Common causes of low back pain (lumbar backache) include

1. Lumbar strain.
2. Nerve irritation.
3. Lumbar radiculopathy.
4. Bony encroachment.
5. Conditions of the bone and joints.

1. Lumbar strain (acute, chronic):

A lumbar strain is a stretch injury to the ligaments, tendons, and/or muscles of the low back. The stretching incident results in microscopic tears of varying degrees in these tissues. Lumbar strain is considered one of the most common causes of low back pain. The injury can occur because of overuse, improper use, or trauma.

Soft-tissue injury is commonly classified as “acute” if it has been present for days to weeks. If the strain lasts longer than three months, it is referred to as “chronic.” Lumbar strain most often occurs in people in their 40s, but it can happen at any age. The condition is characterized by localized discomfort in the low back area with onset after an event that mechanically stressed the lumbar tissues. The severity of the injury ranges from mild to severe, depending on the degree of strain and resulting spasm of the muscles of the low back. The

The diagnosis of lumbar strain is based on the history of injury, the location of the pain, and exclusion of nervous system injury. Usually, X-ray, MRI (magnetic resonance imaging) are helpful to exclude bone abnormalities.

Allopathic treatment for strains consists of resting the back (to avoid reinjury), medications to relieve pain and muscle spasm, local heat applications, massage, and eventual (after the acute episode resolves) reconditioning exercises to strengthen the low back and abdominal muscles. Initial treatment at home might include heat application, acetaminophen or ibuprofen, and avoiding reinjury and heavy lifting. Prescription medications that are sometimes used for acute low back pain include non-steroidal anti-inflammatory medications, such as thiocolchicosdie, sulindac, naproxen, and ketorolac by injection or by mouth, muscle relaxants, such as carisoprodol, cyclobenzaprine, methocarbamol, and metaxalone, as well as analgesics, such as tramadol.

Homeopathic treatment for strains is consist on following medication, diet and at the recovery exercises are sufficient in almost 95% cases.

Hypericum Perforatum, Zincum Metallicum, Bryonia Alba, Rhus Toxicodendron, Stront Carb, Arnica Montana, Ledum Pauluster, Bellis perensis, Dulcamara, Ruta Grevinolis, Apis Melifica, Magnesia Phos, Calcarea Carbonica.

Long periods of inactivity in bed are no longer recommended, as this treatment may slow recovery. Spinal manipulation for periods of up to one month is helpful in some patients who do not have signs of nerve irritation. Future injury is avoided by using back-protection techniques during activities and support devices as needed at home or work.

2. Nerve irritation:

The nerves of the lumbar spine can be irritated by mechanical pressure (impingement) by bone or other tissues, or from disease, anywhere along their paths — from their roots at the spinal cord to the skin surface. These conditions include lumbar disc disease (radiculopathy), bony encroachment, and inflammation of the nerves caused by a viral infection (shingles).

3. Lumbar radiculopathy:

Lumbar radiculopathy is nerve irritation that is caused by damage to the discs between the vertebrae. Damage to the disc occurs because of degeneration (“wear and tear”) of the outer ring of the disc, traumatic injury, or both. As a result, the central softer portion of the disc can rupture (herniate) through the outer ring of the disc and abut the spinal cord or its nerves as they exit the bony spinal column.

This rupture is what causes the commonly recognized “sciatica” pain of a herniated disc that shoots from the low back and buttock down the leg. A history of localized low-back aching can precede sciatica, or it can follow a “popping” sensation and be accompanied by numbness and tingling. The back pain commonly increases with movements at the waist and can increase with coughing or sneezing. In more severe instances, sciatica can be accompanied by incontinence of the bladder and/or bowels. The sciatica of lumbar radiculopathy typically affects only one side of the body. Lumbar radiculopathy is suspected based on the above symptoms.

Increased radiating back pain when the lower extremity is lifted supports the diagnosis. Nerve testing (EMG/electromyogram and NCV/nerve conduction velocity) of the lower extremities can be used to detect nerve irritation. The actual disc herniation can be detected with imaging tests, such as CAT or MRI scanning.

Allopathic treatment of lumbar radiculopathy ranges from medical management to surgery. Medical management includes patient education, medications to relieve pain and muscle spasms, cortisone injection around the spinal cord (epidural injection), physical therapy (heat, massage by a therapist, ultrasound, exercises, electrical stimulation), and rest (not strict bed rest but avoiding reinjury). With unrelenting pain, severe impairment of function, or incontinence (which can indicate spinal cord irritation), surgery may be necessary.

The operation performed depends on the overall status of the spine and the age and health of the patient. Procedures include removal of the herniated disc with laminotomy (a small hole in the bone of the lumbar spine surrounding the spinal cord), laminectomy (removal of the bony wall), by needle technique (percutaneous discectomy), disc-dissolving procedures (chemonucleolysis), and others.

Homeopathic treatment for lumber radiculopathy is same as explained above for strain; no need for any surgery, just 30-60 days treatment and ten days bedrest are sufficient for patient’s full recovery.

4. Bony encroachment:

Any condition that results in movement or growth of the vertebrae of the lumbar spine can limit the space (encroachment) for the adjacent spinal cord and nerves. Causes of bony encroachment of the spinal nerves include foraminal narrowing (narrowing of the portal through which the spinal nerve passes from the spinal column, out of the spinal canal to the body, commonly as a result of arthritis), spondylolisthesis (slippage of one vertebra relative to another), and spinal stenosis (compression of the nerve roots or spinal cord by bony spurs or other soft tissues in the spinal canal).

Spinal-nerve compression in these conditions can lead to sciatica pain that radiates down the lower extremities. Spinal stenosis can cause lower-extremity pains that worsen with walking and are relieved by resting (mimicking the pains of poor circulation).

Allopathic treatment of these afflictions varies, depending on their severity, and ranges from rest and exercises to epidural cortisone injections and surgical decompression by removing the bone that is compressing the nervous tissue.

Homeopathic treatment for bony encroachment is:

Kalmia Latifolia

Kalmia Latifolia is a highly beneficial medicine for ankylosing spondylitis. Rheumatic pains, mostly in upper arms and lower part of legs, constant pain in the spine, Pains shift suddenly, Pain in shoulders. Deltoid rheumatism, Paroxysmal pains, Pain in the lumbar area and a burning/heat sensation in the lumbar spine is present, Tearing pains in hip, in leg, in feet.

A feeling of lameness in the back is present, intense pain in the neck (cervical spine), neck stiffness, neck tender to touch. Rheumatism often attacks heart, oppressed breathing; pains generally go from upper to lower parts; pains shift suddenly, with diarrhea; Weariness in all muscles.

Rigidity of skin, dry skin, erysipelatous inflamed eruption. Red inflamed places exceedingly painful, as if boils would form. Restless sleep

Rhus Tox

Rhus Tox is a well indicated medicine for ankylosing spondylitis, stiffness of the back, the stiffness is most intense in morning after long sitting and/or rest aggravates the stiffness, better after walk and/or after hard pressure. Painful swelling of axillary glands.

Rheumatic tearing between scapulae, not affected by movement better by applying cold, worse by heat. Tearing between shoulders, drawing together from both sides, paralysis, and insensibility of arm, jerking tearing in elbows, wrists, and joints of fingers, hot swelling of the hands in evening. Transient coldness in back. Contusive pain in loins, especially on touching the genital parts, and during repose. Pain in lower spine when sitting still or when lying which are aggravates when lying on hard and from exercise. Bruised pain in sacrum. Cramps in buttocks, thighs, and calves, spasmodic twitching of the limbs when stepping out, paralysis of legs and feet. Erysipelatous swelling of feet.

Painful rigidity in loins. Painful exostosis on sacrum. Distortion of the vertebral column. Opisthotonos. Swelling, stiffness, and paralyzed sensations in joints. Trembling or sensation of trembling in limbs, excessively cold hands and feet

Constipation, sometimes alternating with diarrhea; Pain in the lower back is also severe along with stiffness. Nocturnal diarrhea, with violent colic, headache, and pains in all limbs.

Aesculus Hippocastanum

Constant backache affecting the sacrum and hips, very much aggravated by walking and stooping; almost impossible to rise after sitting down. Back gives out when walking, aching between the shoulders. Spine feels weak. The sacrum, back, neck, head, chest, heart, and abdomen, all seem in remarkable sympathy with the rectum and its vessels pain in the sacrum and the hips, stiffness in the lower back. The symptoms get worse from rising from the seat, patient has to make repeated efforts, sensation as if the back would break.

Aching pains in the lumbar, sacral and the pelvic region, constant backache affecting the sacrum and hips, aggravated by walking and stooping, back gives out when walking. Aching between the shoulders. Spine feels weak, sacrum, back, neck, head, chest, heart, and abdomen, all seem in remarkable sympathy with the rectum and its vessels

Bryonia Alba

Painful stiffness of the neck. Rheumatic stiffness and tension in the nape of the neck, and in the neck. Red spots on the sides of the neck. Red miliary eruption on the neck, with violent itching, backache that is worse from motion or walking, Shootings under the left shoulder blade, extending to the heart, greatly aggravated by cough and respiration. Pressure on the shoulder, with shootings on breathing deeply.

Rheumatic swelling of the r. shoulder and upper arm, with stitches. Tractive pains in the joints of the shoulders and of the arms, with tension, shootings, and shining red swelling, stooping, standing and sitting also worsen the backache.

Hot and pale swelling of the joints of the fingers, inflammation in the back of the hand, with burning pain. Swelling of the hands.

Paralysis of the legs. Tensive and painful stiffness of the knees. Red and shining swelling of the knees, with violent shootings, Stiffness is also present along with a backache, intense that patient has to sit and walk in a stooped posture. Maintaining an upright posture while sitting/walking is difficult.

Erysipelatous inflammation; Miliary eruption; Phlyctenule eruptions, with gnawing or burning itching; Furfuraceous tetters, with burning itching.

Kali Carbonicum

Stiffness between scapulae, dull pain, like hot water, between scapulae, stiffness of nape of neck, weakness of neck muscles. Hard swelling of axillary glands and of those of neck, weakness in the lower back accompanies back pain, drawing pains in back, which often proceed from loins, burning, tearing, Stitching and shooting pains in back, shooting down into gluteal region or hips, lower back, hips, and the thighs; feels better by lying.

Swelling of shoulder, with pain, cracking in shoulder joint, difficulty in turning in bed from a backache. Cold stiffness and numbness of arms, Skin of hands rough and cracked, Gnawing vesicles on fingers.

Numbness and great inclination of whole leg, tearing in hips and knees even while sitting. Paralysis of thighs, Frequent tearing in knees, Crawling shuddering on tibia. Swelling and redness of legs and feet.

Agaricus Muscarius

Agaricus Muscarius pain is, as from fatigue and dislocation in the back, at the nape of the neck and in the loins, especially when sitting or lying down. Painful weakness in back muscles, sensation of soreness and great weakness in the back. Paralytic pain in the loins, increased by walking or by standing, spine is sensitive to touch. The sensitivity of the spine is severe in the morning.

Arms weak and without vigor, burning pain in the arms, followed by an eruption of small pimples with scaling of the epidermis. Irregular and hurried movements of arm, upper arms shaken as from an electric shock. Prostration, weariness, and paralytic feeling, Cramp-like pain in the thumb. Paleness and numbness of the fingers, which are, at the same time, very sensitive to cold. Itching, burning pain, and redness in the fingers.

Limbs affected diagonally; left forearm, right thigh; right knee, left hand. Tearing in limbs feels better in rest or sitting, while worse when moving. Cracking in joints. Subsultus tendinum. Feels as if limbs did not belong to. Legs heavy and fatigued, especially in the thighs. Twitching, quicksilver sensation, in gluteal muscles. Pains in legs like electric shocks, Drawing pressure in the malleoli. Burning itching and redness in the toes.

Natrum Mur

Aching, rigidity, and tension in nape. Stitches in neck and back of head, painful stiffness of the neck, throat and neck emaciates rapidly, especially during summer. Back pain upon lying down, especially on a hard surface. Scurf under axillae. Scabs in axilla, Shootings, incisive pains, and violent pulsation in sacral region. Nocturnal pains in back. Over-sensitiveness of spine.

Wrenching pains in joints of shoulders and fingers. Lassitude and paralytic heaviness of arms. Contusive pain in arms and hands, shocks in elbow. Lancinations in muscles and joints of hands and fingers. Brownish spots on back of hand, Sweat on hands. Difficulty in bending the joints of the fingers. Numbness and tingling in the fingers, in the hands

Tearing across loins and hips, wrenching pain in hips, with shootings drawing pains in thighs, knees, and legs. Restlessness and jerking in limbs (in legs, compelling one to move them constantly). Paralytic weakness of legs, Pain as if knees and ankles were sprained. Weakness and trembling of lower extremities, on rising from a seat, worse from continued walking. Jerking of muscles of thighs. Tension in bends of limbs and sensation as if the tendons were shortened; painful contraction of tendons of ham, Tetters on malleoli, red titter in hollow of knees.

Calcarea Fluor

Indurated cervical glands of stony hardness. Lumbago from strains; severe backache after a long ride; better after rest, worse after moving and from warmth. Tired aching, as from a long ride; with restlessness. Bony outgrowths appearing in the spine, restlessness, cracking in joints. Synovial swellings. Easy dislocations. Exostoses. Skin harsh and dry. Chaps; fissures. Fistulae.

Cimicifuga Racemosa

Spine very sensitive, especially upper part. Stiffness and contraction in neck and back. Intercostal rheumatism. Rheumatic pains in muscles of back and neck. Pain in lumbar and sacral region, down thighs, and through hips. Crick in back, neck (cervical back) pain and stiffness. Uneasy, restless feeling in limbs, aching in limbs and muscular soreness. Rheumatism affecting the belly of muscles, especially large muscles. Choric movements, accompanied by rheumatism. Jerking of limbs. Stiffness in tendo-Achilles. Heaviness in lower extremities. Heavy, aching, tensive pain. A contracted sensation in the neck, neck is sensitive to touch. Pressure seems to worsen the pain. Any motion of the head and hands also aggravates the neck pain. Worsening of neck pain from exposure to cold air.

Tellurium Met

Tellurium Met is a medicine for ankylosing spondylitis with marked sacral pain radiating down the thigh. The back is sensitive, and the pain gets worse from touch. A feeling of weakness in the back, and cervical back pain spreading to the shoulder and between the scapulae Sharp, quick pains in elbows, ankles, and other parts, the cervical spine is also sensitive to pressure and touch. Sciatica with sensitiveness of vertebral column. Tonic muscular contraction of long standing. Contraction of tendons of bends of knees. Bruised pain in hip-joints after walking.

Conium Maculatum

Tension in the nape of the neck, Enlargement of the neck severe aching in the sacral region from walking a short distance. Stitching pain in the sacrum when standing, weakness and lameness in the small of the back, tightness in the nape of the neck with pain and stiffness and soreness in the lower cervical spine are also present.

Shoulders painful, as if they had been bruised and excoriated. Humid, scabby, and burning tetters in the forearms. Numbness of the hands and of the palms. Cracking in the wrist-joint. Sweat in the palms of the hands. Torpor of the fingers. Itching in the back of the fingers, yellow spots on the fingers and yellowish nails. Panaras.

Drawing pains in the hips. Arthritic pains in the knee, tearing, and tensive, aggravated on beginning to walk after sitting down, with a sensation as if the tendons were too short (during the suppression of catamenia). Restlessness and heaviness in the legs. Lassitude in the knees. Cracking of the knee-joint. Painful swelling of the legs and of the feet. Red spots on the calves of the legs, sometimes painful, becoming subsequently green or yellow, as after a blow or bruise, and impeding the movement of the foot, which is drawn back, as if the tendons were contracted. Cramps in the calves of the legs. Coldness, and strong disposition to take cold in the feet (even from a slight exposure of the feet). Torpor and insensibility of the feet. Pustules in the feet.

Guaiacum

Pressure on the vertebrae of the neck. Stiffness in the nape of the neck. Constant frequent stitches on left side of nape, extending from scapulae to occiput, on motion, also on holding head still. Stiffness along the back, from the neck extending to the small of the back and sacrum, intolerable on slightest motion, or turning the part, not noticed on touch or during rest.

Tearing and shooting in one side of the back only. Contractive pain between the scapula. Corrosive itching in the back. Shivering in the back in the afternoon. Weakness in the arms. Rheumatic pains in arms…from shoulder to wrist. Lancinating rheumatic pains from elbow to wrist. Rheumatic pains in wrist-joint. Stitches in thumb.

Rheumatic pains in the joints. Arthritic pains in the limbs, with shootings and tearing, and contraction of the parts affected. The pains are provoked by the least movement, and are accompanied by heat. Numbness of the limbs. Painful weariness and weakness in the arms and thighs, with dread of movement. Immovable stiffness of the contracted limbs.

Pains in the bones of the thighs, pressive and tingling pains in the thighs, when seated. Paralytic tension in the thighs, on walking. Weakness in the thighs. Pricking in the nates, as if sitting on needles. Tearing, drawing lancinations in the leg, from tarsus to the knee. Tension in thighs, as if the muscles were too short, with languor when walking; better by contact, worse when sitting.

5. Bone and joint conditions:

Bone and joint conditions that lead to low back pain include those existing from birth (congenital), those that result from wear and tear (degenerative) or injury, and those that are due to inflammation of the joints (arthritis).

Congenital bone conditions

Congenital causes (existing from birth) of low back pain include scoliosis and spina bifida. Scoliosis is a sideways (lateral) curvature of the spine that can be caused when one lower extremity is shorter than the other (functional scoliosis) or because of an abnormal architecture of the spine (structural scoliosis).

Children who are significantly affected by structural scoliosis may require treatment with bracing and/or surgery to the spine. Adults infrequently are treated surgically but often benefit from support bracing. Spina bifida is a birth defect in the bony vertebral arch over the spinal canal, often with the absence of the spinous process. This birth defect most commonly affects the lowest lumbar vertebra and the top of the sacrum. Occasionally, there are abnormal tufts of hair on the skin of the involved area. Spina bifida can be a minor bony abnormality without symptoms. However, the condition can also be accompanied by serious nervous abnormalities of the lower extremities.

Degenerative bone and joint conditions

As we age, the water and protein content of the body’s cartilage changes. This change results in weaker, thinner, and more fragile cartilage. Because both the discs and the joints that stack the vertebrae (facet joints) are partly composed of cartilage, these areas are subject to wear and tear over time (degenerative changes), these changes are called spondylosis.

Spondylosis can be noted on X-rays of the spine as a narrowing of the normal “disc space” between the vertebrae. It is the deterioration of the disc tissue that predisposes the disc to herniation and localized lumbar pain (“lumbago”) in older patients. Degenerative arthritis (osteoarthritis) of the facet joints is also a cause of localized lumbar pain that can be detected with plain X-ray testing.

Allopathically, these causes of degenerative back pain are usually treated conservatively with intermittent heat, rest, rehabilitative exercises, and medications to relieve pain, muscle spasms, and inflammation.

Homeopathically these causes of degenerating joints and degenerated joints are completely treatable and full recovery is possible but treatment process is long (3-6 months, in some cases even more – individual).

Injury to the bones and joints

Fractures of the lumbar spine and sacrum bone most commonly affect elderly people with osteoporosis, especially those who have taken long-term cortisone medication. For these individuals, occasionally even minimal stresses on the spine (such as bending to pck a pencil) can lead to bone fracture.

In this setting, the vertebra can collapse (vertebral compression fracture). The fracture causes an immediate onset of severe localized pain that can radiate around the waist in a band-like fashion and is made intensely worse with body motions. This pain generally does not radiate down the lower extremities. Vertebral fractures in younger patients occur only after severe trauma, accidents or a convulsive seizure.

In both younger and older patients, vertebral fractures take weeks to heal with rest and pain relievers.

Allopathically compression fractures of vertebrae associated with osteoporosis can also be treated with vertebroplasty or kyphoplasty, which can help only to reduce pain. In this procedure, a balloon is inflated in the compressed vertebra, often returning some of its lost height. Subsequently, a “cement” (methylmethacrylate) is injected into the balloon and remains to retain the structure and height of the body of the vertebra. Pain is relieved as the height of the collapsed vertebra is restored.

Homeopathically injury to bone and/or fractures of the lumbar spine and sacrum bone is curable with medication, but to retain normal bone/vertebral structure vertebroplasty/Kyphoplasty is necessary.

Arthritis

The spondyloarthropathies are inflammatory types of arthritis that can affect the lower back and sacroiliac joints, for example:

Reactive arthritis (Reiter’s disease), ankylosing spondylitis, psoriatic arthritis, and the arthritis of inflammatory bowel disease.

Each of these diseases can lead to low back pain and stiffness, which is typically worse in the morning. These conditions usually begin in the second and third decades of life. They are treated with medications directed toward decreasing inflammation. Newer biological (Homeopathic) medications have been greatly successful in both quieting the disease and stopping its progression.