Lumbar Pain

Symptoms:

  • Pain occurring in the lower back (lumbar spine).
  • Stiffness particularly after getting out of bed or sitting for an extended period.
  • Difficulties standing and changing position in a flare-up.
  • Muscle spasm of the lumbar spine.

Causes:

  • Degenerative changes of the lumbar discs and facet joints with aging.
  • Herniated lumbar disc affecting the nerve root.
  • Narrowing of the space around the nerves due to stenosis of the lumbar spine.
  • Lifting or quick movement-related muscle and ligaments strain.
  • Slippage of a vertebra (spondylolisthesis) and other structural abnormalities of the lumbar spine.

Risk Factors:

  • Occupations requiring heavy lifting or prolonged sitting.
  • Overweight, causing excessive pressure on the lumbar spine.
  • Sedentary way of life and weakness of core muscles.
  • Older age and associated degenerative changes.
  • Smoking, accelerating disc degeneration.

Ways to Manage:

  • Limitation of activities during flares and then a gradual resumption of activity.
  • Physical therapy to help in strengthening the core and supporting the lumbar region.
  • Medications for relieving pain or reducing inflammation.
  • Spinal epidural or facet joint injections for chronic pain.
  • Weight reduction to take the pressure off the spine.
  • Self-lumbar stretching and pelvic tilts.
  • Bridging to help build strength in the glutes and lower back.
  • The bird-dog exercise to help strengthen the core and spine.
  • Gentle walks to keep mobile.

The vast majority of lumbar problems can be treated using conservative techniques. However, surgery may be considered in cases of nerve compression, instability or muscle weakness.

  • Microdiscectomy – for lumbar disc herniation with nerve compression.
  • Lumbar laminectomy – for spinal stenosis.
  • Lumbar spinal fusion (PLIF/TLIF/MIS-TLIF) – for instability or spondylolisthesis.