Lumbago or lumbago (witch's shot)? What is the difference?

Lumbago or slipped disc: Your brain's protective reflex

Almost everyone has experienced it: a banal everyday movement - picking up a sock, lifting a box or a clumsy turn during sport - and suddenly a sharp pain shoots through the lower back. The sufferer literally freezes. It is almost impossible to straighten up, you are standing at an angle and every movement becomes agony. In the past, it was often said that a vertebra had „dislocated“ or that something was „blocked“. Today we know: Anatomically, this is almost never the case. Vertebrae do not simply dislocate.

What is really happening here? Lumbago is usually a Protective reflex of the nervous system. Your brain constantly monitors all movements. If it senses insecurity in a certain situation (e.g. when bending down, perhaps in combination with tiredness or stress), it pulls the emergency brake. It sends a command to the deep back muscles: „Tighten up immediately to stabilize the spine!“ It is therefore a massive one, neuro-muscular protective voltage. The muscles spasm reflexively to prevent movement. This enormous pressure on the tissue causes the pain. Your „alarm system“ has simply overreacted.

The strategy for acute lumbago: Since no structure needs to be repaired, our aim is to calm the brain's alarm system („down-regulation“).

• Safety through gentle movement: Bed rest often signals „illness“ to the brain and increases sensitivity to pain. We have to prove to the brain that movement is safe. We do this by offering very small, pain-free movement.

• Breathing techniques: Breathing is the direct line to your autonomic nervous system. Targeted diaphragmatic breathing reduces stress levels in the body, which often leads to a reduction in muscle tension in the back.

• Discharge: Positions such as the step-in position help to relax the large hip flexor (psoas), which immediately reduces the strain on the lumbar spine.

„Back pain“ (chronic/unspecific): If the alarm is running continuously

The situation is different with back pain that builds up over weeks or recurs repeatedly. In this case, there is often no single event. Doctors speak of „non-specific back pain“. This does not mean that you are imagining the pain, but that no single damaged structure (such as a broken bone) is the sole cause.

The problem with the input Our brain constantly needs clear information (inputs) from the body in order to control muscle tension correctly. This information comes from:

1. The movement itself.

2. The organ of equilibrium.

3. The self-perception of the joints (proprioception).

In our modern day lives, we sit a lot and move around in a monotonous manner. The signals that reach the brain are „blurred“. The brain is no longer able to assess the situation accurately from the back. The brain’s logical consequence is caution. And caution often manifests itself physically in the form of increased baseline tension and pain signaling.

The strategy for general back pain: Massages often only help in the short term, as they treat the symptom but not the cause (the lack of exercise). Our approach is more active:

• Diversity of movement: We break up monotonous patterns. We mobilize the thoracic spine and hips to relieve pressure on the lower back.

• Improvement of body awareness: Through specific exercises, you learn to control your spine precisely again. Once the brain can clearly „see“ and control movement again, it no longer has to build up painful protective tension.

• Nerve mobilization: It is often not the muscles but the nerve tracts that have become immobile due to one-sided posture. We use gentle gliding movements to make these pathways supple again.

When do you need to see a doctor? (Red Flags)

Both for lumbago and back pain, we can achieve a great deal through physiotherapy. However, warning signs that you should see a doctor immediately are: numbness in the groin area („riding tights anesthesia“), loss of control over the bladder or intestines, acute paralysis in the leg, or fever combined with back pain.

Self-help: What you can do yourself to relieve acute pain

• Stay active instead of going to bed – gentle walking helps more than comfort.

• Heat (warm bottle, warm bath) can relax the contracted muscles.

• Avoid sudden movements and twisting with your back bent.

Conclusion:

Whether it’s the acute shock in the back or the chronic pulling: total rest is almost always the wrong approach. Your nervous system needs high-quality movement information to turn off the pain alarm. We help you find the right dose and type of movement that gives your brain reassurance and relaxes your back in the long term. For the acute treatment, we rely on, among other things, our Manual therapy. Book an appointment online now.