Question:
I have
pain affecting the buttock regions and low back and my doctor said
it is a mechanical low back pain.
What
does mechanical low back pain mean?
George
Answer:
Dear
George,
Mechanical
low back pain (sometimes referred to generally as lumbago) is attributed
to structural alterations or functional or postural overloads of the
elements that form the lumbar spine.
Although
these alterations can be implied in the origin of lumbago, a clear
correlation between the patient's referred pain and the anatomical
alteration found by the image techniques does not exist.
Alterations in the biomechanics of the vertebral elements can take
to an imbalance with overload of some structures and secondly to mechanical
pain.
Thus, static alterations, muscular imbalances or ligaments and muscles
overload may be cause of mechanical low back pain or lumbago.
The truth
is that the cause of the symptoms in the majority of the patients
is not known.
Treatment
In the acute phase:
-Rest.
Most
of the patients with acute low back pain or lumbago do not require
rest in bed. Only in cases of intense pain that it gets worse standing
up or with the movements it is recommended to rest in bed 2 to 4 days
(rising for feeding and hygiene).
A prolonged
rest is detrimental. It produces deterioration of physical and mental
shape.
-Local
heat, 20 minutes, several times per day and analgesics like Acetaminophen
(paracetamol)) are also recommended.
-NSAIDs
when analgesics don't work.
-Muscle
relaxants since usually they are associated to muscular contractures
-Chiropractic
manipulation.
Prognosis
70-80%
of the lumbar pains improve within the first month, independent of
the treatment they receive.
Only
a 10% of lumbar pains follow a chronic condition which is defined
as a condition that lasts 12 months or longer.
Recurrences
are frequent.
