Lumbago (Low Back Pain)

The patient typically complains of intense ripping pain in the low back region occurring suddenly after complete freedom from symptoms. Frequently, minor movements, such picking up objects, rotating the upper body, or standing up after bending over can trigger the pain. The pain may radiate from the back to adjacent regions, such as the legs and feet. In most cases, the pain restricts the patient's range of motion significantly. Lumbago may be caused by disk protrusion, a slipped disk, blockage of the vertebral joints, capsular strain, or strained ligaments.

It is important to identify the cause of lumbago as quickly as possible in order to prevent permanent damage. The first step is careful questioning of the patient. In many cases, the tentative diagnosis can be made based on information about the onset and nature of the symptoms. During the physical examination, the doctor's attention will focus on the location of painful sites and, in particular, the radiation of pain and neurological and muscular deficits. During the exam, muscle function and reflexes will be tested as well as the ability of the skin to sense touch.
If disk herniation or nerve involvement is suspected, an MRI scan may also be ordered.

Treatment of the underlying cause of back pain is an important part of lumbago treatment.
If there is blockage of vertebral joints, one can attempt to re-align the joints by manual therapy.
The first priority is to relieve the pain using anti-inflammatory drugs, which can be either taken orally or administered as an infusion. Lying flat on the back with the knees bent and the feet elevated (e.g. on a cushion or sofa) may also help to relieve the back pain. To relax the back muscles, treatment with heat packs and massages can be attempted or muscle relaxants may be prescribed.
Once the acute symptoms are under control, physiotherapy to strengthen the back muscles is an absolute must. A back training course in which the patient is shown back-sparing movement techniques is also essential.
If all of these treatments fail or if there is hardly any improvement of symptoms, injections can be administered directly into the back region. We offer periradicular therapy (PRT).

PRT (periradicular therapy):
The procedure is performed with the patient lying on the stomach. After wide-scale disinfection of the back, the affected site is located under radiographic control. Subsequently, radiographic control is used again to guide the needle through the skin and into the nerve root. The medications (e.g. an anaesthetic or cortisone preparation) are then injected via the needle. After the procedure, slight numbness in the affected region (e.g. leg region) is common. However, this generally disappears within a few hours.