2015-01-29 15:00:00
It is also called “ waistline »: lumbago is characterized by sudden pain in the vertebrae. While more than one in two people experience at least one episode of lower back pain during the year (and one in ten experience sciatic pain), we have learned from studies carried out in recent years (source 1) that paracetamol is not more effective than a placebo. So, what do we do to reduce the pain and the feeling of blockage? Here is an overview of the remedies available.
Lumbago: how to get rid of the pain quickly?
“Be careful not to misinterpret these studies! », Warns Dr Georges de Korvin. ” THE paracetamol doesn’t solve everything, but my experience shows that the pain relief is very real.
You can repeat the doses every four hours (maximum 4 g/day) or, if you can tolerate it, take someibuprofena nonsteroidal anti-inflammatory drug (NSAID) up to three doses at 400 mg per day, every six hours, alone or alternately.
In case of sciatica, they will not be enough. THE paracetamol codeine (dosed at 20 mg of codeine, without prescription) provides more relief and the doctor may prescribe a stronger painkiller (paracetamol codeine 30 mg).
What is the best position when you have lumbago? Should you walk?
We often feel better standing during the crisis. When sitting, we recommend placing a cushion in the small of the back.
Bed rest in case of low back pain is not recommended. Rest and inactivity risk making your pain persist in the long term,” recalls Health Insurance (source 2). “A rapid resumption of daily activities is recommended to regain muscle function because the gradual resumption of physical activities promotes healing. Indeed, it is the movement that heals, because it is through movement that the muscle is repaired, maintained and that the ligaments regain their flexibility.”
Conversely, you must avoid all positions and forward movements which cause the back to twist, recalls Xavier Dufour, physiotherapist.
Apply heat
Heat has been proven to relieve lower back pain. We use a hot water bottle, compresses or heating patches. You can also take a hot bath (not hot!) to promote muscle relaxation.
How long does lumbago last? What to do if it lasts?
“Lumbago can last up to 4 months and its recovery is sometimes long. Its duration depends on the intensity of your pain and the moment from which you decide to take care of yourself,” indicates the École du Dos website (source 3).
Stretch
“Physical activity allows the back to move by stretching and strengthening the muscles, mobilizing the joints and prevents back pain from setting in,” indicates Health Insurance. Certain movements can specifically target the pain of lumbago.
“It is necessary to carry out movements in a direction opposite to the painful position, most often in extension », specifies Xavier Dufour, who. Repeat 10 stretches, three to five times a day.
- Standing, hands on hips, stretch the spine upwards and backwards while pushing the pelvis forward, as you exhale, smoothly;
- Flat on your stomach, arms bent, rest on your wrists, near your shoulders, and straighten your arms. Hold for 10 seconds and come back down. In case of sciatica, bend the leg on the painful side.
Opt for manual therapy
Sessions of physiotherapy or of chiropractic will sometimes be offered. A chiropractor (€40 to €80 per session, covered by certain mutual insurance companies) or an osteopathic physiotherapist (reimbursed at 60%, on prescription) works on muscular tensions to relieve pressure on discs.
You should feel relief from the first session. If that doesn’t change anything, there’s no point repeating the sessions, recommends Dr. de Korvin. On the other hand, sciatica is a contraindication to manipulations that “crack,” because these can fragment an already weakened disc and aggravate the herniation.
Wear a lumbar belt
The lumbar belt force one to assume an upright position, which reduces the pressure on the discs to be used as long as you have pain, but without exceeding two months so as not to risk atrophying the muscles. In pharmacies (50 to 70 €).
Chronic lower back pain: how to relieve this pain?
“Chronic low back pain is defined by pain in the lumbar region lasting more than 3 months”, defines the High Authority of Health (HAS) (source 4). The first thing to do, in this case, is to try to strengthen your back. Certain specific analgesics and corticosteroid infiltrations may be offered.
Strengthen your back with exercises and stretches
“It is the best treatment in cases of chronic pain, which has lasted for more than three months,” explains Dr. de Korvin.
This rehabilitation can be done in physical medicine departments, back schools or at the physiotherapist, at the rate of three sessions per week for one month (reimbursed at 75%).
Use infiltrations in case of sciatica
Ces corticosteroid injections reduce theinflammation around the sciatic nerve, and are effective in 65% of cases: we feel the improvement the next day. A second infiltration can be considered, or even a third. Beyond that, the benefit/risk (infection) ratio decreases.
“Studies show that they are all the more effective if they are carried out under fluoroscopic guidance,” says the doctor. From €150 to €250, partially reimbursed.
Try specific painkillers
Pregabalin (Lyrica) and gabapentin (Neurontin) act on the nerve fiber itself: upon prescription, they can be useful for neurological pain associated with sciatica.
No manipulations without medical advice
Sciatica, as well as lumbago, are often caused by the beginnings of a disc herniation: a small piece of intervertebral disc protrudes or shifts, and can compress a nerve. It is therefore important to always establish a medical diagnosis, particularly before considering manual manipulations which might aggravate the hernia, recalls Dr Georges de Korvin.
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