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Lower back pain in the lower back can be very disabling and sometimes leads to the cessation of all activity. Rest is not always the right treatment: to cure low back pain, you have to move.

Lower back pain, or low back pain, is the second reason for recourse to the treating physician. More than 4 out of 5 people will suffer at least once in their lives, according to the latest figures from Medicare. How to treat low back pain? When to consult? How the diagnosis is done.

Definition

Low back pain is a pain in the lower back, in the lumbar vertebrae. When it happens suddenly, it's called "lumbago." It can occur at any age and affects both men and women. In the vast majority of cases, pain and discomfort will disappear spontaneously in 4 or 6 weeks. But when they persist, care becomes complex. You don't have to wait for low back pain. 

Symptoms

Low back pain manifests as localized pain in the lower back. The pain can be increased during mobilization, walking or effort or on the contrary improved by these elements. Conversely, it can be calmed by rest, or aggravated by it. If low back pain is acute, it occurs in a classic context of false movement or heaving of a heavy load, with its back bent. In the lombosciatic, the pain spreads towards one of the two legs through the buttocks. 

Causes

Acute low back pain can be caused by trauma, physical exertion or, on the contrary, a common gesture, as well as a psychological disorder such as stress.

Sometimes this back pain happens without a known cause. This back pain is primarily a mechanical failure, and all back structures can be the cause (muscle, ligaments, tendons, vertebrae...). For example, it may be the result of a herniated disc, which corresponds to an abnormal protrusion of the intervertebral disc between two vertebrae of the spine, or osteoarthritis.

If pain and discomfort in the lower back is accompanied by pain in the leg, in most cases it can be sciatalgia induced by compression of the sciatic nerve in the lumbar vertebrae. The pain then radiates all the way from the nerve, from the lower back to the buttocks, behind the thigh, and down to the foot (lombo-sciatica). But sometimes it is not the sciatic nerve that is irritated, but the crural nerve located a little higher in the spine. Compression of this nerve causes pain in the hip, on the front of the thigh and the side of the knee

Risk factors

There are also risk factors for low back pain such as physical inactivity, overweight, pregnancy and tension. The wrong positions to carry a heavy object or at work can also promote back pain. Finally, a bad mattress, a bad box spring and the wearing of high heels can be a good factor.

Diagnosis

During a clinical examination and interrogation, the doctor will ensure that there is no underlying pathology that may explain low back pain. For example, they will look for key factors such as a history of cancer, chest pain, prolonged use of corticosteroids or a fever. If none of these disorders are found, other than low back pain, the doctor will not routinely prescribe a follow-up examination. French and international scientific societies believe that an imaging examination is not necessarily required, especially during the acute phase of low back pain, between 4 and 6 weeks.