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Pain in the lumbar vertebrae
Since the lower area of the lumbar spine is exposed to most stresses in everyday life, the most common complaints, the so-called lumbar vertebral pain, arise there. This is usually referred to as lumbar spine syndrome or lumbago. While this pain is not an independent disease, it does indicate that something is wrong with the spine.
The origin of the symptoms can also be located elsewhere in the body. With diseases of the kidneys, genitals, pancreas and gallbladder, radiating pain in the area of the lumbar spine is possible. The "real" back pain, however, has become a widespread disease. Unfortunately, the people affected are getting younger and often children are already affected.
Anatomy of the spine
The entire spine consists of a total of thirty-three or thirty-four vertebrae and is divided into five sections. So the head sits on the cervical spine, which consists of seven cervical vertebrae. It represents the most flexible part of the spine. This is followed by the thoracic vertebrae area, consisting of twelve thoracic vertebrae. This is followed by the lumbar spine (LW) with its five vertebrae, which represent the largest vertebrae in humans.
The lumbar spine passes into the sacrum, which consists of five fused vertebrae. This fusion begins between the ages of sixteen and eighteen and is about twenty-five. The sacrum is the middle of the pelvis and is articulated with both hip bones, although this joint does not live up to its name because it is almost immobile. The tail of the spine forms the tailbone, in which the three to five vertebral rudiments are also fused.
The spine ensures upright walking, forms the pillar of the human body, allows movement, dampens shocks and vibrations with the help of the intervertebral discs and provides protection for the spinal cord.
Causes of Lumbar Pain
Lower back pain is common. These symptoms can occur both acutely and chronically. Low back pain is often of a chronic nature, the main reasons being incorrect posture, one-sided stress and a lack of exercise.
Colloquially, the term "lumbago" is used for lumbar pain. In technical terms, however, there is talk of lumbago or acute LWS syndrome.
The LWS syndrome is not an independent clinical picture but summarizes various symptoms in the area of the lumbar spine. A distinction is made between two types, namely acute lumbar spine syndrome, often also referred to as lumbago, and chronic lumbar spine syndrome. In both cases, lumbar vertebral pain is in the foreground, but it can also spread to other parts of the body. The pain that occurs is dull, pulling or shooting, localized or radiating to the legs.
Sudden onset of massive pain can be found in acute lumbar spine syndrome. Careless movement, carrying or lifting heavy loads and long-standing wear and tear are the most common causes. Improper posture, standing or sitting too long, incorrectly carrying or lifting heavy objects leads to tension over a long period of time, resulting in pain. These then require careful posture, which in turn leads to tension in the muscles and subsequent pain in the lumbar region. Thus the so-called vicious cycle begins.
Not infrequently, a lumbar spine syndrome arises due to a herniated disc. Intervertebral discs are so-called buffers between the vertebrae. They consist of a fiber ring and a gelatin core. This core has the task of distributing the pressure on the fiber ring and thus cushioning it. Intervertebral discs tend to age relatively early.
The ability of the jelly nucleus to absorb some fluid at rest at night decreases over the course of life. This makes it drier, the elasticity is reduced and the fiber ring wears out more and more. It can tear due to incorrect loading that has existed for a long time, whereby the gelatinous nucleus bulges over the edge. This bulging, which can then press on different nerves, is called a herniated disc. This can cause sensitivity disorders, but also paralysis. Obese and pregnant women are at risk for a herniated disc.
Chronic lumbar spine syndrome arises from wear and tear. Slow wear of the intervertebral discs or vertebrae leads to the most varied clinical pictures of the lumbar spine. This includes, for example, scoliosis. This is a lateral deviation of the spine from the normal shape. It usually arises in times of growth. Other causes of the lumbar spine syndrome and associated pain in the lumbar spine are blockages of the vertebral bodies, arthrotic or bony changes, inflammatory diseases, congenital malpositions, vertebral sliding, growth disorders, tumors or metastases, accidents and osteoporosis.
In many cases, the symptoms arise from the lack of back muscles, which are primarily intended to protect the lumbar region. A weak hull cannot absorb shocks and incorrect loads and leads to problems in the area of the lumbar spine. A well-developed back muscles, on the other hand, can protect and support the trunk in such a way that there is little or no pain, even if there are already diseases. However, good back muscles are not enough to completely avoid discomfort. The opposite - the stomach - should also be trained and both should be in a healthy balance. Too much abdominal muscles could also cause incorrect stress.
Muscles that are not challenged recede, but the opposing muscles are overused and tense. This leads to reduced blood circulation in this area, which is why the local pain receptors raise the alarm. The pain cycle begins.
Lumbar pain associated with symptoms such as fever, fatigue, joint pain and nerve disorders are an acute matter that needs to be clarified by a doctor as soon as possible.
Metabolic diseases as the cause
Among other things, rickets and osteomalacia are possible causes of lumbar pain. Both diseases indicate a softening of the bones in which the hardness of the skeleton decreases. Rachitis is a childhood disease, whereas osteomalacia affects adulthood. In both forms, vitamin D deficiency is the cause. Vitamin D is essential for the influx of calcium into the bones. The lack of this vitamin leads to stunted growth at a young age and deformity of the chest and vertebrae in adults. Both rickets and osteomalacia are associated with pain in the lumbar spine.
Another condition that can be associated with lumbar pain is osteoporosis. The balance between the build-up and breakdown of the bones is disturbed and the breakdown predominates. The bones tend to break more easily. This may also affect the vertebrae, which can result in massive back pain.
Diagnosis of lumbar pain
In order to clarify the causes of the symptoms, a thorough medical history as well as physical and neurological examinations are important. An MRI is usually ordered to rule out a herniated disc, for example. Other imaging methods used in diagnosis are CT, ultrasound and X-ray. A referral to a neurologist may also be indicated.
Treatment of pain in the lumbar spine
Here the focus is on treating the cause. In the case of acute lumbar vertebral pain, some protection and oral pain relievers are initially prescribed or injections with local anesthetics or analgesics (analgesic drugs) are carried out. Antiphlogisitka (medications that have an anti-inflammatory effect), such as cortisone, are also used.
If there is massive muscle tension, muscle relaxants (drugs that relax the muscles) help. The short-term use of a pain reliever interrupts the pain cycle, the patient can relax better and leaves his gentle posture, which relieves the muscles. Even with pain in the lumbar spine, warmth is usually perceived as beneficial. Special heat plasters can provide relief here.
The so-called step bed storage relieves the lumbar spine. The back should lie completely flat on a mat and lower leg parallel to it, i.e. the upper and lower leg at right angles to each other. It is best to do this several times a day, using pillows or folded blankets. While rest relieves the spine, lying there for a long time can sometimes make the symptoms worse, because the muscles need movement.
In most cases, individually adjusted physiotherapy is prescribed for lumbar vertebral pain. Massages, electrotherapy and manual therapy are also included. Moderate exercise is recommended to patients, especially the targeted development of back and abdominal muscles. Many statutory health insurance companies offer courses in which something can be done specifically for the back weak point. In some cases, for example if you have advanced osteoporosis, a support corset is a good help. Surgery is necessary in rare cases, especially if paralysis has already occurred.
Naturopathy for lumbar pain
Muscle tension is usually the top priority for pain in the lumbar region. Cupping and Baunscheidt therapy stimulate blood circulation and increase tissue metabolism, counteract tension and can thus relieve pain. A cupping massage with circulation-promoting and warming oils also helps to alleviate the symptoms.
Anthroposophic medicine also has a large number of suitable preparations in its portfolio, which can be administered both internally and as an injection for lumbar pain. Homeopathy also offers options for treating the LWS syndrome. In order to find the right homeopathic remedy, however, it must be sufficiently repertorized (technique of homeopathic remedy selection). The type and duration of the pain, the time of day and the area in which it is spreading should be taken into account. Homeopathic remedies such as Aconitum, Bryonia Colocynthis, Rhus toxicodendron are used more often for pain in the lumbar spine.
Targeted chiropractic or osteopathic procedures can also be used to remove blockages and thus alleviate the symptoms. The use of neural therapy is often helpful, especially for acute symptoms. A local anesthetic is infiltrated, which alleviates the pain, increases blood circulation and thus makes the joints more flexible.
The reflexology massage treats far from the problem area, but can bring great relief to patients with LWS syndrome, especially in acute phases. The same applies to methods of traditional Chinese medicine, such as acupuncture.
External rubs with arnica oil, St. John's wort oil or rosemary oil round off the naturopathic therapy of the lumbar vertebral pain.
The active cooperation of the patient is part of a successful therapy in naturopathic practice. Especially in the case of back pain, those affected should strengthen their muscles by regular, targeted movement. Postural errors have to be corrected and in case of doubt the entire daily routine has to be reconsidered. The correct carrying and lifting of a heavy object must be internalized over time. Daily targeted gymnastics, sufficient exercise and the reduction of body weight support the therapy.
Prevent lumbar pain
Getting back-friendly, both from lying down and sitting, needs to be learned. The abdominal muscles should always be tense and arms and legs included for support. Getting up from the lying position is done by turning to the side, straightening sideways with the help of the arms, so that the sitting position is first taken before the person concerned moves to the vertical. An object is always lifted up out of a crouch. Work is never done in a bent position, the back should always be straight.
It is also important to pay attention to good, comfortable footwear. We also recommend that you never stay in the same position for more than thirty minutes. Relaxation exercises should be integrated into everyday life, because they help to avoid tension. If possible, excess weight should be added so that the back does not have to bear this load. Regular, moderate exercise and targeted muscle building are also recommended. (sw)
Author and source information
This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
Swell:
- Bundesärztekammer (BÄK), National Association of Statutory Health Insurance Physicians (KBV), Association of Scientific Medical Societies (AWMF): National Care Guideline for Non-Specific Low Back Pain - Long Version, 2nd Edition, Version 1, 2017, (accessed on September 2, 2019), AWMF
- Jan Hildebrandt, Michael Pfingsten: Back pain and lumbar spine, Urban & Fischer Verlag, Elsevier GmbH, 2nd edition, 2011
- Hans-Dieter Kempf: The New Back School, Springer Verlag, 2nd edition, 2014
- Jürgen Krämer, Joachim Grifka: Orthopedics, trauma surgery, Springer-Verlag Berlin Heidelberg, 9th edition, 2013
- Bernhard Greitemann et al .: S2k guideline on conservative and rehabilitative care for herniated discs with radicular symptoms, German Society for Orthopedics and Orthopedic Surgery (DGOOC), (accessed September 2, 2019), AWMF
- Dietmar Wottke: The great orthopedic back school, Springer Verlag, 1st edition, 2004
