Dr. Kevin Yip

Dr Kevin Yip
Orthopaedic Surgeon
MBBS(UK), FRCS(EDIN), FAM(SING), FHKCOS(ORTHO)

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Low Back Pain (Lumbago)

Low back pain can occur in connection with most sports, and its precise cause is unknown. Acute lumbago mainly affects those aged 30–40 years.

Symptoms and diagnosis

– The symptoms often appear after lifting a heavy object or turning rapidly, but can also occur without previous exertion.
– The pain is usually located in the lower back and does not radiate down into the legs.
– Stiffness occurs in the back.
– The posture may appear asymmetrical, with the back bent to one side as a result of muscle spasm inhibiting the movements of the back that trigger pain.

Treatment

The athlete should:
– adopt the position that causes the least possible pain;
– apply local heat, for example with a heat retainer and hot baths;
– avoid body movements that involve flexing or turning the spine.

The doctor may:

– give ergonomic advice;
– prescribe analgesic drugs in order to break the pain cycle which arises from reflex muscle spasm impairing circulation and causing muscle pain, which in turn precipitates more reflex spasm. Peripheral
muscle relaxants can sometimes be of value;
– recommend rest several times daily in a psoas position, and give other advice about ensuring good support when in the sitting position, and avoiding positions and movements that cause pain. When rising from a side-lying position the athlete should use the arms for support; similarly, when rising from a chair, the chair arms can be used;
– prescribe a course of physiotherapy when symptoms are recurrent (2–4 visits may speed return to work and sport in acute cases);
– prescribe manipulation;
– prescribe a corset or body belt which gives temporary support and can be worn when the patient carries out activities that usually trigger the problem. A corset can be of value in the acute stage of lumbago but should be used for the shortest possible time if muscle hypotrophy is to be prevented;
– arrange a CT or MRI scan of the lumbar region if pain has been present for more than 1–2 months or if symptoms are recurrent. A raised erythrocyte sedimentation rate (ESR) may be a sign of infection, tumor, or inflammatory disease;
– prescribe preventive and rehabilitative training as early as possible. Jogging has been shown to be beneficial.

Healing time

Lumbago is often benign and as a rule the symptoms disappear spontaneously within 1–3 weeks. In certain individuals, however, symptoms may be prolonged.

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