15 March 2019 Author : Álvaro Lima The lumbar region is a complex structure consisting of: Vertebrae; Muscles; Tendons; Intervertebral discs; Joints; Ligaments; Blood vessels; Nerves. As we move around in an upright position, this area bears the weight of our body every day when we walk or run. It is also subjected to additional efforts whenever we carry heavy objects or repeatedly flex or rotate our torso. Acute lumbar pain associated with physical exertion is a very common complaint. According to the World Health Organisation, it will affect around 80% of the adult population at least once during their lifetime. Frequently incapacitating, acute back pain is the main cause of absence from work in developed countries, and as such has serious socioeconomic consequences. What are the main causes of acute lower back pain? In the overwhelming majority of cases, acute lower back pain is only a symptom, which is associated with the inflammation of any of the structures in the lumbar region , caused by trauma or extreme exertion. As such, it is benign and usually resolves by itself within 2 weeks. The most severe cases can last for 4 to 6 weeks. The most common causes of lumbar pain are: Trauma; Repeated exertion. The following factors may cause lesions to bone, ligaments or intervertebral discs , which can in turn lead to lumbar pain: Trauma; Falls; Direct impacts; Sudden bending or rotation of the torso. Wear and tear of intervertebral discs, ligaments, joints and muscles may also cause painful episodes. This wear may be the result of: Carrying heavy loads; Handling heavy objects; Repeated bending and rotation of the torso; Incorrect posture for long periods of time. What are the symptoms of acute lower back pain? Episodes of acute lumbar pain are characterised by acute central or lateralised lumbar pain , with the following characteristics: Grinding or feeling of weight; Irradiation to the buttocks and back of the thighs; Pain that becomes worse when standing and with the movement of legs and torso; Feeling “blocked”. It may be accompanied by muscle cramps and spasms . Sometimes, muscle contractions can cause the torso to tilt forwards, backwards or to the side. The pain can usually be alleviated by lying on your side or on your back with legs bent. In acute episodes of lower back pain, you should look out for certain symptoms that could indicate the presence of a more serious condition. When should medical help be sought? You should seek medical advice if: The pain gets worse or remains very intense for several days; There is irradiation to one of the legs, accompanied by numbness or lack of strength. You should pay particular attention to any signs of: Fever; Difficulty in passing urine or stools; Pain that gets worse at night; Serious difficulty walking. These symptoms may be indicative of a severe medical condition , requiring urgent medical attention. How is acute lower back pain diagnosed? In typical cases of acute lower back pain, further diagnostic tests are not necessary . However, if symptoms persist for more than 2 weeks , the possibility that you are suffering from a more serious condition should be ruled out. In this case, the doctor may prescribe: A simple X-ray of the lumbar spine - showing the bone structures and its alignment. Infection, osteolytic lesion, fracture and spondylolisthesis (the misalignment of two vertebrae) may be diagnosed; A magnetic resonance of the lumbar spine —showing the musculoskeletal structures and their relationship with the nerve structures in detail. It can diagnose herniated discs, spinal stenosis and tumours. Is there any treatment for acute lower back pain? Treatment of acute lower back pain in the first 48 hours consists of bed rest and the application of ice to reduce inflammation. After this period, the patient should start walking and apply moist heat in order to relax the muscle. During the acute phase of the episode, the doctor may prescribe anti-inflammatories and muscle relaxants. More about the neurosurgery team at Hospital da Luz. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
