Acute Lower Back Pain – Lumbago Causes, Relief and Prevention

Do you know that feeling of acute lower back pain? You just bend forward, and suddenly there’s a snap in your back, and you can hardly move anymore? In this article, I will explain what really happens in your body when you experience an acute lower back pain like this – also known as lumbago.

What Exactly is Lumbago?

Ultimately, lumbago simply describes a sudden onset of lower back pain that usually leads to severe restrictions in mobility due to pain.

Importantly, it says nothing about the cause of the pain. That’s what we’ll get to now with.

What is the Likely Cause of Lumbago?

There is no clear answer to this yet, but it is very likely that it involves the intervertebral disc.

When the discs wear out, the outer rings of the disc become better supplied with nerves. A “healthy” or normal disc is not as well supplied with nerves, which is why usually no threatening signals are sent from receptors directly in the disc to the brain.

Due to the aging process of the disc, however, it can lead to more threatening signals being sent away from the disc itself via nerves to the brain.

An important side note here: the wearing out of the discs is a normal aging process and not necessarily associated with pain, this has been shown in a well-known study by Brinjiki et al. in 2015 that I’ll briefly show here:

Just as an example, 37% of 20-year-olds and 52% of 30-year-olds have disc degeneration without experiencing symptoms like lower back pain.

Let’s look at the disc degeneration in a bit more detail now. Due to the aging process of the discs, various types of tears can happen. I’ll briefly show an illustration here.

You can simply remember that these small tears make it easier for the inner part of the disc to move outward, which we ideally don’t want. Depending on how far the inner part of the disc moves outward, we speak of either a disc bulge, herniation, or extrusion (more on this you can read in the study by Fardon et al.).

You don’t need to remember these different categories of disc changes.

What’s relevant for you is that the disc is likely the trigger, either through these tears themselves sending threatening signals directly from the disc or through the disc material pressing on the spinal cord or nerve – simply put.

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How to Differentiate Lumbago from Other Types of Back Pain?

I’ve already given you some hints here. It depends on whether only the disc itself is affected, or whether it presses on a nerve or the spinal cord.

The simplest way to differentiate is between pain that is only in the back or pain that extends into the leg.

If the pain extends into the leg and is even stronger in the leg than in the back, then the likelihood is very high that the nerve root is affected, meaning that disc tissue is pressing on a nerve.

If that’s not the case, then it’s likely just the disc itself that’s affected.

And if it’s “just” the disc in your case, it was probably some movement that mechanically irritated the disc. This doesn’t necessarily have to involve much strain.

The disc tissue might have just lightly touched the nerve and the nervous system completely overreacted. You unfortunately notice this overreaction of the nervous system through very severe pain and extremely high muscle tension.

Why? Because your nervous system wants to protect you so that you don’t irritate the nerve or disc again.

What Can You Do About This Excruciating Pain?

Usually, you should avoid all painful movements as much as possible during the acute phase.

However that’s what you do naturally anyway, because you’re in a lot of pain.

Now we need to differentiate whether the nerve root is affected or not. Or in simple terms: does the pain radiate into the leg or not.

If the pain does not extend into the leg, then the best thing you can do is stay as active as possible within your pain limits.

So try to keep your range of motion as large as possible and don’t let the pain restrict you too much.

Simply try out what you can do and stay active in sports, your daily life, and your job without letting pain take over.

I know, this is easier said than done. But you should try it, as much as possible. Because if you succeed in staying involved in activities that are emotionally meaningful to you, then your risk of developing chronic lower back pain is significantly lower.

I will show you a few exercises shortly, but please note that there are no best exercises against lumbago.

Before starting with exercises, I always check in with the nervous system first.

What I mean by that is, that I ask myself the question: is the nervous system still in panic mode or not?

If it still is, then I try to avoid lengthening the sciatic nerve too much because this can lead to further irritation. You lengthen the nerve by bending over or lifting your straightened leg up.

What Exercises Are Beneficial for Lumbago?

During the acute phase, you can start very easily with things like pelvic tilts, either standing or on all fours—tilting your pelvis forward and backward or shifting it sideways, or doing pelvic circles. This mobilizes your spine nicely.

As your pain gets better, you can start with core exercises like dead bugs, bird dogs, or plank variations.

Of course you can also train on machines again – for example, doing exercises for your upper body or working isolated on your calves or mobility. There’s so much you can do.

In the third phase, you can start putting more load on your spine again by doing things like hip thrusts, deadlifts, or squats.

I want to emphasize that this third and final phase is absolutely crucial because many people who have had severe back pain are so afraid of loading their back properly again.

So what if you belong to the second category, where pain extends into your leg?

It’s super hard for me to say this, because I love movement early on, literature suggests that it might be better to give your nerve one to two weeks of rest initially. Once your nerve has calmed down, you can go through these three phases that I just mentioned.

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How Can You Prevent Acute Lower Back Pain?

I have three very simple tips here: stay active, do strength training, and avoid repetitive stress as much as possible.

By repetitive stress, I don’t mean doing two or three repetitions in a row, but rather if you have a job where you have to bend down in exactly the same way 2,000 times a day. Consider whether you can adjust this somehow.

By the way, many people think they get back pain because of their anterior pelvic tilt. Read this article now to find out whether there’s any truth to that.

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