Lumbago: What It Is and Why the Lower Back Suddenly 'Shoots'

Lumbago is acute pain in the lower back that appears suddenly and does not always have a clear cause. A person freezes with the feeling that their back has locked up and is afraid to make an extra movement. Below is what is known about the mechanism of such pain, how it differs from other conditions, and in which cases one should not delay.

What is lumbago

Lumbago (from the Latin lumbus — lower back), commonly called a 'shot', is acute pain in the lower part of the back regardless of its causes and nature of manifestation. The term describes a symptom, not a diagnosis: various conditions may underlie it. Lumbago is often confused with sciatica, although they are not the same thing.

Back pain is one of the most common medical problems: 8 out of 10 people experience it at least once in their life. Pain that occurs suddenly and lasts from several days to several weeks is considered acute; if it persists for more than three months, it is a chronic form. Lumbago is more common in men aged 30–40.

Why the lower back suddenly shoots

The lower back is the hinge between the heavy torso and the pelvis; the load is borne by the vertebrae, intervertebral discs, and the musculoligamentous corset.

The causes are most often overstrain of the lumbar region, lumbar hernias, vertebral displacement, congenital or traumatic vertebral anomalies. Severe sudden lumbago when bending or lifting heavy objects is explained by displacement of the intervertebral disc or significant tension of muscles and ligaments. If sciatica is added, the probable cause is disc displacement.

Mechanism of pain: receptors of the fibrous ring of the affected disc and adjacent ligaments are irritated, in response the lumbar muscles tense — this spasm is what a person feels as 'locked up'. Rarely, the cause may be rheumatic diseases, certain infections, or tumors. In 30% of patients, even with modern methods, the cause cannot be determined.

How lumbago manifests

Pain appears at the moment of intense physical exertion or immediately after it. An attack is provoked by overheating with sweating and subsequent cooling. The nature of the pain is tearing, throbbing, stabbing, shooting; it is felt deep in the muscles, ligaments, bones.

During an attack, a person is helpless and freezes in a forced position: any movement intensifies the pain, and spasm of the lumbar muscles develops. Pain lasts from several minutes to several hours and days. At rest and lying on a hard surface, it subsides. Sometimes severe pain disappears as suddenly as it appeared — with the feeling that 'something has fallen into place' in the lower back.

What may hide behind acute lower back pain

A common cause is injury such as muscle strain. But other conditions may present with a similar picture.

• displacement of the intervertebral disc, including hernia;
• nerve entrapment, sciatica;
• ankylosing spondylitis;
• rarely — bone fracture, tumor, or infection.

How a doctor distinguishes lumbago from other causes of pain

The doctor determines when and after what the pain began — suddenly, after exertion, or injury. They ask about weakness, numbness, changes in urination and bowel movements, weight loss, fever.

Examinations include X-ray, MRI, myelography, and discography.

When lower back pain requires urgent medical attention

One should see a doctor if the pain does not ease after home measures for several weeks, interferes with daily activities, or the person cannot cope with it. A reason for consultation is unexplained weight loss, swelling or change in the shape of the back, pain that does not go away after rest, worsens at night, with coughing and sneezing, as well as pain from the upper back between the shoulder blades.

If the pain arose suddenly, is very severe or rapidly increasing, and the person feels fever, chills, or general malaise, urgent medical help is needed. After a serious injury, such as a car accident, the back requires examination.

Lumbago itself is not a reason to call an ambulance. 103 or 112 — if lower back pain is accompanied by at least one sign: numbness, weakness, or tingling in both legs; loss of sensation in the genital and anal area; urinary and bowel disturbances — difficulty urinating or incontinence; changes in sensation during sexual intercourse; chest pain; pain began after a serious accident, such as a car crash.

This material is for reference: it does not replace a doctor's consultation and does not establish a diagnosis.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer