarily by sudden, sometimes stabbing pain in the lower back. This is often accompanied by

• tenderness in the affected area as well as
• severe tension in the back muscles.

A stooped gait is characteristic of lumbago. While this protective posture provides relief at first, it can actually make the symptoms worse. It contributes to improper strain on the body. That is why it is important to begin the proper treatment steps to prevent the condition from getting to that point in the first place.

The pain often radiates upward and downward from the lumbar spine. As a result, those affected frequently experience pain in their legs and in the thoracic spine region as well. Due to this extensive range of symptoms, medical professionals also refer to this condition as lumbar syndrome.

Lumbago often occurs in conjunction with sciatica. A characteristic feature of lumbar sciatica is widespread sciatic pain. The sciatic nerve is the largest nerve in the body and runs from the lower back through the hip joint into the leg.

In the pelvic region, the sciatic nerve passes through strong muscles of varying sizes (e.g., the piriformis). If these muscles are tense, they press on the sciatic nerve and trigger neuralgic pain. Therefore, in cases of lumbar sciatica, hip and leg pain accompany the back pain.

Pain also occurs in the leg with lumbar sciatica © rumruay | AdobeStock

Lumbago usually occurs after everyday movements, such as bending over or lifting. An awkward movement during sports can also cause lumbago.

The symptoms of lumbago already point to the causes of the sharp lower back pain, namely

• muscle tension,
• sacroiliac joint blockage, or
• in severe cases, a herniated disc.

Lumbago Caused by Muscle Tension

The back consists of various muscle groups, some superficial and others deep. Together, they are responsible for posture and movement.

Improper strain on the muscles also affects the deeper supporting muscles. The deep muscles are connected to the spine and stabilize it. However, these muscles can also exert tension or, when tense, reduce the mobility of the vertebrae.

Muscle tension and vertebral blockages can result from:

• overuse,
• sudden movements in cold weather,
• weak muscles,
• poor flexibility, or
• inappropriate movements that place rapidly changing demands on the muscles (e.g., in sports requiring explosive power such as soccer or tennis)

Tension or strains in the back muscles are a common cause of lumbago © bilderzwerg / Fotolia

Lumbago Caused by an SI Joint Blockage

Occasionally, lumbago results from a blockage of the sacroiliac joint (SI joint). The SI joint, also known as the sacroiliac joint, is the joint between the sacrum and the ilium.

This disc-like joint serves as the stabilized yet flexible connection between the spine and the pelvis. The sacroiliac joint ensures the pelvis’s mobility while walking.

When it becomes blocked, it can no longer follow its normal range of motion. You’ll experience this SI joint blockage as painful, stiff immobility. Even the slightest movements can then cause sharp, stabbing pain.

The sacroiliac joint is a synovial joint and prone to blockages © Marinesea | AdobeStock

Without consistent treatment, chronic lumbago can develop—even after recovery.

Lumbago or herniated disc?

It is important to distinguish lumbago from a herniated disc. In fact, more serious injuries to the musculoskeletal system, such as

• disc protrusion or
• disc herniation (prolapse)

often present with similar symptoms. For this reason, a careful medical diagnosis is of great importance. The correct diagnosis ensures the best possible treatment.

A herniated disc requires a different treatment than lumbago. In some cases, surgery may even be necessary.

Herniated discs in the lumbar spine may, in some cases, also manifest as nerve deficits. This can lead to abnormal sensations (paresthesias), such as a sensation of heat or cold, or paralysis (paresis) in the lower body.

Are you experiencing these symptoms? If so, this is not a simple case of lumbago, but possibly a herniated disc with nerve damage.

First and foremost, the doctor will take your medical history and ask you about any events or activities that may have preceded the onset of lumbago. This is followed by motor and neurological examinations. These help the doctor rule out more serious problems, such as a herniated disc.

If these examinations do not lead to a clear diagnosis, doctors will use imaging techniques, such as

• a computed tomography (CT) scan or
• magnetic resonance imaging (MRI).

These can detect disc damage or conditions affecting the bony spine, such as spondylosis.

Whether you have lumbago or a herniated disc is important for determining the subsequent treatment. The following criteria help distinguish between the two:

• Herniated discs may initially be asymptomatic, while lumbago causes acute symptoms.
• Symptoms of paralysis and severe neuralgia (abnormal sensations caused by nerve damage) occur only with a herniated disc.
• Herniated discs require urgent treatment; lumbago does not.

Many people tend to rest their bodies when they have lumbago. The acute pain also makes it nearly impossible to do anything other than adopt a protective posture. A brief initial rest is, of course, acceptable, but you should resume activity as soon as possible. Staying active and engaging the body is very important for recovery.

After an initial rest, movement helps loosen the cramped muscles and release the blockage. A leisurely walk is ideal. A short break in nature also helps you relax and mobilize the sacroiliac joint.

When your back hurts, heat therapy is very soothing—for example,

• a hot water bottle,
• a warming pain-relief ointment—for example, one containing chili extract—or
• a hot bath with additives that promote blood circulation and relax muscles.

Rest and gentle exercise further promote your recovery. 

For acute pain, topical analgesics such as diclofenac are suitable. This medication is available, for example, as an ointment that can be applied to the affected area. For more severe pain, doctors may also administer injections, such as cortisone. This is injected directly into the painful area to provide relief.

If exercise and pain relievers alone are not enough, doctors sometimes prescribe muscle relaxants. These medications relax the muscles and help loosen the cramped muscle tissue. However, they are associated with temporary

• weakness,
• fatigue, and
• muscle weakness

and are therefore used with caution.

Once the acute episode of lumbago has subsided, active prevention is the best strategy for your back. This absolutely includes exercise, ranging from a simple walk to fitness training.

Strong core muscles—including the abdominal and back muscles—protect your back. You should also stretch all parts of your body regularly. Stretching relaxes the muscles and makes them more supple. Supple muscles function better and are less likely to cramp.

With the help of stretching exercises and regular exercise, you can significantly reduce your risk of lumbago.

Lumbago is usually a harmless condition. With proper treatment, the pain subsides within a few days to a few weeks. Long-term damage to the lumbar spine is uncommon.

Measures such as

• more exercise,
• less sitting, and
• regular mobilization of the spine through stretching and strengthening exercises

help prevent lumbago in the future.

What is lumbago?

Lumbago refers to acute back pain in the lower back or in the lumbar spine. Medically, the condition is also known as lumbago or lumbalgia. Typical symptoms include sudden, shooting pain in the lower back and limited mobility.

What are the symptoms of lumbago?

The most common symptoms include severe pain, a stabbing or shooting sensation, and tight back muscles. The pain in the lower back can radiate into the buttocks or down into the lower leg or thigh. Many people affected adopt a protective posture.

What helps with acute lumbago?

For acute lumbago, heat therapy, elevating the lower back, and light physical activity can help. Heat therapy can relax tense muscles and relieve pain. In addition, pain relievers such as ibuprofen are used to improve mobility.

When should you see a doctor?

You should see a primary care physician or orthopedist if the back pain persists for a long time, becomes chronic, or if neurological symptoms occur. Imaging tests and a physical examination may also be necessary if a herniated disc is suspected or if there is radiating pain in the lumbar region.

How can you prevent lumbago?

Lumbago can be prevented through regular exercise, strong back muscles, and maintaining good posture in daily life. Heavy lifting, prolonged sitting, and improper movements should be avoided. Good blood circulation and relaxed muscles help prevent acute symptoms.