One awkward movement in your day-to-day life, during exercise or at work and, just like that, you're in pain: lower back pain (lumbago, acute lumbalgia) is sudden, acute back pain, which in most cases affects the lower spine and is often triggered by everyday movements. This article will explain everything you need to know about the causes, symptoms and treatment of lower back pain.
Overview: what is lower back pain?
Who's never experienced it? One wrong move and suddenly a sharp pain shoots through your back. When muscles that are already under strain make a jerky movement, the body reacts with a kind of tension to protect itself. The deep spinal muscles cramp up. The brain reacts reflexively to prevent pain in the lower back: our muscles tense up to prevent us from making any further movements. This process acts as the body’s own protective mechanism.
The lumbar spine is often affected. In some cases, people with lower back pain can even find it difficult to stand fully straight. They find it difficult to achieve an upright posture. In the end, the acute muscle tension also affects neighbouring structures and, as a result, leads to more or less pronounced symptoms.
Although lumbago can sometimes cause very severe pain, the sciatic nerve and intervertebral discs only rarely play a role. The good news is that the lower back pain usually disappears by itself within a few days and the limits on movement are loosened. Supportive treatments and lower back pain exercises can speed up this process and put an end to the back pain.
By the way, if you’re wondering where the German term for lower back pain, Hexenschuss, comes from, you don’t have to look far: The term ‘Hexenschuss is closely linked to the folk beliefs of the Middle Ages. In those days, the sudden pain was attributed to a magical sting by a witch, or Hexe in German. The term is still used today.
First aid for lower back pain: what should you do?
What relieves lower back pain? Treatment by a doctor can help. However, sufferers can also take immediate measures themselves to alleviate the pain.
Z-lying position (relief through lying on your back)
The Z-lying position relieves the strain on your spine and relaxes your back muscles in three simple steps:
- Lie on your back.
- If possible, support your neck with a small pillow.
- Bend your legs and place your lower legs on a chair.
Important: In the Z-lying position, your lower legs and thighs as well as your thighs and hips should form a 90-degree angle.
Apply heat correctly
Heat can also relieve pain. For example, you can relax stiff muscles by taking a shower and guiding the shower jet over the painful areas. You can also use the following aids:
- Heat cushion
- Hot-water bottle filled with warm water
- Kidney belt
Keep moving
As soon as your acute symptoms have subsided, we recommend doing exercises to improve your mobility. A physiotherapist can help you learn suitable exercises.
Lower back pain: causes and risk factors
Lower back pain is usually caused by sudden tensing or straining of a muscle caused by an awkward movement such as heavy lifting, quick turns or even sitting for long periods of time.
Although lower back pain usually comes on unexpectedly, certain risk factors may lead to the occurrence of lumbago:
Degenerative spinal conditions
These include herniated discs and calcification of the vertebral joints, which can have a negative effect on the structures of the lumbar spine and lead to muscle spasms.
Weak back muscles
Insufficient strengthening of the back muscles can make the back less stable and more prone to injuries such as lower back pain.
Poor posture
Poor posture, especially when sitting or standing for long periods of time, may put excessive strain on the muscles in the lower back and increase the risk of lower back pain.
Wear and tear
As people age, signs of wear and tear can develop in the spine, increasing susceptibility to muscle stiffness and strains.
Stress, anxiety and other psychological distress
Stress, anxiety and other forms of psychological distress can also cause increased muscle tension in the back and thus increase the risk of lower back pain.
Flu and infections
Illnesses such as flu and infections can lead to general weakness and a weakened immune system, which can contribute to muscle stiffness and lower back pain.
Other risk factors
There are a number of possible causes of lower back pain. Other possible causes include:
- Lack of sleep
- Being overweight
- Predominantly sedentary work
- Drafts and cold
- One-sided or sudden stress at work
Symptoms of lower back pain
Lower back pain refers to severe back pain (usually lumbalgia), which is generally harmless and usually characterised by the following:
- Stabbing/shooting pain in the back
- Protective posture, often slightly bent forwards
- Movement restricted due to stiffness of muscles in the lower back
- Stiff, tense back muscles are tender
- Limited mobility when bending and standing up
- Increased pain when coughing, sneezing and straining
Lower back pain or herniated disc?
Lower back pain can also actually be a symptom of a herniated disc. If you have a herniated disc, you will often get neurological symptoms. These can include paralysis in the leg muscles, tingling in the leg or numbness. In such cases, people affected often find it difficult to stand on their heel or toes.
Your attending doctor can perform a series of tests to determine whether you have a herniated disc. These tests include tests of your sensitivity in your lumbar spine and your legs. Your reflexes and your mobility are also examined.
The following table shows how a herniated disc differs from lower back pain.
| Characteristic | Lower back pain | Herniated disc |
| Place of pain | Lower back, limited | Lower back with radiation |
| Radiation into the leg | No | Yes, often up to the buttocks, legs or feet |
| No | Yes, typically | |
| Muscle weakness, paralysis | No | Yes, possible |
| Onset of pain | Sudden | Sudden or progressive |
| Typical duration | Days to two weeks | Weeks to months |
| Imaging required | No, usually not | Yes, usually MRI |
Find out more about herniated discs.
When should you see a doctor about lower back pain?
Whether and when lower back pain should be checked out by a doctor depends on the accompanying symptoms and the course of the condition.
Have lumbago checked out by a doctor immediately in the event of:
- Numbness or tingling in the leg, buttocks or genital area
- Muscle weakness or signs of paralysis in the leg
- Urinary or bowel movement disorders
- Fever that occurs together with back pain
- Pain after a fall or accident
- Osteoporosis or tumour
Have lumbago checked out by a doctor in the event of:
- No improvement after about a week
- Recurring symptoms (several times a year or at ever more frequent intervals)
- Pain that occurs at night or gets worse when lying down
- Ongoing need for painkillers
How is the diagnosis made?
An orthopaedic specialist can usually diagnose lower back pain based on the typical symptoms. The course of the symptoms is recorded, the area of the pain is located, and the restrictions on movement are checked with a thorough medical history and a physical examination.
As part of the physical examination, the spine and back muscles are examined and checked for tension and tenderness. In addition, certain causes of the complaints are ruled out. These include a possible vertebral fracture due to osteoporosis or a herniated disc, which brings with it the risk of nerve damage.
Imaging techniques such as X-ray imagescan be used in some cases to confirm the diagnosis and to help detect possible degenerative lumbar spine conditions.
Treatment of lower back pain
The treatment of lower back pain aims to relieve the acute pain in the lower back and restore the patient’s mobility. Generally, the following measures can be used to treat lumbago, with the choice of treatment approach largely depending on the severity of the pain in the lower back and the specific needs of the patient:
Short-term relief
Typical measures include the short-tern relief of the strain on the affected region to prevent further symptoms. Prolonged bed rest leads to an unnecessary prolongation of the symptoms and should therefore be avoided.
Medicine: medication therapy
Anti-inflammatory medicine in the form of medications such as ibuprofen can be used to treat lumbago.
Heat and massage
Physical measures, such as heat treatments or massages, can be used in a targeted manner to relieve muscle tension, promote blood circulation and thereby help ease pain and relax the back muscles.
Physiotherapy for muscle development
Physiotherapy measures such as targeted exercises to build muscle, strengthen the back muscles and improve flexibility also aid recovery.
Complementary therapies
In some cases, complementary therapies such as electrical stimulation, acupuncture and chiropractic treatment may be considered in order to alleviate the symptoms of lower back pain.
After the acute pain has subsided, stretching and relaxation exercises are recommended. Targeted muscle training and instructions on how to lift loads can help prevent lower back pain in the future.
Lower back pain: prevention & early detection
Prevention of lower back pain focuses on strengthening the back muscles and avoiding placing excessive strain on the spine. Strengthening the surrounding muscles, improving posture and lifting technique, as well as relaxation exercises help to prevent lower back pain.
Strengthening the back and abdominal muscles
To prevent lower back pain, it is important to train your back muscles regularly. Targeted exercises that strengthen both the back and abdominal muscles help to stabilise and support the spine.
Physiotherapy as a preventive measure
Physiotherapy can also be used as a preventive measure. The training program is adapted to the individual and gradually increased. Movement sequences that help protect the back when bending, lifting, and carrying objects are learned. Doing the exercises regularly can help stabilise your back muscles in the long term and prevent relapses.
Posture and lifting techniques
Good posture and correct lifting technique prevent excessive strain on the spine. Consistent use of the correct lifting technique protects your back and therefore helps prevent lower back pain.
How to lift items in a way that protects your back:
- Get close to the object.
- Bend your knees and keep your back straight.
- Grip the object with both hands.
- Lift the load using your legs.
- Carry the item close to your body and avoid sudden rotational movements.
Workplace ergonomics
Ergonomic adjustments at the workplace and in everyday life, for example a height-adjustable desk, can also help to prevent both lower back pain and chronic back pain.
How to set up your workstation ergonomically:
- Set the upper edge of the screen at approximately eye level.
- Keep a distance of about 50 to 80 cm away from the screen.
- Make sure you sit upright.
- Place your feet fully on the floor.
- Change your position, stand up briefly or move around every 30 minutes to relieve strain on your back and muscles.
Stretching and relaxation exercises
Regular back relaxation and stretching exercises not only help to deal with lower back pain that has already occurred, they also actively help prevent tension and increase the flexibility of the back muscles.
What is the quickest way to help with lower back pain?
Short-term relief, heat and the Z-lying position can alleviate acute symptoms. In contrast, prolonged bed rest is not recommended. Physiotherapy and targeted exercises support mobility and the back muscles and can prevent the recurrence of lower back pain.
What should you not do if you have lower back pain?
Avoid prolonged bed rest, as it can prolong the symptoms unnecessarily. You should also initially avoid sudden, jerky movements and heavy strain. As soon as you feel better, gentle movement is advisable.
How long does lower back pain last?
Lower back pain usually subsides on its own within a few days. The mobility deficit is gradually eased. If the back pain persists for a prolonged period or if there is no improvement after about a week, lower back pain should be examined by a doctor.
How do you recognise lower back pain?
It typically manifests as sudden, stabbing back pain in the lower back. Tense muscles, a protective posture and limited mobility are often added to this pain. Lower back pain can also be exacerbated when bending down or standing up.
How can I sleep better if I have lower back pain?
A supportive sleeping position can alleviate back pain. If your pain is very severe, lying in the Z-position before going to bed may be helpful. Heat can also relax tense muscles.
Can lower back pain turn into a herniated disc?
Lumbago doesn’t just turn into a herniated disc. However, lower back pain can actually be a symptom of a herniated disc and should be checked by a doctor if the pain persists. A herniated disc can cause back pain similar to lumbago. It can also often cause symptoms such as numbness, tingling, muscle weakness or paralysis that can indicate nerve damage.
What are the risks of taking NSAIDs (non-steroidal anti-inflammatory drugs) for back pain?
Despite their widespread use, taking NSAIDs for pain also involves risks: Stomach discomfort, ulcers and even gastric bleeding and perforations can occur. This risk is particularly high with high doses or long-term use. Taking certain NSAIDs can also increase the risk of a stroke or heart attack. Therefore, caution should be exercised, especially in the case of people with existing cardiovascular disease risk factors.
