Sudden non-specific low back pain is usually triggered by incorrect loading of one or more intervertebral joints or pronounced painful muscle hardening. If the sciatic nerve or its nerve roots are also under pressure when passing through the lower lumbar vertebrae or the sacrum, this can indicate a herniated disc. In rare cases, the increasing wear and tear of the intervertebral discs or broken bones in the vertebral bodies - for example as part of bone loss (osteoporosis) - can lead to the bony side holes through which the nerve roots exiting the spine on the left and right becoming smaller. As a result, nerves can come under pressure or tension during certain movements, which can cause shooting pain.
Lumbago (Back Pain) Symptoms
Sometimes a certain rotation or lateral bending of the torso or the courageous lifting of a load, such as a crate of drinks, is enough to trigger lumbago. The sudden, severe back pain, which often radiates through the buttocks into the leg, leads to cramping of the back muscles and a relieving posture, which is usually aggravated by the fact that the person concerned tries to avoid another painful shooting.
In most cases, lumbago is a form of non-specific back pain. In the case of lumboischialgia, i.e. when the sciatic nerve is irritated, the pain radiates at least into the foot. The pain in the leg is then often stronger than in the small of the back. Nerve pain is typically sharp and electrifying, accompanied by tingling and numbness in certain areas of skin (dermatomes) associated with the injured nerve.
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Lumbago (Back Pain) Treatment
In the case of non-specific lumbago, the same treatment recommendations apply as for other non-specific back pain. In the first few hours and days, when the pain is still very severe, physical applications such as cold or heat, painkillers such as ibuprofen or diclofenac can help to overcome the unfavorable relieving posture as quickly as possible and to resume the usual movement sequences. Manual therapy methods, also called chirotherapy or chiropractic, can help.
The chiropractor exercises a targeted, often jerky hand movement in the affected section of the lumbar spine; In this way, he maneuvers the complex structure of the spine and back muscles, which have gotten into a tense imbalance, back into balance. This can provide short-term relief. After that, it's all about preventing further pain events - and not by resting or immobilising, which tend to aggravate the problem, but by persistent training of the back muscles. Movement therapy is therefore the be-all and end-all, combined with various pain-relieving and relaxing measures as well as counseling sessions that are suitable for exploring how to deal with your own body, the attitude you have in life, as well as interpersonal and professional stress factors and so on adapt so that the back also emerges strengthened in a figurative sense.
Tip: Common painkillers such as diclofenac or herbal alternatives such as arnica or comfrey are available in preparations for external use. An advantage over taking painkillers is that the active ingredient does not get into the bloodstream in significant quantities when used externally, but only to where it hurts. Therefore, externally applied funds are particularly well tolerated and low-risk. The effect can be enhanced by iontophoresis. Iontophoresis is a form of electrotherapy in which weak electrical currents pull the externally applied drug deeper into the tissue.
Operations are rarely necessary
In the case of additional nerve pain, the treatment is based on the cause of the disease. The reason for irritation of the sciatic nerve is usually a herniated disc, although only a small proportion of all herniated discs cause symptoms and require treatment. Even the herniated discs, which put nerves under pressure, only need to be operated on to a small extent. Non-surgical treatment, as in the case of non-specific back pain, is usually sufficient. In addition, certain drugs that are otherwise used to treat depression (antidepressants) or seizures (anticonvulsants) can have a pain-relieving effect on nerve pain. Antidepressants are more likely to be used for persistent pain, anticonvulsants for attacks of shooting pain or if an antidepressant proves to be ineffective for two to four weeks.
In the case of very severe nerve pain, in addition to the usual over-the-counter painkillers, temporary treatment with prescription morphine-like painkillers (opioids) may be indicated, provided that there are no contraindications such as addiction or mental illness. In order to reduce the risk of drug dependency, you should only use slow-acting preparations (sustained-release preparations) and adhere to regular intake at certain times.
Lidocaine plasters are particularly suitable for the external treatment of nerve pain. Lidocaine is a local anesthetic. Externally applied capsaicin, the stimulant from the chili pepper, can also be indicated in certain cases; whether this is promising in individual cases depends on the neurological findings. Invasive pain therapy measures only make sense in individual cases, such as the surgical insertion of an electrical stimulation probe, nerve blocks - similar to anesthesia close to the spinal cord before operations - and the injection of cortisone-like agents (glucocorticoids) close to the nerves. These methods require careful consideration of the expected benefits and associated risks and are only indicated when all other therapeutic options have been exhausted or are not an option.