Lower back pain is widespread and affects around 80 percent of the population once or several times in their lives. Unaccustomed lifting or carrying loads often precede the pain by 1 to 2 days.
Below you will find further information and selected specialists for the treatment of lower back pain.
Back pain in the lower lumbar spine (lumbar spine) is widespread. Around 80 percent of the population is affected once or several times in their lives.
This back pain is often caused by damaged intervertebral discs. Other wear and tear disorders of the lumbar spine can also cause pain in the lumbar spine. These include wear and tear of the small vertebral joints (so-called facet joint arthrosis).
The lumbar spine is the lower part of the spine © Peter Hermes Furian / Fotolia
However, a muscular imbalance, i.e. uneven muscle ratios, leads to pain in the lower lumbar spine far more frequently. One example of this is weak abdominal muscles with normally strong back muscles. The pain is usually preceded 1 to 2 days before the onset of pain by unaccustomed lifting or carrying loads (e.g. unaccustomed gardening etc.).
Unfortunately, muscular tension cannot be seen on X-rays or MRI scans. As a result, doctors often mistakenly focus on the intervertebral discs and small vertebral joints when looking for the cause. Functional muscular imbalances are often disregarded as a cause of pain.
Pain in the lower lumbar spine often manifests itself as an unstable "breakthrough feeling". Movement-dependent stabbing pain also occurs. It sometimes radiates into the flank. Some patients are no longer able to move quickly from a bent posture to an upright posture.
Many people suffer from back pain in the lower lumbar spine over the course of their lives © artstudio_pro / Fotolia
Patients with symptoms in the lumbar spine area often adopt a relieving posture due to the pain. This causes them to adopt a slouched or misaligned posture.
This posture leads to further discomfort in the long term. It is therefore an important therapeutic goal for the patient to get out of this posture.
Depending on the cause, pain in the lumbar spine can lead to various symptoms. The exact pain situations provide information about the possible clinical picture:
Conventional X-ray diagnostics are often used in the acute stage. Doctors often only document the misalignment of the lumbar spine. If the pain radiates into the legs, an MRI(magnetic resonance imaging) is also often used. This allows massive herniated discs to be detected or ruled out.
Far more helpful than X-ray diagnostics is
Almost all patients report unusual muscular overload shortly before the onset of the pain event. The diagnosis is then often acute lumbago (= acute back pain of the lumbar spine, also known as lumbago ) due to muscular imbalance.
A stepped bed position is often used as an initial measure for lower back pain. This involves the patient lying on their back and bending their legs at a 90° angle at the hip and knee. A foam cube, a drinks crate with a blanket or a chair are helpful here.
This stepped bed position relieves pressure on the
A hot water bottle on the abdomen and buttock muscles can also help.
Intensive heat treatment of the muscle groups around the hips, e.g. hot showers, is also suitable.
Physiotherapeutic measures including massage and mud are also useful for the affected, overloaded muscle groups. This stretches and loosens the muscles and, if successful, returns them to a pain-free state.
Conventional painkillers rarely help with muscular back pain. Medications from the muscle relaxant range often have a better effect here.
If a slipped disc or facet joint syndrome is the cause of the pain, this underlying condition should be treated. Compensating for muscle imbalances then only has an accompanying effect.
The duration of treatment, including physiotherapy, depends on the patient's general condition and the severity of the pain. A guideline is approximately 3 to 6 weeks. If there is no clear improvement after this period, the diagnosis should be reviewed and further examinations should be carried out.
In the case of a slipped disc, an operation can provide relief. A neurosurgeon weighs up the benefits and risks with the patient. Injections have proven to be an effective treatment for facet syndrome . The video shows the exact procedure for facet infiltration as pain therapy:
Pain in the lower lumbar spine can occur repeatedly.
Suitable preventative measures include
One-sided training often promotes muscular imbalance rather than improving it. It is therefore better to exercise under the guidance of a physiotherapist.
Improved joint mobility also has a positive effect on lower back pain. Walking and cycling are gentle forms of exercise that are recommended for back pain.
Excessive rest and exercise breaks are only useful as an initial measure against pain. Exercise should be part of the daily program again as soon as possible so that the muscles do not break down. Start with a small amount of exercise, the important thing is regularity and a gentle increase.
Being overweight puts strain on the back and its structures. Reduce excess body weight to relieve the spine. A balanced diet and more exercise according to the principle "consume more than you consume" will help you achieve your goal. Nutritional advice can give you individual tips.
You should stretch and loosen your muscles sufficiently before exercising © Nastassia Yakushevic / Fotolia
As soon as the pain has disappeared, you can generally resume any sporting activity. The prerequisite for this is that no real structural damage to the intervertebral discs has been detected.
As you get older, however, you will need to pay more and more attention to muscle hygiene. This means that you need to warm up, loosen up and stretch the muscle groups that are used during sporting activity. This ensures optimal muscle function and prevents injuries. Otherwise, the risk of a torn or strained muscle fiber increases.
Lower back pain is very rarely caused by disc damage or a herniated disc. Muscular overload is far more common. Treatment must therefore focus on the cause (= the muscles).
If the pain lasts longer and conservative therapies do not help, the diagnosis must be continued.
If neurological deficits are also present, the diagnosis should focus on disc damage or damage to the spinal nerves. Neurological deficits are, for example
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