What happens when you shoot?
The lumbar region bears the main load during body movements. With a sudden movement or unusual load, microtrauma of the muscles, ligaments or intervertebral joints occurs, and the body responds with a protective muscle spasm. The spasm fixes the spine, but itself causes severe pain. Sometimes the cause is a herniated disc, irritating a nerve root: then the pain radiates to the leg. Changes on MRI in the form of protrusions often occur in people without pain, so they do not always explain the lumbago.
- Nonspecific musculo-ligamentous pain is the most common
- Pain from intervertebral joints
- Radiculopathy - pain radiates to the leg below the knee
- Specific causes—fracture, infection, tumor—rare
Causes and risk factors
Backache often occurs in people who sit for a long time and then perform sudden physical work: lifting a heavy bag, lifting a child, moving furniture. The combination of tilting and turning the body is dangerous. Predisposed by weak back and abdominal muscles, excess weight, smoking, chronic stress. Hypothermia itself does not damage the spine, but it can increase muscle tension.
- Lifting weights with tilt and turn
- Prolonged sitting, inactivity
- Weakness of the core muscles
- Excess body weight
- Previous episodes of back pain
- Stress and lack of sleep
Symptoms
The pain appears suddenly, sometimes with a clicking sensation, and is localized in the lower back and can radiate to the buttock. Movements are sharply limited, the person leans forward or to the side. The back muscles are tense, and the pain intensifies when coughing and sneezing. If the pain spreads along the back or side of the leg below the knee, accompanied by numbness or weakness, we are talking about irritation of the root, and you need to consult a neurologist.
- Acute lower back pain
- Inability to straighten up
- Back muscle tension
- Increased pain when moving, coughing
- Sometimes kickback to the buttock
- Relief in a comfortable position
Diagnostics
Diagnosis is made by complaints and examination. The neurologist checks reflexes, sensitivity, leg muscle strength, and looks for warning signs. For a typical lumbago without such signs, MRIs and X-rays are not needed in the first 4–6 weeks: they do not speed up recovery and often show age-related changes not associated with pain. An examination is prescribed if a fracture, infection, tumor, root compression with increasing weakness is suspected, or if pain does not go away despite treatment.
- Neurological examination
- MRI of the lumbosacral region - according to indications
- X-ray for injury and suspected fracture
- Blood tests for fever and weight loss
- ENMG for persistent numbness or weakness
Treatment and prevention
The main thing is to remain as active as possible: walk, do normal activities, avoiding sudden movements and lifting heavy objects. Strict bed rest is not recommended. Local dry heat and non-steroidal anti-inflammatory drugs relieve pain; if spasm is severe, the doctor may add muscle relaxants for a short period of time. After acute pain subsides, physical therapy, massage and manual techniques from a qualified specialist are useful. For prevention, strengthening the core muscles, proper lifting of weights with squats, and regular breaks during sedentary work are important.
- Walking as hard as you can instead of bed rest
- Dry heat on the lower back
- NSAIDs and muscle relaxants - as prescribed by a doctor
- Exercise therapy and massage after acute pain subsides
- Lift weights with a straight back and bent knees
- Seated work breaks every 30–60 minutes