yogabook / pathologie / lumbago

Lumbago (lumbago, local lumbar syndrome)

Definition of

Acute, highly non-radicular, painful restriction of movement in the area of the spine with tension in the paravertebral musculature, presumably often due to strains or neuromuscular malreactions, which leads to persistent cramping of synergistic musculature (or weaker parts) of the musculature that is overtaxed by a movement or posture. Most common 30th-60th year M/F equally frequent. In addition to the acute form, there is also the chronic form with more or less continuous subacute to subclinical pain or complete remission; in recurrences, the pain is often (but not necessarily) less severe than in acute cases. Lumbago is not a disease in the true sense of the word, but a picture. The term is not used consistently in the literature; in some cases lumbago is used as „acute lumbalgia“, which contradicts the definition of lumbalgia as having a radicular aetiology. In addition to the lumbar spine form, there is also

1. Cervical spine form of lumbago with severe tension in the neck, neck stiffness and possibly nuchal headaches and possibly painful movement restrictions in one or both arms
2. Thoracic spine form (quite rare) with pronounced painful restriction of movement of the thoracic spine and painful restriction of breathing

In both cases, the psychological component is probably much more pronounced. The term lumbago is based on mythical ideas

ICD M54

Cause

1. Trigger: Overstraining of the muscles due to abrupt, often heavy movements, usually lifting, or prolonged bent forward posture, often in combination with cold and wet conditions

Predisposing

1. Weakness and lack of elasticity of the muscles in the lumbar spine area
2. muscular imbalances
3. Tired muscles
4. Stressful psychological factors
5. Frequent prolonged one-sided postures

Diagnosis

1. If necessary, imaging procedures to rule out non-muscular events
2. Rarely: Blood laboratory, cerebrospinal fluid puncture

Symptoms

1. Lightning-like onset of severe pain, often described as a „knife rammed into the back“; sometimes a rapid increase in tone leading to a painful spasm is also felt
2. Partial complete inability to move
3. The smallest movements in the degree range, especially slight forward bending movements with slight rotation of the spine, can trigger maximum pain
4. Reactive tension in other muscle groups
5. paravertebral myogelosis
6. Gentle posture

Therapy

For exercise therapy for lumbago, see also the recommendations in the FAQ.

1. KG
2. Chiropractic
3. Stretching exercises
4. There is no evidence for the effectiveness of muscle relaxants
5. Preventive and to prevent recurrence: Strengthening the back muscles
6. only in highly acute cases, step bed positioning if necessary
7. NO bed rest. Exercise, minimize resting posture!
8. Heat applications
9. NSAIDs if necessary, also as infiltration
10. local ointments
11. Even untreated, spontaneous healing within days or weeks, usually 90% of patients are symptom-free after 4-6 weeks, but recurrence is possible!
12. Muscle relapse prevention and movement/posture training

NHK

1. Local anesthesia with wheals

DD

1. Lumbalgia with disc hernia
2. Vertebral joint blockages
3. Muscle strains