Lumbalgia: Causes, Symptoms and Treatment
Lumbalgia refers to pain in the lower back region (lumbar spine). It is one of the most common medical complaints and can occur in acute or chronic form.
Things worth knowing about "Lumbalgia"
Lumbalgia refers to pain in the lower back region (lumbar spine). It is one of the most common medical complaints and can occur in acute or chronic form.
What is Lumbalgia?
Lumbalgia is the medical term for pain located in the lower back, specifically in the region of the lumbar spine. The pain may be described as dull, pulling, stabbing, or burning, and can appear suddenly (acute) or persist over a longer period (chronic). Lumbalgia is one of the leading causes of doctor visits and work-related disability worldwide.
Causes
The causes of lumbalgia are diverse. A distinction is made between specific and non-specific causes:
Non-Specific Lumbalgia
In the majority of cases (approximately 85%), no clear organic cause can be identified. Contributing factors include:
- Muscle tension and spasms
- Physical inactivity and compensatory postures
- Poor posture or incorrect lifting techniques
- Prolonged sitting, especially in non-ergonomic positions
- Stress and psychological burden
- Excess body weight
Specific Lumbalgia
Less commonly, an underlying organic condition is responsible, such as:
- Herniated disc (prolapse) with nerve root compression
- Spinal stenosis (narrowing of the spinal canal)
- Osteoporosis or vertebral fractures
- Inflammatory conditions such as ankylosing spondylitis
- Tumors or metastases in the vertebral region
- Kidney disease or other visceral causes
Symptoms
Symptoms of lumbalgia can vary depending on the cause and severity:
- Pain in the lower back that worsens with movement, bending, or lifting
- Morning stiffness in the lumbar region
- Radiation of pain into the buttocks, thigh, or leg (sciatica)
- Tingling, numbness, or weakness in the legs (when nerves are involved)
- Reduced range of motion of the spine
Diagnosis
Diagnosis of lumbalgia begins with a thorough medical history and physical examination. Depending on clinical suspicion, further investigations may include:
- X-ray of the lumbar spine
- Magnetic resonance imaging (MRI) to visualize discs and nerve structures
- Computed tomography (CT) in case of suspected fractures
- Blood tests to rule out inflammatory or systemic diseases
- Electrophysiological tests (e.g., EMG) when nerve involvement is suspected
If so-called red flags are present -- such as numbness in the perineal area, bladder or bowel dysfunction, unexplained weight loss, or fever -- immediate medical evaluation is required to exclude serious conditions.
Treatment
Treatment depends on the underlying cause and duration of symptoms:
Conservative Treatment
- Exercise therapy and physiotherapy: Targeted back and core muscle strengthening
- Pain medication: Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or diclofenac; muscle relaxants for severe spasms
- Heat application: Heat pads or mud packs to relax tense muscles
- Manual therapy and osteopathy
- Psychological support for chronic pain management (cognitive behavioral therapy)
- Acupuncture as a complementary method
Invasive Treatment
- Infiltration therapy (injections of corticosteroids or local anesthetics near affected structures)
- Surgery is reserved for severe specific cases (e.g., herniated disc with significant neurological deficit)
Prevention
- Regular physical activity and back-strengthening exercises
- Ergonomic workplace setup and proper lifting techniques
- Weight management
- Stress reduction strategies
References
- Airaksinen O et al. - Chapter 4: European guidelines for the management of chronic nonspecific low back pain. European Spine Journal, 2006; 15 (Suppl 2): S192-S300.
- National Institute for Health and Care Excellence (NICE) - Low back pain and sciatica in over 16s: assessment and management. NICE Guideline NG59, 2016. Available at: www.nice.org.uk
- World Health Organization (WHO) - Musculoskeletal conditions: Low back pain. Available at: www.who.int
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