Lumbago: beware of the risk of paralysis

---

Extract from the article: Thousands of Togolese suffer from back pain. Mild or intense, persistent or fleeting, violent, throbbing, unbearable - back pain is often overlooked, but it can land a person in a wheelchair.

---

Thousands of Togolese suffer from back pain. Mild or intense, persistent or fleeting, violent, throbbing, unbearable - back pain is often overlooked, but it can land a person in a wheelchair.

One morning a few months ago, as he was getting out of the shower, Richard, a 34-year-old accountant in a computer maintenance company, felt a sort of dizziness and an intense pain in his lower back, and found himself lying on the floor. He couldn't move or get up. He felt intense pain in his back. People had to come and get him up and take him to hospital immediately.  He spent several days unable to walk normally. He couldn't bend down or stand for a few minutes. After taking painkillers and applying an ointment prescribed by the doctor, he returned to normal. « For a moment I thought I was going to be paralysed or end up in a wheelchair. I couldn't even walk. I had no idea that I could suffer from the discomfort that almost turned my life's dream into a nightmare », he says. Five months later, he was back in the same situation. Except that it happened in the middle of the street, in town, while he was simply shopping. He confides that the pain is more intense than before: « I really panicked and I was afraid of becoming disabled ». He finally consulted a doctor specialising in physical medicine and rehabilitation, who prescribed physiotherapy sessions. He was soon back to normal.

Francine, aged 47, a trader at Assigamé, Lomé's main market, met at a physiotherapy centre in Lomé and has been suffering from low back pain for 4 years. She has also started to suffer from other ailments affecting her heart. « I couldn't bend down or pick anything up off the floor. When I sat down for a long time, the pain became unbearable ». She could no longer move or sleep in any position. She had to take several weeks off work. The doctor ordered her to buy a lumbar belt, which she had to put on when she did work. But after six months, the pain got worse. So the doctor prescribed physiotherapy sessions. She's doing better thanks to various exercises to tone her back muscles.

All concerned

Young or old, all age and socio-professional categories are affected. In Africa, low back pain is the number one reason for rheumatological consultations. « Low back pain is not only a public health problem, but also a health problem in the workplace, with a direct impact on professional activities. A large number of work stoppages are linked to lower back pain », warns Innocent Lakna, physiotherapist and Director of the Centre National d'Appareillage Orthopédique (CNAO-Lomé).

A condition not to be overlooked!

The Centre National d'Appareillage Orthopédique (CNAO-Lomé) has already seen more than 260 cases of low back pain in the first quarter of 2023. Physiotherapist Innocent Lakna, Director of the CNAO-Lomé, explains that low back pain is pain felt in the lower back between the 12th rib and the lower gluteal fold.

There are three forms, and the most common is common lumbago, lower back pain with no specific cause, which accounts for 95% of cases of lower back pain. « There is also back pain caused by violent trauma, fractures, accidents or other illnesses, such as cancer; this is what we call specific low back pain », explains Innocent Lakna.

This specialist in orthopaedic manual therapy explains that there are three categories of low back pain, depending on the duration of the pain: acute low back pain (pain lasting less than six weeks), sub-acute low back pain (between 6 and 12 weeks) and chronic low back pain (more than three months). When the sciatic nerve is affected, the pain can extend down to the legs - this is known as radiating lumbago or lomboradiculalgia.

Innocent Lakna mentions the risk factors for low back pain: « sitting or standing for long periods, being overweight, especially if you have a large belly, heavy workloads, lack of physical activity, and bones that wear out. Back pain is common in the working population, aged between 30 and 59, who are more exposed to various physical tasks or stress ».

Unfortunate consequences

The director of the CNAO-Lomé points out that low back pain, especially in men, has a major impact on sexual relations. A person suffering from low back pain may lose the ability to perform certain tasks, especially those requiring bending over, or may no longer be able to hold themselves in certain positions.

If left untreated or well treated, low back pain can be disabling when the wear and tear on the vertebrae in the lower back affects the nerves. The patient may end up in a wheelchair.

Consult a specialist

Because of the pain, many people prefer to remain immobile so as not to aggravate their condition. But « immobilisation weakens the back and is a major factor in loss of confidence. It risks reinforcing the fear of moving and, ultimately, increasing the risk of recurrence. On the contrary, to recover quickly, people with low back pain should resume appropriate physical activity as soon as the pain stops being a nuisance, on the advice and under the supervision of their therapist », Innocent Lakna points out. As a general rule, when faced with persistent lower back pain, it is essential to seek medical advice in order to identify the exact problem. There's a big risk that if it's not common lower back pain and you do self-treatment or massage, you'll make the situation worse.

Practical advice

The specialist advises people to get used to some « trivial » but very important practices to prevent this disease: « avoid sitting for long periods. Once you are seated, position yourself well in the chair and avoid bending over. If you're in front of a computer, keep a distance of at least 50 cm. Look straight ahead, at the height of the top of the screen, to avoid tilting your head ».

If you're carrying a rucksack, make sure it's properly slung over both shoulders for balance. Avoid wearing shoes with high heels. Practise sport, three times a week, for at least 30 minutes. Take breaks between working hours, walk around a bit, sit down to wash up, wear pants, trousers and closed shoes, and have a washing-up container at waist height. To pick up or lift an object from the floor, squat down first. Lie down on a hard mattress.

If the pain is constant, progressive and present at night and is not relieved by lying on the back, if there is unexplained weight loss, fever, shivering and urinary incontinence, it is probably specific low back pain. It is essential to see a doctor as soon as possible in order to identify the underlying illness and ensure that it is treated appropriately.

Abel OZIH