Orthopedics-Online

Lumbar spine pain

Synonyms

Dorsalgia (Latin dorsum - the back; Greek algos - pain)
Lumbar pain / Lumbago (Latin lumbus loin; German also Lumbago) if the lumbar and sacrum region is affected

English: chronic back pain, lower back pain

introduction

Back pain have now become a species Common disease developed. Besides infectious diseases, they are one of the most common reasons to see a doctor. So diverse the causes can be, one stands at the treatment but mostly in front of you mystery. For the most part, patients with back pain are in the range of Lumbar spine affected

definition

Back pain is a painful condition that can occur in different sections of the back.
According to their predominant frequency, they can be divided into different degrees.
Acute back pain occurs either for the first time, suddenly or after a break of at least six months. They shouldn't last more than three months.
In contrast, chronic, persistent back pain takes up most of everyday life and persists for more than three months. The symptoms can recur or only be temporary.
Furthermore, back pain can also be divided into radicular and pseudoradicular pain according to its quality.
The radicular pain (radicula - the root) is based on a compression of the nerve root, as is the case with a herniated disc in the lumbar spine. The pseudoradicular pain (apparently more radical) is caused by changes in the small joints of the spine.

Appointment with a back specialist?

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Who am I?
My name is dr. Nicolas Gumpert. I am a specialist in orthopedics and the founder of .
Various television programs and print media report regularly about my work. On HR television you can see me every 6 weeks live on "Hallo Hessen".
But now enough is indicated ;-)

The spine is difficult to treat. On the one hand it is exposed to high mechanical loads, on the other hand it has great mobility.

The treatment of the spine (e.g. herniated disc, facet syndrome, foramen stenosis, etc.) therefore requires a lot of experience.
I focus on a wide variety of diseases of the spine.
The aim of any treatment is treatment without surgery.

Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

You can find me in:

Lumedis - your orthopedic surgeon
Kaiserstrasse 14
60311 Frankfurt am Main

Directly to the online appointment arrangement
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Further information about myself can be found at Dr. Nicolas Gumpert

frequency

Approx. 60-80% of all women and roughly 65-70% of all men suffer at least partially from Back pain.
More than half are related to their profession. over 75% of the complaints can be in Lumbar region locate. Of the Lumbar spine with their five vertebrae it is followed by the sacrum, which is articulated to the pelvis.
If the pain affects this joint, one speaks of "Lower back pain"(Sacroiliac complaints) or according to the Latin name of the joint - Sacroiliac joint - also "sacroiliac (ISG) syndrome".
In 25% of patients they go Back pain from the neck and neck region. The distribution of herniated discs follows the frequency of the localization of the pain. So they are more common in the lumbar region.
In Germany, spa and disability applications are made in over 60% of cases due to back pain and cost around 49 billion euros.

Localizations of pain

Right

Often, back pain in the lumbar spine area only occurs on one side, for example on the right.

There are various possible causes for this, which in most cases are harmless and can be improved through regular strengthening exercises. Because often the back pain on the right side is muscle tension or pinching of a nerve. The latter often leads to pain that extends into the right leg, as many nerves come from the lumbar spine and run down the leg.

So-called spinal stenosis can also lead to these symptoms. This is a narrowing of the spinal canal, which occurs mainly in the lumbar spine. Local inflammation or, for example, an abscess, i.e. a cavity filled with pus, are also possible causes of back pain on the right side.

If the pain is severe over a long period of time, a lateral disc herniation or a bulging disc should also be considered. Right kidney disease, such as pelvic inflammation, can also cause back pain in the right side of the lumbar spine. Other symptoms such as fever or bloody urine often occur.

Left

Back pain in the lumbar spine area is often unilateral and many sufferers complain of pain in the lower left back. There are various possible reasons for this. This also includes tension or strains in the muscles, which can occur during exercise, for example. Often the strongest hip flexor, the so-called ilipsoas, is tense, which compresses the nerves in the vicinity. This causes the pain to radiate into the left leg. Depending on the severity of this nerve compression, this pain can also get worse and better depending on running.

Spondylolisthesis, i.e. vertebral slipping when the spine is unstable, often occurs in the lumbar region and can lead to unilateral pain on the left side. A common cause is also the herniated disc or the bulging of the intervertebral disc, which depending on the severity can cause pain mainly on the left. In some cases, diseases of the left kidney can lead to back pain at the level of the lumbar spine. If there is any suspicion, attention should therefore also be paid to other symptoms, such as fever and blood in the urine. The intestines can also lead to back pain in the lumbar spine on the left side if there are severe digestive problems.

On both sides

Back pain in the lumbar spine often occurs on both sides. There are also different causes for this.

For example, everyday problems such as bad posture or weak muscles can lead to complaints. The intervertebral discs most often cause pain in the lumbar spine area when they bulge or shift. In extreme cases, fractures or tumors that press on the spinal canal are also conceivable. However, this is rather rare.

The kidneys can also be the cause, although it is more common that kidney disease only occurs on one side.

Painful situations

Pain when seated

When sitting, the back pain gets worse with many diseases and tension in the lumbar spine area. The reason for this is an increased load on the spine with body weight.

This can be a typical sign of a herniated disc, for example. However, the cause is often less serious and the pain is load-dependent. Usually it is already very helpful if you pay attention to a correct posture while sitting. Strengthened muscles in the back are also important. In addition, office workers, for example, should ensure sufficient exercise during the day to relieve the lumbar spine.

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Signs of a herniated disc

Laying

In some cases, back pain in the lumbar spine occurs mainly when lying down and is exacerbated as a result. Since the muscles are less stressed when lying down, the muscles can become shortened when lying down for a long time. This is because muscles can regress if they are underused. This can worsen various restrictions, such as tension, but also herniated discs.

But there are also diseases, such as spinal stenosis, in which the pain is better when lying down. This is a narrowing of the vertebral canal, which is widened a little while lying down.

Especially in the morning

There are various reasons for lumbar spine back pain, especially in the morning after sleep. The most common cause of the discomfort is an incorrect sleeping position. If the spine cannot relax and relieve stress enough, tension or existing pain will be significantly increased. Therefore, care should be taken to use a back-friendly mattress. Various pillows can also correct the sleeping position.

Back pain that occurs in the morning can also be an indication of a rheumatic disease. Often other joints are also affected, which hurt especially in the morning. In such cases, a doctor should be consulted for clarification.

At night

Sometimes it happens that back pain occurs in the lumbar spine, especially in the evening or at night while sleeping. They can become so strong that they wake up and then have trouble falling asleep again.

One possible cause is an unfavorable sleeping position for the back, which leads to muscle tension and irritation of the nerves. This can be improved with a back-friendly mattress and sleeping pillow. Another possible cause is ankylosing spondylitis, in which the pelvic joints become inflamed and the pain is transferred to the back.

After the sport

It happens to many people in the course of their lives that they make awkward or unfamiliar movements while exercising and suddenly have pain in their back. The lumbar spine is often affected in sports that involve bending or crouching. When doing weight training and weightlifting, it is therefore particularly important to ensure that the lumbar spine is relieved. But also in other sports, such as hockey or gymnastics, the lower back can be very stressed.

The pain is most often caused by muscle tension, muscle strain and a possible pinched nerve as a result. They are often stinging in character and can often be completely cured by rest, massage or physiotherapy. But ligament tears or other more serious injuries are also possible causes. In the event of severe pain that does not improve even after several days, an orthopedic surgeon should be consulted. In addition, it is always advisable to strengthen the back with targeted exercises during regular exercise.

Pain character

Sharp pain

The pain in the back can vary in character. If they are described as stinging, the cause is often in the nerve area. Many of those affected describe it as having a knife rammed into their back.

This stinging character is caused by compression, i.e. an entrapment, of one of the nerves running there. As a result, it becomes very irritated and sends warning signals to the brain. Such entrapment can have various causes. Often it is extreme muscle tension, also called muscle tension. Since a herniated disc is also a possible cause, a doctor should be consulted for clarification.

Other causes

Pain from a hollow back

An upright posture is very important both when sitting and standing. It happens again and again that a wrong posture leads to severe and long-term back pain in the lumbar spine. Often the hollow back is to blame.

The excessive curvature of the spine puts too much strain on the lower back in particular. The consequences often only show up after a few years. Since the posture is an automatic behavior, it is often very difficult to correct it in everyday life. Physiotherapy is very helpful in such cases in order to integrate a correct posture into everyday life through various exercises and tricks.

Inflammation

Inflammation can cause pain in the back in the lumbar region. These are usually relatively acute and with other signs of inflammation, such as redness and swelling. There are several ways in which the inflammation develops on the back.

Bechterew's disease is an inflammation of the pelvic joints, i.e. the transition between the intestine and sacrum. This often manifests itself in back pain in the lumbar spine. Another possible cause is psoriasis, also known as psoriasis, which often leads to inflamed joints in the spine and is then also known as psoriatic arthritis.

pregnancy

Back pain in the lumbar spine is common during pregnancy. The increase in waist size and weight put a heavy strain on the back. In addition, some areas of the mother's body change during pregnancy. This also includes widening the pelvis a little to prepare for the upcoming birth. This can also cause lower back pain.

In order to prevent or counteract these complaints, it is important to ensure an upright posture that relieves the back. This should also be considered while sitting. If necessary, seat cushions can have a supportive effect. Nowadays there are also many offers in the sports and fitness area for pregnant women. This is not only about the classic birth preparation, but also about courses in which the muscles of the back are strengthened. This is very important and should be started early in pregnancy.This can prepare the body for the weight gain and the resulting stress.

Accompanying symptoms of back pain

In the beginning, many sufferers perceive the first signs or complaints with back pain in the lumbar spine / lumbar vertebrae in the form of:

Tension
Exhaustion
and
Morning stiffness of the back or joints

not serious, ignore them or try to get relief through various countermeasures and relieving postures.

However, this leads to exactly the opposite and usually makes the situation even worse. Bad posture and increasing pain follow. It is important that everyone observes themselves closely and asks themselves the following questions, for example:

"In which situations do I have back pain?"
"How often and when exactly do they occur?"
"Where do I have back pain?"
"How is this pain and how long does it last?"

However, every doctor will also ask about these circumstances in a specific pain history. This is particularly important in order to find out the cause of the back pain and to initiate targeted further diagnostics and therapy for the back pain.

Radiation of pain into the leg

It happens again and again that back pain occurs on one side of the lumbar spine that extends down into the leg.

Typically, this pain is a nerve that is pinched. Many nerves in the leg come from the spinal cord at the level of the lumbar spine. If the sciatic nerve is irritated, i.e. the thickest nerve that pulls into the leg, one speaks of lumbar sciatica. This can also lead to paralysis. Spinal stenosis, in which the spinal canal is narrowed, can also lead to referred pain in the leg and should be treated as soon as possible.

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stomach pain

Sometimes back pain in the lumbar spine appears together with abdominal pain. It should, of course, be taken into account that the complaints appear independently. In many cases, however, there are also connections.

The gastrointestinal tract is supplied by various nerves, many of which ultimately come from the spinal cord. This can mainly reflect problems of the large intestine and the rectum in the back. Especially with digestive disorders with frequent diarrhea, which are often painful in the abdominal area, back pain in the lumbar spine can occur. But constipation also affects the back due to the increased volume and weight of the intestine. This mainly affects the muscles between the back and the gastrointestinal tract. This also includes, for example, the hip flexor muscle Ilipsoas. With increased stress, this can cause pain in the lumbar spine, especially when straightening up. Therefore, if stomach and back pain occur together, it makes sense to treat indigestion. Often a change in diet and, if necessary, detoxification of the intestine is sufficient.

diagnosis

At the beginning of every diagnosis of back pain in the lumbar spine is the individual anamnesis (Medical history) of a patient.
The aim of the doctor's detective work is to get an overview of the current complaints.
Specific questions about:

Localization and perhaps transmission of the pain to other areas, such as the legs
Quality and intensity of complaints and timing of occurrence
such as
possible intensification or weakening of the pain by certain circumstances

are absolutely necessary.

Questions about previous illnesses are no less important. In our case, the attending physician should check for accompanying diseases such as osteoporosis (Bone loss) or osteoarthritis (Joint wear) ask.
Furthermore, a search is made for social conditions such as work, partnership, family and stressful situations.

This thorough “interview” is followed by a physical examination, which can provide initial information.
The following can be seen from the outside:

the position of the pelvis and shoulders
Curvature of the spine and the entire posture.

Additionally:

Muscle strength
Reflexes
Touch sensations (sensitivity)
and
the mobility of the joints, especially that of the spine

checked.
If these measures do not exactly reveal the cause of the back pain, additional technical methods such as:

X-rays
MRI (magnetic resonance imaging, nuclear spin)
CT (computed tomography)
and in special cases
myelography (special type of x-ray in which a contrast medium is injected into the spinal canal)

to disposal.

therapy

What should be done if the back hurts, muscles are tense and mobility is severely restricted in everyday life?
Basically, every therapy of the lumbar spine is based on the cause of the ailment. So if an organic cause is found, it should be treated first. Back pain is often caused by imbalances in the muscles in the trunk area. For many patients, back pain occurs in episodes and requires quick and targeted action. A specific diagnosis of these imbalances followed by training of the core muscles helps in most cases to get back pain under control.
The following methods are open to everyone:

Heat applications (above all for mild back pain)
Medication
acupuncture
massage
Relaxation procedures and sports
Behavioral therapies
Operations

In many cases, heat relieves acute pain. Heat applications have proven particularly useful for muscle tension.
Here the spectrum ranges from:

Baths
Envelopes
Heat packs
Pave
up to
Sauna visits

Painkillers can acutely relieve stress-related back pain, but they do not address the underlying cause of the back pain.
However, pain relievers are a first choice and alternative when surgery is not absolutely necessary.
Above all, non-steroidal anti-inflammatory drugs (NSAIDs) are used. They relieve acute pain and inhibit inflammation. This can be particularly helpful when the pain causes relieving postures and thus tension in the muscles.
The pain relief provides a reasonably normal posture and mobility, possible inflammation also heals and the patient quickly experiences freedom from symptoms.
In the case of chronic back pain in the lumbar spine, however, other methods such as acupuncture or behavioral therapy have proven themselves. Long-term administration of painkillers can in fact require higher and higher doses as the body gets used to them, and so quickly end up in addiction.
It is interesting to follow studies on the treatment of chronic back pain of the lumbar spine with acupuncture. Here, the therapeutic success seems to be significantly higher than that of conventional therapy with painkillers and accompanying physiotherapy in a shorter treatment time.
Nevertheless, physiotherapy / physiotherapy or especially back training is the method of choice for targeted muscle building of the back area and for relieving tension. Everyday movements, back-friendly lifting, standing, walking and sitting are trained.
Experts particularly recommend sporting activities and lots of exercise that do not strain the back. Swimming, especially crawl swimming and long walks, are very suitable.
Operations are only carried out in the rarest of cases. Severe herniated discs in the lumbar spine are a common indication. In addition to the large open operations, procedures are also used that allow a smaller intervention (so-called minimally invasive procedures) - especially in less serious cases.

Examples of minimally invasive procedures are chemical dissolution of the intervertebral disc by enzymes (Chemonucleolysis), Vaporization of parts of the intervertebral disc by means of laser and spinal surgery by means of endoscopy (with the help of a tubular system in which a camera is built (endoscope) the doctor can see cavities in the body and treat disorders).

Exercises

There are many exercises that can help relieve lower back pain. Above all, they serve to stretch and strengthen the muscles in the back, which ensures a better posture and thus relief of the painful back.

At the beginning it is recommended to improve the perception and fixation of the lumbar spine in the body. The best way to do this is to lie down on a mat, bend your legs and place your arms relaxed next to your body. Now the tips of your feet are pulled up, the heels and lower back press into the mat.

There are some exercises in the prone position to strengthen the back muscles. In this position, for example, your arms and legs can be easily lifted off the floor. This position is then held for a while; swimming movements can also be made. It is important to make sure that there is no hollow back. To strengthen the muscles in the lumbar spine area, an exercise can also be performed that has the quadruped position as the starting position. Now the right arm and the left leg are alternately extended and then the left arm and the right leg. You should try to form a horizontal line with your arm and leg. This exercise also improves balance and thus ensures better posture for the entire back.

Kinesio tape

Applying kinesiotape can often help with back pain in the lumbar spine.

This relieves the pressure on the vertebrae and in many cases reduces the pain. However, if the injury is serious, such as a herniated disc, kinesiotape is not enough. If you are unsure about the origin of the pain, you should therefore consult a doctor. There are several variants for taping the lumbar spine, the most common being the star shape or a Y-stripe.

Further information on this:

Tape bandage

Home remedies

In the case of back pain in the lumbar spine, home remedies are often sufficient to relieve muscle tension, for example.

A very popular aid are heat cushions or hot water bottles, which relax the structures locally. In some cases, cold packs or ice can also help to numb the pain. Oils, e.g. St. John's wort oil or oils mixed with ointments such as arnica or devil's claw can be rubbed into the affected areas. Alternatively, cloths can be soaked in the oils and then worn as a wrap overnight.

acupuncture

Many people with back pain in the lumbar spine report that acupuncture has relieved their symptoms.

The idea of acupuncture is based on the targeted treatment of so-called trigger points. These trigger points represent junctions of various nerves running there and are often the places where the pain is greatest. Therefore, this form of therapy can help reduce pain.

forecast

With the majority of people Lumbar spine pain the prognosis is good. In more than half of the cases the pain disappears within a week, after two weeks around 80% of the patients have recovered at least enough to be able to resume their normal activity. In over 60% of the cases, however, complaints recur.

Duration

In order to assess the duration of back pain in the lumbar spine, the cause must first be considered. For example, if there is an acute inflammation, it can usually be treated successfully and the pain is only present for a few days to weeks.

Unfortunately, back pain is often chronic. If they occur in old age, it is often a cause mixture of many components. So-called degeneration, i.e. wear and tear, of bones often occurs in old age. This is especially true for the spine, as it is stressed every day. In such cases, the cause can only be influenced to a limited extent, which means that the back pain is unfortunately often not completely curable. The consequence of this is that those affected have to learn to deal with the complaints in everyday life. It is therefore important to listen to your own body and to counteract the pain early on. An upright posture in everyday life is just as important as regular exercise and strengthening the muscles in the back.

Another cause that occurs again and again is a herniated disc, which, depending on the severity and timing of therapy, can lead to symptoms for different lengths of time. Unfortunately, pain often persists in the long term due to the damage to the nerve structures.

Summary

Strength Lumbar spine pain are not uncommon, nothing unusual, and yet should never be underestimated. What started out as a fairly harmless acute back pain (e.g. Morning stiffness or slight neck tension) can develop into chronic, in the worst case lifelong, back pain. The bottom line is that many symptoms can be alleviated with simple measures and even prevented with a little initiative.

How can everyone prevent this martyrdom?
Now the most important aspect, in addition to a healthy lifestyle, is a lot of exercise, sporting activities and a balanced amount of relaxation.
If a job is carried out that is associated with activities that are particularly stressful on the back, such as office work, heavy lifting on construction sites, etc., one is recommended Back school, to the Musculature to strengthen and learn back-friendly lifting and work-related behavior.
Obesity should also be due to a healthy eating be avoided. Too many kilos put a strain on them Spine and lead quickly to Lumbar spine pain.