THAT BACK PAIN CALLED: LUMBAGO

Mr. Campbell (not real name) was seeing – off a friend, suddenly, he sneezed, then, a sharp reverberating pain at the lower back side. He attempted to move on, but could not, what followed next was near immobility and excruciating pains. He was glued to the spot for about 15 minutes before he could respond to entreaties from passers- by. Eventually, he was able to foot drag to his house without raising suspicion or arousing the curiosity of neighbors and friends. Of course, he was stylishly aided back home by his friend. All through the day, he practically crawled from one part of his house to the other. Thank God for his wife and children who helped out with virtually everything; including undressing, bathing and getting a comfortable position to sleep on. Of course, his comfortable bed was out of the picture. Campbell, for the first time since he could remember slept on bare floor, thanks to his neighbour who advised so based on what he has been told about such excruciating pain.

Expectedly, he rushed to his doctor very early the following day. He was diagnosed of LUMBAGO. The doctors told him, it was not an unusual discomfort, also common mostly among men. It is not pile as some ‘tradomedical’ practitioners are wont to label it, he warned

SO WHAT IS LUMBAGO?
Lumbago is a general term used to describe pain in the lumbar region, or lower back. It is defined as a mild to severe pain or discomfort in the area of the lower back. Ranging in severity from acute (i.e. sudden and severe) to chronic (if it has lasted for more than three months) lumbago can occur in any age group, but is common among younger people who engage in hard physical work and also among people of retirement age. Lumbago is also referred to as "back strain”.

What are the symptoms of lumbago?
If you are suffering from lumbago, some or all of the following symptoms may be present:
• Mild to severe pain across the lower part of the back which sometimes travels into the buttocks, the groin area or down into the back of the thigh. This pain is usually aggravated by movement.
• A stiff neck, which is caused by the muscles surrounding the spine going into spasm.
• Difficulty in bending forward and leaning back. Again this is caused by spasms in the muscles surrounding the spine.
• There may be a change in posture (e.g. leaning to one side) due to the severe pain and spasms in the lower back.
• There may sometimes be a tingling sensation or a feeling of numbness in the back, buttocks or down along one or both legs.

What causes it?
Identifying the exact cause of lumbago is very difficult. It can be caused by a variety of conditions such as a slipped disc, scoliosis (deformation of the natural curvature of the spine), osteoporosis (brittle bone disease) or, more rarely, by tumours or infection in the spinal area. It is usually only possible to pinpoint the exact cause of lumbago in about 30% of cases. The majority of those where another cause is not found are believed to be due to muscle sprain.

What are the warning signs?
The main warning signs to look out for, and which warrant urgent investigation by your doctor, are:
• A sudden inability to control bladder or bowel movements.
• A feeling of numbness or tingling in the area of the lower back, buttocks or legs.
• A dull, aching pain in the lower back which is accompanied by reduced strength or muscle bulk in one or both legs.

How is lumbago diagnosed?
In the majority of cases, your GP will be able to diagnose the problem on the basis of the information supplied by you, the patient. It is seldom necessary to take X-rays, scans or blood test unless your doctor feels that there is a more serious underlying cause for the pain.
Orthopaedic treatment
The orthopaedic solution has two objectives: to decrease the pain and to rest the contracted musculature.

During an episode, wearing a lumbar support belt makes it possible to recover a symmetrical position by relaxing the muscles.

Wearing a lumbar support belt can be recommended for prevention in people subject to lumbago (secondary prevention) or in people doing an activity at risk (primary prevention).
A lumbar support belt perfectly adapted to your morphology will allow you to continue your daily activities. There is a wide range of belts available to fit in with your lifestyle.

The aim of wearing a lumbar support belt preventively is to increase the level of vigilance and thus avoid reproducing the dangerous movements.
In addition, by increasing intra-abdominal pressure decreases the constraints on the vertebrae. Contrary to popular opinion, wearing a lumbar support belt (even for long periods) does not increase the risk of muscle loss (abdominal and dorsal muscles).
Can lumbago be treated at home?
There are a number of practical steps which can be taken at home to reduce back pain. These include:
• The use of painkillers or anti-inflammatory tablets to relieve the pain and relax the muscles.
• Staying active. Resting for long periods of time is not helpful for those with back pain, so it is important to get on with your life within the limits of your pain.
• Gentle exercise is beneficial, especially swimming in a warm swimming pool.
• Developing good posture and having a firm, supportive chair and your worktop / desk at the correct height.
• Resting and sleeping on a very firm, flat surface (some people actually sleep on the floor!).
• Lumbago or backache is very rarely caused by a serious illness and will usually right itself within a matter of days or weeks, so try not to get too anxious or upset about it.

But what if my lumbago is chronic?
Chronic lumbago is defined as backache which has persisted for more than three months, and obviously this type of pain will have an effect on your life. It is difficult to ascertain what type of treatment is most suitable for chronic back pain, but a range of treatments will probably be applied in the hope that one will succeed in relieving the pain. Unfortunately, some patients fail to find long-lasting relief from chronic back pain for a number of reasons.
Treatments which may be helpful include physiotherapy, a graded exercise programme and swimming. Some people with chronic low back pain find massage helpful.

What are the future prospects?
The prospects for sufferers of lumbago are good provided early treatment is sought and the patient remains as active as possible.
The vast majority of people are born with a healthy spinal column, which continues to perform heroically throughout the average lifespan, despite the fact that it is very often abused. It is a well-known fact that weak back and stomach muscles can contribute significantly to the risk of developing back pain. Therefore, it is essential that a programme of moderate exercise to strengthen these muscles is embarked upon.
Prevention is the key when dealing with the back, as very often it is too late to try to protect the back after the damage has been done.
Orthodox medical practitioners are quick to diagnose Lumbago once the symptoms are noticed. But, in virtually all parts of Nigeria, there are traditional healers whose specialisation is massage, bone repositioning and bone setting. The Ilajes, the Huasas, the Eguns, and the Ijaws (perhaps, there exist in other tribes too) are good.