Lower back pain (lumbago) usually clears up by itself

First, the bad news: lower back pain is incredibly unpleasant. But the good news is that it usually clears up on its own and is not caused by anything serious.

Prof. Dr. med. Kan Min

12. March 2024

Man holds his back in pain
The back needs to be trained to avoid lumbago. (Image: Adobe)

Sometimes all it takes is a small, ill-considered movement and suddenly you feel a dart of pain shooting up your back. When this happened during medieval times, people were convinced that it could only mean one thing: a witch had shot them with an arrow, which is why the German term is “Hexenschuss” (witch’s dart).

This non-professional term, which is still commonly used by German speakers to this day, actually describes a severe tensing of the muscles in the lower back, while the vertebrae in the lumbar region become blocked. As a result, movement is initially restricted or even impossible. Even the slightest shift in position can be so excruciating for those affected that they have to remain in it until the worst of the pain has subsided. The discomfort is often so severe that those who are affected by it believe they may have a slipped disc. However, this is, in fact, quite rarely the cause of lumbago.

Around 10 per cent of the Swiss population experiences an acute bout of back pain every year. It affects four out of five Swiss people at some point in their lives. “It is a very common and widespread complaint”, says Prof. Dr. med. Kan Min, a specialist in orthopaedic surgery and traumatology of the musculoskeletal system and attending physician at Klinik Hirslanden and Hirslanden Klinik im Park in Zurich.

Multiple causes of lower back pain
As Professor Kan Min explains, you cannot generalise which situations are the most frequent triggers of lower back pain. “Basically, it can happen at any time and without warning. Some people experience no pain at all beforehand.” It affects women and men more or less equally, although it is those aged between 35 and 55 who mainly tend to suffer from the complaint. People who are overweight tend to be affected more frequently than those who maintain a normal weight.

In addition, the number of incidents is higher among those who work in physically demanding jobs, such as lifting, carrying, pulling or pushing heavy items. “This means that manual workers and people who are physically active are at a higher risk of suddenly experiencing a stabbing pain”, continues Professor Kan Min.

The causes of acute lumbar spine syndrome, the medical term for what is known colloquially as lumbago, are just as varied as the situations in which it occurs. Muscles – or joint capsule strains, osteoarthritis, symptoms of wear and tear, inflammation of the muscles and joints or spasms are just some of the many reasons why a “witch’s dart” can hit you.

Lower back pain? Here’s what you need to do.
The good news is that the pain usually goes away on its own. Consequently, 80 to 90 per cent of all cases of lumbago are not even diagnosed, as Professor Kan Min explains.

As a rule, there is only one thing that helps: taking anti-inflammatory painkillers or medication to relax the muscles. Once you are able to move again, start off slowly by taking a moderate amount of exercise. “For a long time, patients suffering from lumbago were prescribed bed rest. We now know that this is actually counterproductive”, explains the specialist. Patients should remain physically active. This is because maintaining a protective posture for too long can result in permanently tense muscles, which in the worst case can turn into a chronic condition.

You only need to see a doctor in the initial stage if the pain cannot be managed with conventional painkillers. However, it is a different story if your symptoms have not improved or have even got worse after two to four weeks. If the pain radiates down your legs, or if you experience tingling, numbness or weakness, you should consult a doctor.

“In this case, it is important to find out exactly what is causing the pain," says Professor Kan Min. “In theory, a herniated disc, osteoporosis, fractured vertebrae, rheumatoid arthritis flare-ups, but also infections or metastases could be the cause of this kind of acute pain”, says the specialist, but simultaneously reassures us: “these are exceptions.” In the majority of cases, he adds, lower back pain is not a symptom of a bad back, but the painful consequence of an ill-considered movement.

Forewarned is forearmed
If you wish to avoid getting lumbago or prevent it from recurring after an acute bout of pain, you will need to strengthen your back. Specifically, this means learning to lift, stand and walk correctly (Suva prevention module “The right way to lift and carry things”). Going for several short walks every day, gentle cycling and doing regular back strengthening exercises can also prevent lumbago from recurring. In most cases, this alone will be enough, says Professor Kan Min.

The Compassana app also accompanies and supports patients with back pain - just like healthy people who want better orientation in the healthcare system: How should I take my medication? Where am I on my treatment journey? Which costs are covered by my health insurance? How do I quickly find the relevant people to contact? Often, the answers to these questions aren't that complicated - at least not with Compassana app.

This article first appeared on Hirslanden's blog. Hirslanden regularly informs people interested in health through publications, patient magazines and public lectures by around 2,000 doctors on current health-specific specialist topics. The Hirslanden blog makes medical expertise available to the entire population and regularly comments on general topics relating to health and medicine.