Overview of Back Pain Caused by Lumbago

Lumbago is a general term often used to describe pain in the lower back. Most of the time, lumbago is due to muscle strains, fatigue (poor posture), spinal stenosis, or arthritis. Fractures, cancer, infection, and vascular disease are less common causes.

Getting Your Lumbago Diagnosed

The term “lumbago” doesn’t give specific information as to the cause of the low back pain, and it's not an official medical diagnosis. Low back pain can cause persistent discomfort, and it can limit your activities. If it's not properly managed, symptoms can worsen and the underlying issue can progress. For example, mild muscle strain can lead to severe muscle spasms or spine deformities over time.

During your initial evaluation, your doctor will ask you questions about your pain such as:

• The intensity of your symptoms
• The location(s) of symptoms and pain
• The type of sensations you experience (i.e., are they dull, throbbing, sharp, etc.)
• The timing of the pain (i.e., are you constantly having symptoms, or only intermittently, or is there a particular time of day when they are worse or better?)

They will also talk to you about how much your symptoms disrupt your daily activities or quality of life. And you will have a physical exam, which can help determine whether you have nerve or spine involvement.

Depending on your initial evaluation, the next steps may include:

• Imaging tests such as MRI, CT scan, and/or X-ray to look for structural problems, such as a fracture or a tumor
• Laboratory tests such as complete blood count (CBC), C-reactive protein (CRP), or erythrocyte sedimentation rate (ESR), to check for signs of inflammation or infection

What Are the Treatments for Lumbago?

Your healthcare provider will recommend some treatments, based on the cause of your low back pain. Treatments can be used to relieve symptoms, and also to manage the underlying problem, and prevent it from getting worse.

Some recommendations your provider might make include:

• Over the counter acetaminophen or a nonsteroidal anti-inflammatory drug
• Prescription muscle relaxant, anti-inflammatory, or pain reliever
• Referral to a physical therapist
• Referral to a spine specialist or a pain management specialist

Often, several therapies are initiated at the same time for more effective outcomes. This can include a combination of physical therapy and over-the-counter acetaminophen, for example.

Treatment usually follows a stepwise progression, with conservative, less risky treatments used first. You might have physical therapy before proceeding to surgical evaluation. However, if there is a serious structural issue that is expected to improve with surgery, you might be referred for a surgical evaluation sooner, without an initial trial of conservative management.

To Operate or Not to Operate?

If your lumbago is accompanied by pain, electrical sensations such as pins and needles, shock, burning, weakness, or numbness that goes down one leg, your healthcare provider may refer you to a spine surgeon.

Many people worry that because they need to see a spine surgeon, this automatically means they will need some kind of a procedure, or that they will be pressured to agree to one. The truth is that a visit to a surgeon may mean back surgery is in your future, but it doesn't have to. Often, spine surgeons recommend other less invasive options, such as pain injections or injections of antiinflammatory medication.