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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.

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