Lumbalgia or lumbago is also commonly referred to as lower back pain. It indicates a pain that affects the bones and muscles of the back, more precisely those of the lower back.
There are two types of back pain:
- Acute lower back pain is due to a sudden movement, an effort or a muscle injury. It has a duration of 4 weeks at most..
- Chronic lower back pain is defined when back pains are prolonged and last for at least 3 months without interruption.
Making a diagnosis of lower back pain can be very complicated.
Initially, you should contact your primary care physician rather than a specialist. This is because knowledge of the patient’s clinical history is very important.
First of all, the doctor localizes the pain and assesses its characteristics. He or she can then determine whether it is due to diseases related to other organs or previous episodes of diabetes, kidney stones or a heart murmur.
The doctor also takes care of performing minor physical tests to evaluate or exclude the need for surgery.
In cases of possible infections, inflammations, tumours, pelvic or abdominal diseases and fractures, the doctor will prescribe an X-ray examination. This will not however, always disclose what the cause of the lower back pain is. This is why it is always essential to take the patient’s clinical history into consideration.
Once the cause of back pain has been identified, the doctor can direct the patient to a specialist. Normally these can be a physiotherapist, an orthopaedist or a neurologist. But could even be a surgeon, in cases where the need for a surgical intervention needs to be assessed. Furthermore, we should not forget that back pain can be connected to a dental problem (for example, cases of dental malocclusions).
It is not entirely correct to talk about the symptoms of lumbago, since lower back pain is a symptom and not a disease.
Most people identify low back pain as a general lower back pain, which is a pain in the lower back area. It also happens that people suffering from back pain confuse back pain with kidney disease. The latter, however, manifests itself with pain in the hips or in the lumbar region, reaching up to the lower abdomen.
In fact, lower back pain can be classified according to the type of pain that is felt, which can be acute or chronic.
The acute pain in the back, which is localized and does not extend to the legs, is almost always caused by a distortion or a muscular tear.
As a rule, it occurs within 24 hours of lifting a weight or incorrectly performing movements of the back.
If the pain persists for several weeks, we refer to it as chronic lower back pain.
Unlike acute lower back pain, there are various causes of chronic pain.
The most common are obesity, pregnancy and incorrect posture during the day, particularly in the workplace. In adults, another common cause is the presence of a herniated disc.
In the minority of cases, chronic low back pain can be caused by a form of arthritis or a tumour that has spread to the spine from other organs (such as the lungs or the prostate).
In contrast to acute lower back pain, in which pain is relieved with rest, chronic pain is perceived to be stronger when sitting or lying down.
LOCALIZATION OF PAIN
It is important to distinguish whether the symptom is located in the dorsal area of the back or in the lumbar region.
Dorsal pain affects the area between the spine and the shoulder blades but not the lower parts of the back.
It can be due to incorrect posture, injury to vertebral discs or diseases such as pleurisy or pneumothorax. In chronic cases other causes can be scoliosis, osteoporosis and osteoarthritis of the vertebral column.
There are many causes of back pain and these can be vastly different from each other. Most are related to incorrect posture and risky movements that cause strains, contractions or muscle sprains.
For this reason, employees who remain in front of a computer for hours, workers who need to lift weights and athletes are all subjects at risk.
Other causes can be linked to poor physical status. This is the case of overweight people and those who lead a sedentary life. Stress and smoking are also considered risk factors.
It is quite normal for women to suffer from back pain during pregnancy. Among the main causes are:
- Weight gain, especially in the months preceding childbirth.
- The arrival of the menstrual cycle and the premenstrual syndrome.
- Osteoporosis, which is a disease characterized by a reduction in bone density.
- Endometriosis that is the growth of a tissue resembling the lining of the uterus where it should not grow.
- The presence of ovarian cysts, which cause pain in the back and thighs.
- Pelvic inflammatory diseases
- A retroverted uterus.
- Uterine fibroids, which swell from the back of the uterus, exert pressure on the spinal nerves.
- Thrombosis of the ovarian vein.
- Malignant neoplasms of the reproductive system.
Finally, another common cause of back pain is sciatica, which is an inflammation of the sciatic nerve.
Physical therapy involves the execution of physiotherapy exercises for the treatment and rehabilitation of the hand, hip, knee, foot and limbs in general.
There are a host of remedies to be taken into consideration, and depend on the type of low back pain. Also in this case, the main difference is between acute and chronic low back pain.
All therapeutic treatments aim to relieve symptoms in the patient or prevent possible interference with the healing process. No treatment can accelerate a patient’s recovery.
Acute back pain remedies include the use of non-steroidal anti-inflammatory drugs (such as ibuprofen or aspirin) or the application of hot or cold compresses.
Also in the case of chronic lower back pain is prescription of non-steroidal anti-inflammatory drugs, but with some precautions. These drugs are in fact not recommended for patients suffering from hypertension, stomach ulcers and kidney problems.
Cures in the case of chronic pain also include physiotherapy and back pain exercises.
When necessary, smoking cessation and losing weight is also advisable.
Only in cases where conservative treatment does not lead to any results should surgical treatment be considered.
Contrary to what you might believe, during the recovery period, there is a need to try to return to performing routine work and home tasks, to restore a normal lifestyle. Even bed rest should be reduced, and you need to get used to and train your body into a correct posture during the day.
Prevention and maintenance
Back pain exercises are useful, not only as therapy, but also in the prevention of back pain.
So if you think the activities you do every day at work or when you play sports could lead you to have unpleasant consequences, here are a few exercises you could perform:
- The analgesic position, which allows relaxation of the Ileo-Psoas muscle and reduces its stretch over the lumbar vertebrae.
- The position of the sphinx, is suitable for those suffering from a herniated or protruding disc.
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