Lumbago: Symptoms, Categories, Causes, Diagnosis and Treatment


Most low back pain is not a symptom of a serious underlying disorder, and does not require extensive visits to a doctor, chiropractor, x-ray or other images.

Most of the time, you can continue with your normal activity, while avoiding strenuous activity.

Until you have recovered, over-the-counter painkillers such as acetaminophen and nonsteroidal anti-inflammatory drugs, such as ibuprofen and naproxen , should relieve pain.


Please consult your health care provider if:

  • You have recurring pain, and if it spreads down the leg.
  • Pain that causes difficulty in controlling your bladder or bowels.
  • Pain that causes weakness or problems to lift the foot.
  • Pain that is accompanied by other symptoms, such as fever.

Categories of back pain

The lumbar spine that supports the weight of the body can be prone to injury and pain. The low back pain (lumbago) varies from mild to severe depending on the amount of injury. It can also be acute or chronic.

Acute low back pain

Acute low back pain occurs abruptly and usually heals within a number of days or weeks. The source of pain is commonly the muscles and ligaments, joints or discs.

Occasionally, mechanical back pain results from tense muscles, degenerative discs, and inflamed facet joints instead of pinching.

Chronic back pain

Chronic low back pain (lumbago) persists for more than 3 months; It can be felt all the time or worse with specific activities.

Although it can be difficult to trace the source, the possible causes may be things like nerve damage, scar tissue, arthritis or emotional effects of pain.

The duration of back pain is not always the best indicator of the severity of the condition. Acute and chronic types of back pain can indicate minor or serious problems.


Causes of low risk of back pain

Easily managed with over the counter medications
1. Effort of the lower back

Tension of the lower back is one of the most common causes of back pain. Tension is caused by excessive use or excessive stretching, which can cause small tears in the muscles or tendons of the back.

Back pain may begin after sitting for a long time, or may be due to poor posture (there was a good reason why your mother always told you to sit upright).

Sometimes, tension in the lower back is caused by injuries when lifting heavy objects or falling. If you have tension in your lower back, you should anticipate a full recovery.

2. Mechanical idiopathic pain

Mechanical idiopathic pain is usually caused by muscle tension, being really active and moving the body in a way that normally does not, such as lifting heavy objects or heavy furniture or running an obstacle course.

For example, when you have not trained for that. Chances are that if you spent yesterday helping your best friend move to an apartment with no elevator on the 4th floor, with all the push-ups, lifting and twisting you did, it’s no wonder you woke up this morning with back pain.

This type of mechanical idiopathic pain is usually located in the lower back, or lumbar area, the part of the back that literally lifts heavy objects.

3. Premenstrual syndrome

Premenstrual syndrome is that dull, persistent, sharp, painful pain in, under, and around your sacrum (the area of ​​your back between your hips).

Back pain related to premenstrual syndrome is a visceral pain, one that comes from an organ of the body instead of one of the structures of the back. As your uterus clears, the pain refers to your back, and you may have cramps in your back.

Back cramps can cause low back pain and pelvic pain. Dry heat (such as a heating pad) and non-steroidal anti-inflammatory medications such as ibuprofen and naproxen will help relieve back pain related to premenstrual syndrome.

Nonsteroidal anti-inflammatory medications are most useful if you start taking them a day or two before your back pain begins; As an added benefit, they can also make your period lighter.

4. Muscle knots and tension

Muscle knots are particularly sensitive spots along the muscles or connective tissue. It is not clear if the pain of muscle knots is caused by a muscle injury, such as muscle tension, or if the underlying cause has more to do with the nerve injury.

Vigorous massage will often relieve the pain of muscle knots. These are the most common causes of back pain because those muscles, ligaments and discs experience the greatest pressure when you are sitting or lifting objects.

Shoveling snow or helping your neighbor move a couch occasionally can overextend muscles or ligaments. It can end with strains or sprains. Most of these lesions heal in several days or weeks.

5. Pregnancy

Low back pain is one of the many common discomforts of pregnancy. As the weight and size of your baby (and belly) grows, there is a tendency to tilt the pelvis forward, which exaggerates the curvature of the lumbar spine.

This position, called lordosis, puts pressure on the muscles of the lower back and can even cause sciatic nerve shock ( sciatica ).

Back pain associated with pregnancy can be relieved by strengthening the core muscles, maintaining proper posture and wearing an abdominal support garment designed for use during pregnancy.

A cold compress and rest can help relieve headaches and muscle aches during pregnancy, but if you need additional relief, your doctor may recommend acetaminophen (the active ingredient in Tylenol).

When this medication is used as directed, it is a safe option. However, it is best to avoid aspirin and nonsteroidal anti-inflammatory drugs, such as ibuprofen (the pain reliever in Advil and Motrin) and naproxen (the active ingredient in Aleve).

Some studies suggest that taking these medications close to conception or early in pregnancy may increase the risk of miscarriage and birth defects.

Causes of low-medium risk of back pain

Generally administered as an outpatient by your doctor with prescription medications
1. Herniated disc

A herniated disc (also called a slipped disk, ruptured disc or bulging disk) is the most common cause of acute and chronic low back pain. The herniated disc can occur in the upper back or middle back, but it is more common in the lower back.

When a disc is herniated or ruptured, some of the gelatinous material inside the disc seeps and irritates the surrounding nerves.

Most people recover from a herniated disc, but the recovery period can be marked by back pain that can limit movement (especially when leaning forward, such as when tying shoes).

A 2010 study found that Discal Hernia can not be correctly diagnosed only through a single test.

2. Sciatic nerve pain (also called “sciatica”)

The sciatic nerve is the largest nerve in the human body. The root of the sciatic nerve is found where the lumbar section of the spine meets the sacral section of the spine.

This area of ​​the lower back is known as the lumbar-sacral region. Sciatica is a symptom of lower back disease or injury, not a disease or injury in itself.

Any disease or injury that affects the lumbar-sacral region of the spine has the potential to cause sciatic pain.

Sciatic pain usually occurs on only one side of your body. The pain is triggered (almost like an electric shock) from the lower back to the back of the leg, and can reach the ankle and foot.

Sciatica can cause severe back pain, numbness or tingling; Less often, you can limit your ability to move your ankle and foot.

3. Stone in the kidney

Kidney problems can cause back pain because the kidneys are located towards the back of your body at the height of the middle part of your back. Kidney stones are small pieces of calcium that form in the kidney.

Many people have kidney stones and never know they have them. You can ignore them. You notice the stones, even if they try to pass through the urinary tract with urine.

However, with larger kidney stones and their size increases with time, the pain when passing these larger stones can cause unbearable pain as the body tries to extract the stone from the narrow ureter.

4. Kidney infection (also called pyelonephritis )

The symptoms of kidney stones and kidney infection are similar. Both kidney stones and kidney infections can cause back pain on the affected side.

Pain related to kidney stones and pain caused by kidney infections can spread from the kidney area to the lower part of the stomach.

Both kidney stones and kidney infections can cause some bleeding, which can make the urine pink, red, or brownish.

How do you know if you have a stone in your kidney or a kidney infection that causes pain? With a kidney infection, you will usually have a low fever and, in advanced cases, may feel like you have the flu, if you have a kidney infection, but not if you are having a kidney stone.

5. Spondylosis

Spondylosis is a term that covers everything for any degenerative condition of the vertebrae. Spondylosis is literally a pain in the neck. The joints and ligaments keep the bones of the spine in place.

If they become too loose, the bones can slide or slide against each other. They can also press against sensitive nerves. Spondylosis most typically affects the cervical (neck) and lumbar (lower back) regions of the back.

As an arthritic condition, it becomes more common with advancing age. The pain of spondylosis worsens with activity and improves with rest.

Causes of medium risk of back pain

You may require a visit to the emergency department or hospitalization. Prescription medications generally needed.
1. Fibromyalgia

Fibromyalgia commonly affects women. It results when there is a disturbance in the natural way the body manages pain. The pain that most people experience is not the result of a structural abnormality.

Often, these pains are the result of the deterioration of pain processing mechanisms. It may be that the brain is hypersensitive to the incoming sensory input, or that it lacks the natural system to reduce pain.

Pain is one of several symptoms of fibromyalgia. Fibromyalgia is a term used to describe a combination of symptoms that may include pain, fatigue, trouble sleeping and emotional distress.

We are not sure exactly what causes fibromyalgia, but there is strong evidence that genetics comes into play. With fibromyalgia, there seems to be a problem with the way the central nervous system processes pain, which increases your experience of discomfort.

The pain of fibromyalgia can occur anywhere in the body, which means it can cause pain anywhere on the back.

2. Rheumatoid arthritis

Rheumatoid arthritis causes joint pain and stiffness, usually in smaller joints, such as those in the hands, wrists, and feet. The cervical spine, or neck, is another target of rheumatoid arthritis.

Rheumatoid arthritis causes the vertebrae in your neck to decompose. As the vertebrae rupture, the nerves that originate in the cervical spine are compressed or pinched.

Any injury to the nerves of the cervical spine can cause pain in the neck, pain that can travel through the arms.

3. Scoliosis and hyperkyphosis

Scoliosis causes a side-to-side curvature of the spine, while hypercholysis causes a forward bend from the upper back (think of “hunchback”).

These curves can be formed as your spine develops during growth, or due to a disease in your spine or back muscles.

In the extreme, these abnormal curves can limit your ability to move normally, or even limit your ability to breathe easily.

4. Ankylosing spondylitis

Let’s face it, that; Smoking has never improved any condition. Did you know that smoking can worsen your low back pain (lumbago)? Smoking worsens the pain associated with ankylosing spondylitis, a type of inflammation that can cause fusion of the vertebrae.

The pain of ankylosing spondylitis can be in the neck or lower back, it is typically chronic and will get progressively worse over time.

With ankylosing spondylitis, gradually loses flexibility throughout the body and especially in the back, and may eventually experience compression of the spinal cord .

5. Spinal stenosis

The bones of the spine surround the spinal cord. The spinal cord is a group of nerves that send signals between the brain and the body.

If the room around your spinal cord narrows, you can put pressure on the nerves and this can cause pain. The most common cause of this type of pain is osteoarthritis, which can lead to bone growths known as spurs.

These press in the room around the spinal cord. Spinal stenosis can be the result of arthritis or, sometimes, injury. The word “stenosis” refers to the narrowing of a passage in the body of any type, such as an airway passage.

In the case of spinal stenosis, there is pain of nerve compression, caused by a narrowing of the spinal canal, or of the spaces between the vertebrae.

Nerve compression causes pain, with numbness or tingling in the lower back and both legs. Although your pain is on both sides, it can be worse on one side than on the other.

6. Degenerative disc disease

With degenerative disc disease, the term “disease” is a misnomer. Degenerative disc disease is not a disease. It is part of the normal process of aging, and occurs because of the “normal wear” on the discs.

It is the condition of discs that lose their water content and fluffiness with age. It can result in osteoarthritis, herniated discs or bulging discs.

While you can not avoid aging, there are things you can do to slow down the progress of disc degeneration.

We know that smoking and being overweight causes discs to break down faster and earlier; Stopping or better yet, not smoking and maintaining a normal weight are the best ways to prevent disc degeneration.

7. Osteoarthritis

Osteoarthritis is more common than other types of arthritis, such as rheumatoid arthritis. As with degenerative disc disease, being overweight increases the risk of osteoarthritis. Osteoarthritis can be debilitating.

In osteoarthritis, there is a breakdown of the cartilage, the tissue that is found in the joints, between the bones, to prevent them from rubbing. Osteoarthritic pain occurs as the cartilage breaks down.

Osteoarthritis can affect the joints in the spine known as facet joints. It can also affect your knees or wrists. As you grow, your discs break down and shrink.

Facet joints can begin to caress one another. Your back may feel stiff when you wake up or feel pain after standing or walking.

Causes of medium-high risk of back pain

Necessary hospitalization, usually not life threatening, but could be
1. Osteoporosis

Weaker bones make fractures more likely, including fractures in the spine. Osteoporosis is sometimes called ” brittle bone disease .”

You can think of osteoporosis as something that happens to older women. It is true that osteoporosis is more common in older women, but men can also have osteoporosis.

As the bones lose density or mass, they weaken and are more likely to break. The bones of the lower back can break without any obvious injury, causing lower back pain.

It is easier to prevent osteoporosis than to treat it. Doing a lot of exercise (at least 150 minutes per week), maintaining a normal weight, avoiding smoking and consuming alcohol, and ensuring an adequate amount of calcium in your diet are some of the best prevention measures.

2. Vertebral compression fracture

A vertebral compression fracture occurs when a vertebral column collapses, usually because it is weakened by osteoporosis. Often, there is no obvious injury that breaks the bones.

The pain of a vertebral compression fracture varies where and how extreme the pain will be. It may be a dull or sharp pain that starts slowly, usually in the lower back, and may spread to the stomach.

Vertebral compression fractures are often found not because of pain, but because it is shortened, often due to aging or osteoporosis.

3. Pancreatitis

Your pancreas is the organ in your abdomen that produces insulin, a hormone required by your cells to break down food for energy.

While the pain of pancreatitis begins in the upper abdomen, which occurs in about half of all people with pancreatitis, the abdominal pain will move to the back and will usually be on the right side.

Pancreatitis does not cause back pain without other symptoms (stomach pain, nausea and vomiting). Pancreatitis is severe enough to be admitted to a hospital for treatment.

Causes of high risk of back pain

Threat to life and death is possible. Care of the Intensive Care Unit often necessary.
1. Broken neck (cervical fracture)

If you dive into shallow water and hit your head at the bottom of the pool, you could break your neck. The same if you fall from a significant height.

Any extreme trauma to your neck (think of a car accident or a violent or traumatic injury) can cause your neck to break. Usually, there is an obvious event that causes the neck bones to break.

It is a serious injury that causes pain and can also cause paralysis. A broken neck requires emergency medical attention.

2. Equine Tail Syndrome

It affects a group of spinal nerve roots that start at the lower end of the spinal cord.

People with cauda equina syndrome feel a dreary pain in the lower back and upper buttocks, along with analgesia (lack of sensitivity) in the buttocks, genitals and thigh.

These occasionally cause alterations in bowel and bladder function. Cauda equina syndrome is another condition that requires immediate medical attention. Prompt medical attention can help prevent permanent damage or disability.

Many different mechanical and malignant conditions can cause horsetail syndrome (damage to the nerve bundle that extends from the base of the spine).

The characteristic symptoms are progressive worsening, severe lower back pain accompanied by weakness, numbness or tingling in both legs, and loss of control of the bladder and bowel.

3. Abdominal aortic aneurysm / aortic dissection

An abdominal aortic aneurysm is a bulge in the wall of the abdominal aorta, the large vessel that carries the oxygenated blood from the heart to the lower part of the body. This lump increases the risk of the aorta breaking.

The pain of an abdominal aortic aneurysm or rupture is sudden. It is felt in the lower back (and abdomen), and is often described as a burning sensation. Immediate medical attention (ideally before the aneurysm is broken) can save lives.

Men over 65 who smoke have the greatest risk of having an abdominal aortic aneurysm.

4. Meningitis

Meningitis is an infection of the meninges (the membranes that cover the brain and spinal cord). The infection can be caused by a virus or by bacteria.

I would feel more stiffness than the pain of meningitis, meningitis and stiffness will be found mainly in the neck area. You may also have a fever or headache. It may bother you to look at the bright light.

There are vaccines available for children and adults that protect against bacterial meningitis.

5. Heart attack

When you think about a heart attack, do you see an older man, holding his chest, sweating and talking about feeling a crushing chest pain as if an elephant were walking on him? Think again.

Yes, crushing pain in the chest is the most common symptom of heart attack in both men and women.

However, you may not (especially if you are a woman), experience this type of powerful pain in the chest, or any sensation in the chest, even during a heart attack.

In contrast, women may have fewer typical symptoms, such as pain or pressure in the upper back.

6. Metastatic cancer

If you have cancer, you probably know that your cancer may spread. Cancers of the breast, kidney, prostate, lung or thyroid often spread or metastasize to the bones of the back.

The metastasis back causes pain due to nerve compression, or metastasis caused because the bone fracture.

It becomes a medical emergency if horsetail syndrome occurs, it is a serious disease that describes the extreme pressure and swelling of the nerves at the end of the spinal cord.

7. Osteomielitis vertebral

When bacteria infect the bones of the spine (the vertebrae), osteomyelitis (which means “bone infection”) develops.

The infection usually begins elsewhere and spreads to the vertebrae. The symptoms of osteomyelitis include back pain and fever.

Diagnosis and treatment

Examination in the doctor’s office

A number of general practitioners or primary care physicians will be able to diagnose back pain after a physical examination and consultation with the patient.

In a good number of instances, image scans are not essential. We also have some physical exams and videos that you can do yourself.

Usually, a careful medical examination is done to determine the type and cause of your back pain and to decide on the best treatment options. A diagnostic evaluation includes a medical history and a physical examination.

Sometimes image scans (eg, X-rays, bone scans, magnetic resonance imaging or CT scans, electromyography) and tests to check muscle strength and reflexes are used.

Physiotherapy / exercise

Physical therapy can help you get back to maximum activity as soon as possible and avoid a new injury.

Physiotherapists will guide you in the right techniques for lifting and walking, including exercises that strengthen and stretch the back, legs and abdominal muscles.

Massage, ultrasound, diathermy, heat and traction can also recommend it for short periods.

A review of evidence-based clinical trials found that therapies without medication, including spinal manipulation, along with exercise, massage and physiotherapy, can be used in the treatment of low back pain.

One study found that yoga can benefit people with chronic low back pain.

A Cochrane review in 2011 of 26 clinical trials found that spinal manipulation is effective in the treatment of chronic low back pain, which reduces pain and improves function.

Often surgical treatment is not required unless you have weak muscle weakness, a diagnosed herniated disc, severe stenosis, horsetail syndrome or severe pain that does not go away after some time of non-surgical treatment.

The therapy of percutaneous neuromodulation (SOPs for short) is a minimally invasive treatment, office, recently investigated for LBP wherein the paraspinal electrical stimulation is administered peripheral nerves.


Back pain often goes away with rest, the application of ice or heat, massage, analgesics and gentle stretching. If self-care treatments are not producing the desired results within the first few days, visit your doctor.


Several people use over-the-counter non-steroidal anti-inflammatory medications to relieve pain such as aspirin, ibuprofen, or naproxen. A muscle relaxant may be recommended for spasms.

If the pain is severe, an analgesic may be recommended along with over-the-counter non-steroidal anti-inflammatory drugs or muscle relaxant.

Steroids can reduce swelling and inflammation of the nerves. They can be taken orally or by injection.