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Central Sensitization
With prolonged pain, the nervous system "gets used to" pain signals, lowering the sensitivity threshold. Normal movements begin to be perceived as painful. Treating chronic pain is significantly more difficult.
What is lumbago
Lumbago — acute sudden pain in the lower back, «low back pain». Occurs with sudden movement, bending, or lifting heavy objects. The patient is «stuck» in a forced position. Pain causes reflex muscle spasm — protective fixation of the spine.
Forms of low back pain
Lumbago (acute low back pain)
Sudden acute pain. Duration: hours — days. Localized in the lower back without radiation to the leg. Powerful muscle spasm. ICD-10: M54.5.
Lumbalgia (chronic)
Dull aching pain for more than 3 months. Worsens after exertion, prolonged sitting. Often — result of untreated lumbago.
Lumboischialgia
Pain in the lower back with radiation to the leg. Indicates compression of a nerve root.
Causes of lumbago
Disc protrusion or herniated disc (50%)
Sudden disc bulging irritates nerve endings of the posterior longitudinal ligament and annulus fibrosus.
Facet Joint Syndrome (30%)
Blocking or inflammation of facet joints. Pain on extension, paravertebrally. Does not radiate below the knee.
Myofascial spasm (15%)
Reflex muscle spasm without structural damage. Trigger points. Provoked by cooling, stress.
SI joint dysfunction (5%)
Pain in the sacroiliac joint area, radiation to the buttock. Often after childbirth.
Red flags
Cauda equina syndrome
Numbness in the perineum + urinary dysfunction + bilateral leg weakness. Emergency MRI.
Progressive paresis
Increasing foot weakness — nerve root compression. Urgent intervention.
Pain + fever
Possible spondylodiscitis, tumor, metastasis. Contrast-enhanced MRI mandatory.
Lumbago (acute low back pain): treatment options and what is known about them
The treatment plan is made by the clinic doctor after an examination and a review of your images. The table shows the options usually discussed for this diagnosis and how well they have been studied.
| Option | What to expect | How well studied |
|---|---|---|
| Exercise therapy and physiotherapy | Reduces pain, strengthens muscles, improves function; the basis of treatment | Well studied, recommended |
| Painkillers and NSAIDs | Ease pain during flare-ups; long-term use is limited by side effects | Moderate evidence |
| Corticosteroid injection | — | Not usually used for this diagnosis |
| PRP / CGF | — | Not usually used for this diagnosis |
We send your request to several partner clinics. Some will suggest conservative treatment or injections, others surgery; each clinic quotes its own conditions and price. We help you compare the options.
Regenerative methods: realistic expectations
Most back pain comes from muscles, joints and discs and settles within a few weeks. Staying active and regular exercise help most; painkillers are for short courses. For facet pain confirmed by a diagnostic block, radiofrequency denervation can help. There is little data on PRP for back pain; age-related changes on an MRI do not need injections in themselves.
When surgery is discussed. Surgery for back pain without nerve compression rarely helps. It is discussed for vertebral instability, fractures or nerve root compression.
If an injection helps, the effect usually builds up over 6–12 weeks, and the result is assessed after 2–3 months. No clinic can guarantee a result.
Good to know: diagnosis, self-help, outlook
How to tell lumbago from more serious causes
Lumbago is sudden acute low back pain, often after bending or lifting, without numbness or weakness in the legs. If pain spreads below the knee with numbness, a disc herniation irritating a nerve root is likely. Pain that does not depend on movement, with fever or bladder problems, requires ruling out kidney disease and other causes. Imaging is not needed for ordinary lumbago in the first 6 weeks.
What you can do yourself
Stay as active as you can and walk rather than lie down: bed rest slows recovery. Apply heat to the lower back and take a short course of anti-inflammatories as agreed with a physician. After a few days do gentle exercises, then gradually return to normal activity.
Outlook and timelines
Most episodes of lumbago settle within 1–6 weeks. Recurrences are common, so regular exercise for the back and core muscles matters. If pain does not ease after 6 weeks or warning signs appear, a physician’s examination and an MRI are needed.
Recovery and timelines
After an outpatient injection procedure, most patients return to normal activity within 1–3 days. Sport and heavy loads are resumed according to the physician’s plan, usually after 2–6 weeks, alongside therapeutic exercise. The effect is assessed after 6–12 weeks. After surgery, rehabilitation takes longer and depends on the operation.
Who it is not suitable for and possible risks
Contraindications
- Active infection — at the injection site or systemic, with fever.
- Active cancer or ongoing chemotherapy.
- Blood clotting disorders or a low platelet count. Anticoagulants are discussed with the physician.
- Pregnancy and breastfeeding — the procedure is usually postponed.
- A corticosteroid injection into the same area in recent weeks.
- Urgent surgery, not injections, is needed if there is progressive leg weakness, numbness in the groin area or bladder dysfunction.
Possible risks
- Pain and swelling at the injection site for 1–3 days.
- Bruising where blood or fat tissue is taken.
- Rarely, infection. The procedure is therefore performed under sterile conditions with ultrasound or X-ray guidance.
- The effect may be absent or smaller than expected.
- Injections into the intervertebral disc carry a rare risk of disc inflammation (discitis).
If any of these apply to you, mention it in your request. The coordinator will check with the clinic physician whether treatment is possible. Contact a coordinator.
Scientific evidence
Studies of regenerative methods show mixed results. Clinic physicians rely on research including the following:
- Tuakli-Wosornu YA et al. Lumbar Intradiskal Platelet-Rich Plasma (PRP) Injections: A Prospective, Double-Blind, Randomized Controlled Study. PM R, 2016.
- Lurie JD et al. Surgical versus nonoperative treatment for lumbar disc herniation: eight-year results for the Spine Patient Outcomes Research Trial. Spine, 2014.
Next steps: Treatment methods · Treatment cost · How treatment in Germany is organised
Questions about Lumbago
RegenPAS is a patient service centre in Munich, not a clinic. We review your images and symptoms and send a request to several partner clinics at once. Clinics that can accept you send their own conditions and price; prices differ between clinics, and you choose the option that suits you. The coordinator replies within 24 hours, and a clinic physician’s preliminary opinion follows in 1–3 business days. We then arrange the appointment, visa invitation, interpreter, transfers and accommodation. Treatment decisions are made by the clinic physician. Contact a coordinator.
Your MRI (or CT, X-ray) report and the images if you have them, plus a short description of your symptoms and previous treatment. Send them via the form on the website — the assessment is free and without obligation: the coordinator replies within 24 hours, and the clinic physician’s preliminary opinion follows in 1–3 business days.
The cost depends on the method, the diagnostics needed and the clinic itself: prices differ between clinics. We request offers from several clinics and send you their conditions and quotes so you can compare. Price guidance is on the treatment cost page. For an outpatient procedure, 2–3 days in Munich are usually enough: examination, procedure and follow-up visit.
Clinic and method matching — free of charge
Describe your case and attach your MRI report. We will identify clinics that use the relevant methods and forward your request to them. No obligation; we reply within 24 hours.
Send a request