Orthopedics-Online

Lumbar spine syndrome

Localization of pain in the lumbar spine syndrome

Synonyms in a broader sense

Lumbar spine syndrome
Lumbago
chronic back pain
chronic lumbar spine discomfort
Lumbar Spine Pain Syndrome

English: low back pain

introduction

This article is mainly written from a physiotherapy / physiotherapy point of view.

The term Lumbar spine syndrome does not describe an independent clinical picture that can be traced back to certain anatomical or morphological conditions, but is a collective description (Syndrome) for various symptoms (symptoms). The main symptom of the lumbar spine syndrome is the local one related to the lumbar spine Back pain.

The majority of all adults already have experience with the topic "Back pain“Need to collect. Almost everyone will suffer from back pain at least once in their life. Hardly any other orthopedic symptoms have seen such a rapid increase in recent years as the number of patients with back pain in need of therapy. Pain in the region of the Lumbar spine (Lumbar spine) can be roughly divided into two large areas:

more acute and
chronic Subdivide back pain.

Appointment with a back specialist?

I would be happy to advise you!

Who am I?
My name is dr. Nicolas Gumpert. I am a specialist in orthopedics and the founder of .
Various television programs and print media report regularly about my work. On HR television you can see me every 6 weeks live on "Hallo Hessen".
But now enough is indicated ;-)

The spine is difficult to treat. On the one hand it is exposed to high mechanical loads, on the other hand it has great mobility.

The treatment of the spine (e.g. herniated disc, facet syndrome, foramen stenosis, etc.) therefore requires a lot of experience.
I focus on a wide variety of diseases of the spine.
The aim of any treatment is treatment without surgery.

Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

You can find me in:

Lumedis - your orthopedic surgeon
Kaiserstrasse 14
60311 Frankfurt am Main

Directly to the online appointment arrangement
Unfortunately, it is currently only possible to make an appointment with private health insurers. I hope for your understanding!
Further information about myself can be found at Dr. Nicolas Gumpert

Figure lumbar spine syndrome

Broad back muscle -
M. latissimus dorsi
Twelfth thoracic vertebra -
Vertebra thoracica XII
First lumbar vertebra -
Vertebra lumbalis I
Broad back muscle -
M. latissimus dorsi
Iliac crest -
Iliac crest
Fifth lumbar vertebra -
Vertebra lumbalis V
Gluteus Middle -
M. gluteus medius
Gluteus Muscle -
Gluteus maximus muscle
Sciatic nerve -
Sciatic nerve
Iliac scoop -
Ala ossis ilii
Lumbar sacrum nerve plexus -
Lumbosacral plexus
Tailbone -
Os coccygis
Femoral shaft -
Corpus femoris
A. - pancreas
B. - Uterus
C. - urinary bladder
D. - Sciatic nerve

You can find an overview of all Dr-Gumpert images at: medical illustrations

Causes of a lumbar spine syndrome

The causes of lumbar spine syndrome are numerous. The most common cause of pain in the lumbar spine syndrome is degenerative changes in the lumbar spine.
These include, in particular, protruding discs in the lumbar spine (Protrusion) and herniated discs of the lumbar spine (Prolapse), which can lead to nerve pain in the back, as well as arthritic changes in the vertebral bodies and joints, such as osteochondrosis.
Spinal stenosis of the lumbar spine (Vertebral body tightness) and a spondylolisthesis (Vortex sliding) can result from wear and tear on the spine and cause lumbar spine syndrome. Muscle tension and poor posture of the back due to weakness in the back muscles are also common causes of a lumbar spine syndrome.

osteoporosis

Another important cause of complaints in the context of a lumbar spine syndrome are injuries to the spine, for example vertebral body fractures. Vertebral body fractures can result from trauma to the spine (for example in a car accident), but more common are so-called osteoporotic vertebral body fractures, i.e. vertebral body fractures caused by osteoporosis. In osteoporosis, which can also be referred to as bone loss, there is a breakdown of bone material and thus a decrease in bone density and strength of the bone, which can lead to fractures, among other things in the spine.

Read more on the topic: What kind of pain occurs with osteoporosis?

Another disease, osteomalacia, in which there is a mineralization disorder of the bones, is less common and causes vertebral body fractures.
Read more on this topic at: osteoporosis

Another important cause of a lumbar spine syndrome is the group of inflammatory diseases of the back, which can be rheumatic and infectious in origin. Inflammatory diseases of the back of rheumatic origin include Bechterew's disease, reactive joint inflammation (e.g. Reiter's syndrome), enteropathic spondylarthritis (an inflammation of the joints associated with chronic inflammatory bowel diseases such as Crohn's disease or ulcerative colitis), psoriatic spondylarthritis ( joint inflammation associated with psoriasis) and the undifferentiated joint inflammation that often occurs in children and adolescents.

In very rare cases, tumors of vertebral bodies in the lumbar spine or congenital malformations of the lumbar spine, such as scoliosis (lateral curvature of the vertebral body), are the cause of a lumbar spine syndrome.

Read more on the topic: Causes of a lumbar spine syndrome

Symptoms

The Lumbar spine syndrome (lumbar spine syndrome) refers to a collection of various complaints in the lumbar spine area.
This Symptoms affect either the region of the Lumbar spine themselves or start from this region and can go up to coccyx radiate.
Symptoms in this area are more common than other areas Spine, as the lumbar spine is exposed to particular loads.

Affected patients often describe that the Pain suddenly has occurred and the strength depends on the position in which you are currently.
Certain behavior on the part of the patient can make the pain feel stronger or weaker, for example when walking or sitting.
In addition, the intensity of the symptoms can vary when:

to cough
Sneeze
or
Press

be reinforced.
The pain itself is often called Dull pain, less often as a sharp pain.
The most common cause this sudden, stabbing pain is a Lumbago (lumbago), often preceded by a Bad posture of the Lumbar spine and then suddenly becomes very painful with a certain movement. Lumbago is most common with jerky movements, heavy lifting or bending.

If the symptoms start rather insidiously, this indicates an increased Wear (degeneration) of the lumbar spine down.
Here you can Vertebral joints, Tapes and muscle equally affected.
Other causes, such as inflammation, tumors, or deformities, are less likely to be the cause of this Lumbar spine syndrome (lumbar spine syndrome) found.
In addition, the pain can be localized in the lumbar region, but originate in the internal organs (for example uterus, pancreas or bladder).
This is also rather rare, but requires more detailed clarification in order to malignant neoplasms (carcinomas) to be able to recognize early.

The symptoms of Lumbar spine syndrome (lumbar spine syndrome) According to its name, it is mostly located in the lumbar spine itself, but it can also be above or below the lumbar spine be localized. The symptoms rarely radiate to the extremities (legs). If the pain does radiate to the extremities, it often is Sciatic nerve (sciatic nerve) affected.
Doctors call this sub-form of the lumbar spine syndrome Lumboischialgia or Lumbar root syndrome.

Radiate the symptoms as described above into the legs and additional symptoms such as:

deafness
tingle
or
Signs of paralysis

observed, a doctor should be consulted urgently.
Does it come in addition or in isolation? Bladder and bowel disorders, this is particularly alarming and should therefore be clarified in an emergency.
These ailments often go with you acute herniated disc hand in hand, so that an operative intervention is necessary to the annoy in the Spinal cord to relieve again.

Besides the Back pain it can too increased sweating at night come. It is not uncommon for patients to sweat so much that a change of bed linen is inevitable.

Step next to the Back pain also has fever attacks an inflammatory disease of the lumbar spine (e.g. a Spondylodiscitis) to be clarified. This is a medical emergency.

Pain

Pain in lumbar spine syndrome is expressed as Back pain in the lumbar spine, which extends into the tailbone, into the legs and even into the feet radiate can. Pain associated with lumbar spine syndrome is from pulling, stabbing or dull, pressing character different intensity and are characterized by a sudden, sudden occurrence out. It can become a Chronification the pain comes, i.e. the pain can persist over a longer period of time.

In addition to the pain, the lumbar spine syndrome can lead to other complaints such as Sensory disturbances, for example Numbness, Pins and needles or tingling, as well as to one Reduced strength the legs come.

Pain in the context of a lumbar spine syndrome should definitely treated otherwise it will become an avoidance of movement and a long-term one Bad posture of the back can come. Usually preparations from the group of non-steroidal anti-inflammatory drugs are used to relieve pain in the lumbar spine syndrome (NSAIDs), how Ibuprofen, Diclofenac or Naproxen applied. In the event of intolerance or contraindications to NSAIDs, alternatively Paracetamol can be used, which also has an analgesic effect via a different mechanism than the NSAIDs. If the pain in the lumbar spine syndrome does not respond to the drugs mentioned, stronger painkillers from the group of Opioids, like for example Morphine or Tramadol be applied.

Also read: MRI back

Localization of pain in the lumbar spine syndrome

When patients over Back pain complain, complaints are common in the field of Lumbar spine meant.
Alternatively, the term problems with the spine or back pain is also used in the case of a lumbar spine syndrome.
As a rule, the pain is felt as dull or aching. In part, this pain can turn into the legs radiate. This form of Back pain is also known as Lumboischialgia designated.

Acute lumbar spine syndrome

Acute complaints in the lumbar spine syndrome:

A large proportion of these complaints result from a herniated disc in the lumbar spine (prolapse). Most herniated discs are found in the lumbar spine (lumbar spine) area.

While herniated discs in the cervical spine (cervical spine) are still quite common, they are very rare in the thoracic spine (thoracic spine) area.

Many patients with sudden (acute) back pain are primarily concerned that a herniated disc of the lumbar spine could be the cause of their symptoms. The clinical picture is widely "known" and is classified as serious and dangerous - and not without good reason.
Little is known about other diseases that can lead to an acute lumbar spine syndrome or so-called “lumbago”. At most, the term “blockage of the lumbar spine” in the broader sense for the presence of a lumbar spine syndrome is still known. Patients usually understand it to be an acute back pain that leads to limited physical mobility and resilience.

Characteristic signs of a herniated disc of the lumbar spine are:

A sharp back pain that pulls into the leg (lumbar sciatica), which often radiates into the foot. In most cases, however, lumbar sciatica has a more harmless cause.
Pain exacerbation from sneezing, coughing or pressing.
The pain in the leg outweighs the back pain.
There are abnormal sensations (paraesthesia; e.g. tingling, pins and needles) or reduced sensations (hypesthesia; e.g. "as if the foot were wrapped in cotton wool") in the area of the legs.
There is paralysis or a loss of strength in certain muscle groups (difficult toe or heel position).
Loss of control of urination or bowel movements (incontinence).

In any case, if you are unsure about the cause of the disease, you should consult a doctor (orthopedic surgeon).

Further information on the subject of herniated discs can also be found at:

Herniated disc of the lumbar spine
- Symptoms of a herniated disc of the lumbar spine
Tingling sensation indicating a herniated disc
L5 syndrome

Chronic lumbar spine syndrome

Chronic complaints of the lumbar spine syndrome

Diseases such as:

Osteochondrosis = joint disease of the intervertebral disc and vertebral body in the context of wear-related (degenerative) changes.
Spondylarthrosis = arthrosis of the vertebral joints (facet syndrome)
Small herniated disc (herniated disc of the lumbar spine)
Disc protrusion of the lumbar spine
Spinal canal stenosis = tightness of the vertebral canals caused by wear
Spondylolisthesis / Spondylolysis = sliding vertebrae
Scoliosis = lateral curvature of the spine
Muscular insufficiency = weakness of the back muscles
Chronic muscle tension = painful muscle hardening / cramps
Osteoporosis = bone loss
Vertebral body fracture = mostly osteoporotic vertebral fracture
Etc.

Most of these clinical pictures can be summarized under the term degenerative spine disease.

The above Disease pictures can occur in combination with one another or as a single disease. In the case of severe, wear-related changes in the spine, differentiating the cause of pain is very difficult. For detailed information on individual clinical pictures, please follow the link.

The application of physiotherapy and physical therapy measures is very successful in the treatment of the lumbar spine syndrome and is routinely used, at least in hospitals.

diagnosis

Since the lumbar spine syndrome does not in itself describe a disease of its own, the possibilities for diagnosis are also very different.
LWS syndrome is called the local lumbar pain which can have a variety of causes.
Through the targeted anamnese The possibility of the causes of the pain can be narrowed down many times over. The doctor asks about the location, duration and type of pain but also whether the pain changes in different situations.

The pain is dependent on movement and causing one Restriction of movement, the most obvious cause is one Muscle tension in the lower back. The question of the profession and everyday life can provide further clues. Already a physical consideration reveals bad posture, which often indicates a long-standing problem. Which includes Hollow crosses or lateral curvatures of the spine.

If the problem is muscular, that can also be passed Palpation of the back muscles determine. In this case, these are hardened and sensitive to pressure.

If the patient names a specific event, for example an accident, as the cause of the pain that occurs, muscular problems are less likely.
Are involved in a neurological examination Spinal nerves near or if the accident occurred while bending down or lifting heavily, diagnostic equipment should be used.
Which includes roentgen, CT and MRI of the lumbar spine Recordings. There is a suspected diagnosis of one Intervertebral disc prolapse or Herniated disc of the lumbar spine.

In severe cases, with the participation of annoy acute symptoms of paralysis occur. The diagnosis must be confirmed quickly, and MRI is the first choice. An X-ray image shows mainly bony structures well, whereas the MRI can show soft tissue in particular in detail.

On the image of the MRI, the doctor can then assess the shape and the damage to the intervertebral disc and in which direction the damage can spread. Based on this assessment of the picture, which is very detailed compared to the other diagnostic options, the doctor can plan a targeted therapy. Even in the rare case of one Tumor, of the Back pain caused, the diagnosis can be made with an MRI image.

In extremely rare cases you can Borreliosis or Herpes infections cause similar pain.
If nothing can be seen on the MRI image, such pathogens can be detected by a Blood test determine.

Lumbar spine syndrome or facet syndrome

The so-called facet syndrome is a degenerative disease of the facet joints. Together with the intervertebral discs, these form the connection between neighboring vertebral bodies. Characteristic of the pain that occurs in facet syndrome is an aggravation of the pain after exertion or when the upper body is bent back. Often the pain radiates down to the legs out.

In contrast, the lumbar spine syndrome occurs frequently Numbness or a changed sensation in the legs.

Read more on this topic in our article: Facet syndrome

ICD 10

ICD is the abbreviation for "International Statistical Classification of Diseases and Related Health Problems". This is an international, statistical one classification for diseases and health problems. The current version is the ICD-10, whereby in Germany the ICD-10-GM (stands for “German Modulation”), ie a version specially tailored to Germany, is valid.

Each clinical picture has its own code, i.e. an encryption that consists of letters and numbers. Back pain in general all starts with M54. The numbers that come after that indicate how exactly the back pain is classified. In the case of lumbar spine syndrome, the encryption is M54.1.

GdB

The GdB (Degree of disability) depends on the Restriction of the patient. A careful examination and subsequent assessment by an orthopedic surgeon or trauma surgeon must be carried out.

If there is no restriction of movement or instability of the spine, this corresponds to a GdB of 0. In the case of slight restrictions due to recurring short spinal symptoms, this corresponds to 10, in the case of frequently recurring problems that last several days, 20. If 2 spinal sections are affected, this corresponds to a GdB of 30 to 40, with stiffening of large parts of the spine 50 to 70. The values 80 to 100 are reached in the heaviest Exercise problems up to Inability to stand.

Therapy of a lumbar spine syndrome

Since the Lumbar spine syndrome to a collection of various complaints in the field of Lumbar spine acts, must depending on the Origin of pain another Therapeutic approach to get voted. That is why it is particularly important to have an accurate anamnese (survey of the medical history) is collected so that the cause of pain can be narrowed down as well as possible.

The most common cause for the acute, sudden one Lumbar spine syndrome is the Herniated disc (prolapse of the lumbar spine).

At the Herniated disc of the lumbar spine pushes the shifted Intervertebral disc on annoy in the Spineso it too Pain and Paralysis that often radiate into the legs.

If the herniated disc has recently occurred, the first goal of therapy is to reduce the patient's pain. Already in this phase the pain of the patient can be actively determined physiotherapeutic positioning maneuvers be alleviated, for example by the Step storage. If the pain is more severe, a MRI image of the lumbar spine of the back can be made to recognize where and how strong the Intervertebral disc presses on the nerves.

Is this through conservative therapy like:

Protection
acupuncture
or
physical therapy

not to be treated, an operation for the herniated disc of the lumbar spine must be considered as a solution.

Basically it is surgery the conservative methods of treatment but only think about it if the patient is already Signs of paralysis has in the legs. In addition to physical therapy can warming tapes or Compresses be applied. During the entire therapy it should always be ensured that the patient is through appropriate Medication with pain relievers is as painless as possible.

Please also read our topic: Operation of a herniated disc in the lumbar spine

In rare, particularly severe cases, the patient is advised to have an operation in which the adjacent vertebral bodies are stiffened (Spinal fusion).

In order to prevent the future development of the lumbar spine syndrome, I should give the affected patient precise instructions from their doctor or physiotherapist Posture in everyday life as well as for sporting or physiotherapeutic activities that protect the injured regions in the back and counteract renewed damage.

Home remedies

The simplest treatment for the symptoms of lumbar spine syndrome is one Change of attitude and an optimization of certain movement sequences. It is especially important when To lift of objects to make sure that you get enough into the knee goes. When straightening up from a lying position, care should be taken to roll over to the side to take the strain off the back. Also one Step storage sleeping with the legs raised and the knees bent at right angles is advisable to relieve the discomfort.

walks can help to relax yourself and thus loosen up your muscles. Likewise is warmth usually helpful for back pain.

homeopathy

An attempt can be made to relieve the pain of a lumbar spine syndrome with the help of homeopathic remedies. On the one hand there are creams with active ingredients that can be applied to the painful area or globules can be taken. It is recommended Rhus toxicodendron Apply as a gel or take 5 globules 3 times a day. Also Aconite and Bryonia Colocynthis are said to be helpful for lower back pain.

Kinesio tapes

The application of kinesio tapes can alleviate the symptoms of a lumbar spine syndrome. On the one hand, this is because the tapes give the back more stability and the posture is generally often improved by pulling the tape. On the other hand, the tapes cause the movement to generate friction between the skin and the underlying tissue, which causes warmth arises. Warmth is particularly helpful in the case of muscular imbalances and relaxes the muscles.

Used to tape the lumbar spine area four tape strips needed. The patient should sit slightly bent over. The first strip is under the painful area maximum tension glued along the spine. The second strip will horizontal glued over the pain point so that the two tapes are attached to the Pain point cross. The other two strips will be diagonal glued so that at the end a star is created. When straightening up, the tapes should pucker.

Lumbar spine syndrome in pregnancy

During pregnancy, women often complain of back pain in the lumbar spine area. This is also referred to symptom-oriented as the lumbar spine syndrome. The causes for this can be very different. Often it is disc-related pain, as there is an increased risk of disc protrusions and herniations in pregnant women.

But the symptoms of a lumbar spine syndrome can also arise from the growing baby and the increasing expansion of the uterus. The baby needs more and more more room in the lower abdomen and the pressure on the Sciatic nerve can increase as a result. It creates a Lumboischialgia.

The lumbar spine syndrome can also occur due to the shift in the body's center of gravity due to the increasing abdominal girth. The reason for this is often muscular imbalancesas the pregnant woman adopts a different posture. In addition, the back muscles are generally more stressed during pregnancy and tension in the muscles or blockages in the vertebrae can arise.

The following article may also be of interest to you: Back pain in pregnancy

Lumbar spine syndrome with abdominal pain

A lumbar spine syndrome can also be accompanied by abdominal pain, depending on the cause. If there are deformities of the spine, the deformation can exert increased pressure on the abdominal organs. Depending on how that deformity is pronounced, different postures can improve or worsen the abdominal pain.

On the other hand, pain in the lumbar spine without a cause must always be thought of as an organic disease. Are there inflammations or other diseases of the Abdominal organs before, this pain can also radiate into the lower back. For women, definitely should gynecological disease be excluded.

Lumbar spine syndrome with abdominal pain

In women, the cause of back pain is often not at all in the back itself, but radiates from the abdomen to the lower back. The pain can cycle-dependent occur and in most cases occur at the time of ovulation or the onset of menstrual bleeding. But abdominal pain that is independent of the cycle can also occur. Here should definitely be by one Gynecologist clarified whether there is an organic disease.

Lumbar spine with lumbar sciatica

Lumboischialgia causes pain in the area supplied by the sciatic nerve and in the lumbar spine area. The most common cause of this is a disc prolapse or one Intervertebral disc bulge. This compresses the sciatic nerve and creates pain and possibly Numbness or Paresthesiathat can stretch along the thigh to the lower leg and foot. But inflammation or tumors of the spine can also lead to a Lumboischialgia to lead.

Lumboischialgia with numbness

Numbness in the legs or feet often occurs when a disc prolapse (Prolapse) is the cause of the pain. Then the leaked core of the intervertebral disc can press on a spinal nerve and this pressure can cause a Numbness arise. This can be improved for a short time by raising your legs. However, it can also become chronic if the compression of the nerve continues for a long time.

Duration

The Duration of a lumbar spine syndrome is very variable and depending on its cause and the extent of the lumbar spine damage. Depending on the cause, lumbar spine syndrome occurs conservative and operative therapeutic measures into consideration, the duration of which can vary greatly.

As soon as possible, even after a surgical procedure, it should be carried out more regularly physical therapy and performing exercises for Building the back muscles can be started as this accelerates the healing process and the duration of the illness can be shortened.

Therefore the gift of is also important pain reliever drugs, as they allow the back to move painlessly.

If the cause of the lumbar spine syndrome is not treated or treated too briefly, it can lead to one Chronification of the complaints come, that is, the complaints can last for a longer period of time.