OVERVIEW
It is most widely known as lumbago, from the respective English medical term. This is a symptom that may originate from several clinical patterns, and is described as pain or discomfort in the lower back. Pain can be acute or mild, and sudden or chronic. If it extends to the lower extremity, along the sciatic nerve path from the spine to the feet, then we are talking about a sciatica.

WHICH ARE THE SYMPTOMS?
It is estimated that the average person shall complain about lower back pain (at the point corresponding to the lumbar spine) at least once in their life. The signs of lower back pain - in addition to pain that usually worsens during movement and irradiates to the back of the thigh or the groin - is the containment of the spine, especially in the back and forth movement, and the stiff back, which is caused by muscle spasms. During an event of severe pain and spasms, the body position changes and the back “moves” towards one side. In the cases of sciatica, namely, the sciatic nerve stimulation, there is also a sensation of numbness or tingling in the back, or in the buttocks, even through the whole leg.
Children and adolescents are not excluded from such symptoms in the spine. If they are not attributed to developmental causes (Scheuermann’s kyphosis, painful scoliosis, etc.), infections or malignant neoplasms, the cause is an injury. Unlike children with lower back pain associated with demanding sports activities, adults are associated with lack of exercise.

HIGH RISK GROUPS
Since lower back pain and sciatica are the symptoms rather than the causes, it is important to correctly diagnose them. Large clinical trials show that we are talking about a common finding that is troubling the global medical community as it is common to all age groups, in both sexes. It is also associated with long periods of absence from work, disability and high healthcare costs.
Although, in a high percentage of patients, acute low back pain subsides without having the opportunity to identify what caused it, however we know that it is associated with injury to the muscles, ligaments and joint capsules, due to weight lifting, and, in general, the straining of the lower back from poor posture, obesity, or pregnancy. Some conditions affecting the bones (spondylitis, spinal stenosis, osteoarthritis, spinal disc herniation, osteoporosis, etc.), conditions affecting the pelvic organs (peptic ulcers, urinary tract infections, etc.), microbial infections (tuberculous spondylitis , osteomyelitis), degenerative spinal lesions, congenital anomalies, stones or inflammation or tumors in the kidneys, inflammations or tumors in the prostate gland, ovaries, uterus, intestine, aneurysms and aortic obstruction.
On the other hand, there may be hiding behind the sciatica: intervertebral disc herniation, spinal arthritis, vertebral stenosis, spondylolisthesis, piriformis syndrome, or sacroiliac joint dysfunction.

WHICH IS THE BEST TREATMENT?
Visiting the orthopaedist should be done if the events of back pain and sciatica are frequent, cause severe pain and last for over two weeks. The obtaining of a detailed medical history and a clinical examination shall “show” which examinations are required, in order for the diagnosis to be confirmed. Usually, analgesics, anti-inflammatory or muscle relaxants are prescribed, bed rest and warm waist pads are recommended for 2-3 days.
Once the pain subsides, kinesiotherapy begins, which can be accompanied by massages, diathermies and ultrasounds. At the same time, mild, specific exercises are proposed to strengthen the muscles of the lower back and abdomen (swimming is considered ideal) and the changing of simple everyday habits, such as good body posture, not spending long periods sitting down, changing of the old mattress, a footrest for sedentary workers, etc.

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