When searching for the older term “lumbago,” the modern medical concept is low back pain (LBP). LBP is one of the most common physical complaints worldwide, affecting up to 85% of people at some point in their lives. This broad, descriptive term has replaced the older, less precise name to better reflect the complexity and various causes of discomfort in the lumbar region.
The term “lumbago” literally means a pain in the loins, referring to the lower back region. For centuries, it served as a simple, catch-all diagnosis for any pain experienced between the lower ribs and the crease of the buttocks. The use of low back pain is now preferred because it is purely descriptive of the location, allowing medical professionals to proceed with a more accurate classification of the pain’s source and duration.
Classifying Low Back Pain
Low back pain is systematically classified along two primary dimensions: the duration of the symptoms and the specific cause of the pain. The duration of LBP is categorized into acute (less than six weeks), sub-acute (six to twelve weeks), and chronic (twelve weeks or more) phases.
The second classification separates LBP into specific and non-specific types based on the underlying source. Specific LBP accounts for a small minority of cases, typically 10-15%, and involves an identifiable cause. Examples include vertebral fractures, infections, tumors, or radiculopathy (pain radiating down the leg from a compressed nerve root).
The majority of cases (85% to 90%) are classified as non-specific low back pain. This diagnosis is applied when a thorough medical evaluation, including a review of “red flag” symptoms, fails to identify a single, serious underlying pathology. Non-specific LBP is often mechanical, meaning the pain is related to how the spine, muscles, and joints move and bear load.
Common Sources of Non-Specific Low Back Pain
Non-specific low back pain is predominantly mechanical, originating from the spine, intervertebral discs, or surrounding soft tissues. The most frequent mechanism is a strain or sprain of the muscles and ligaments supporting the lumbar spine. This may result from a sudden movement, such as lifting or twisting, though patients often cannot recall a specific event.
Another common source involves the cumulative effect of poor movement patterns and sustained, awkward postures. Prolonged sitting or standing that places undue stress on spinal structures can lead to tissue irritation and discomfort. Pain often arises when the load or activity exceeds what the tissues are conditioned to handle.
Degenerative changes are also a frequent component of non-specific LBP, though they are often misinterpreted as the sole cause of pain. Changes like mild disc degeneration or osteoarthritis in the facet joints are common findings on imaging, even in people without pain. These age-related changes can contribute to mechanical irritation. The pain typically manifests as a deep, dull ache localized to the lower back, sometimes radiating only as far as the buttocks.
General Management and Recovery Strategies
The modern approach to managing non-specific low back pain strongly emphasizes active recovery and movement, moving away from past recommendations for prolonged bed rest. Staying active is fundamental, as gentle exercises like walking or swimming promote blood flow, reduce stiffness, and strengthen supporting muscles. Gradually increasing activity levels is key to recovery from an episode of LBP.
Initial self-care often involves over-the-counter pain relievers, such as non-steroidal anti-inflammatory drugs (NSAIDs), to manage acute discomfort. Applying heat helps relax tense muscles, while cold therapy may reduce inflammation during acute episodes. Addressing lifestyle factors, such as maintaining a healthy weight and practicing good body mechanics during lifting, also helps reduce strain on the back.
Physical therapy, including structured exercise, core strengthening, and manual therapy, is a central strategy for managing LBP. Patients should seek professional medical attention if they experience any “red flag” symptoms, which may indicate a more serious condition:
- Progressive weakness or numbness in the legs.
- A history of cancer.
- Unexplained weight loss.
- New problems with bladder or bowel control.