Lumbago is an endemic disease

By chief physician dr. med. Peter Kryger, speciality in rheumatic diseases

Back problems is an endemic disease. At some point in our lives, we will all suffer from back problems in some form. About 20% have regular problems with their back and the number of work days lost due to back problems is only second to the number lost due to colds and other diseases of the respiratory system. In most cases problems can be attributed to our way of living as overweight, heavy and uniform labour, smoking and insufficient excercise all have a role to play. With this in mind the individual effort is the single most important way to avoid a back problem.

Back problems can be divided in acute and chronic pains.

Acute Back Pain
Acute back pain is normally called lumbago. It is caused by sudden stress e.g. working in the garden, getting out of a car or standing up after sitting in an airplane seat for an extended period of time. Lumbago is either caused by cramp or a spraining of one of the small articulations of the spinal column.

Acute pains will last from a few days and for up to a week. An otherwise healthy person only needs to rest and if necessary take non-prescription medicine for the pain. After the pain subsides it is important to resume work and normal behavior in order to retain fitness. If the pain does not subside within 3-4 days, a doctor should be consulted. A doctor should be contacted at once in case of symptoms such as numbness, paralysis, bladder- or bowel problems as these point to a possible slipped disc.

X-rays
If back pains continue for several weeks, an x-ray should be performed in order to rule out rare and/or serious injury or diseases. It should be kept in mind that x-rays are only a helpful instrument to rule out tumours, broken bones or infections. In case of lumbago x-rays will not help to diagnose or explain the nature of the problem. Parodoxically, it is possible to have severe pains that will not show up on an x-ray and have an x-ray that shows osteoarthritis on a patient without any symptoms at all. A slipped disc can only be diagnosed by performing a CT- or MR-scan.

Nine out of ten will recover from lumbago within a few weeks and very few will develop chronic problems after experiencing acute back pains.

Back pains can often be attributed to social, physical and/or psychological factors, which can complicate the search for an accurate diagnosis. Even with this in mind it is important to remember that even if a reasonable explanation for a back problem cannot be offered, it is possible to succesfully treat and prevent future problems through good advice and common sense.