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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.
Video about the MIBRAR® Method
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.
Why lumbago cannot simply be «waited out»
60-80% of lumbago episodes resolve within 2-4 weeks. But in 30% of patients, pain returns within a year, and in 10% it progresses to chronic form. The reason — damaged structure (disc, facet joint) remains untreated.
Vicious cycle: pain → spasm → ischemia → pain
Muscle spasm disrupts blood supply, inflammatory products accumulate, maintaining pain and spasm. Without breaking this cycle, chronic pain syndrome develops.
Treatment of Lumbago using the MIBRAR® method
MIBRAR® is applied after resolution of the acute episode (usually after 3-7 days) to eliminate the cause and prevent recurrences.
1. Diagnosis of the Cause
Lumbar MRI identifies the structural cause: disc protrusion, herniated disc, facet arthropathy, SI joint dysfunction.
2. Regeneration of Damaged Structure
For discogenic cause — intradiscal injection of CGF + Lipogems. For facet joint syndrome — injection of CGF into affected joints. For SI dysfunction — periarticular injection.
3. Anti-inflammatory Effect
CGF suppresses the inflammatory cascade, breaking the vicious cycle of "pain-spasm-ischemia." Muscle spasm resolves as inflammation subsides.
Don't Wait for the Next Attack
Each recurrence increases the risk of chronicity. Eliminate the cause now.
Send MRI ImagesTreatment Results for Lumbago
MRI follow-up confirms disc regeneration and elimination of the cause of acute back spasms after the MIBRAR® procedure.
WGZM Case: female, 43 years
Diagnosis: chronic lumbago due to lumbosacral destabilization. Pseudoretrolisthesis L4-L5, disc wear L5/S1 after nucleotomy. X-ray with color-coded sagittal balance.
Result at 18 months: complete stabilization — disc height restoration, retrolisthesis elimination. No recurrence of acute episodes.
View case study →
Same patient — sagittal MRI
Three sagittal slices of the lumbar spine: disc degeneration L4/L5 and L5/S1 visible (dark signal), protrusions, decreased intervertebral height.
Result: disc rehydration, increased disc space height, protrusion resolution. Cause of acute spasms eliminated — segments stabilized.
View case study →Questions about Lumbago
First 24-48 hours: NSAIDs (ibuprofen), muscle relaxants, moderate activity (no bed rest!). Cold for 15 minutes every 2 hours. If pain does not decrease in 3-5 days or weakness/numbness in the leg appears — see a doctor urgently.
Acute episode usually resolves in 2-4 weeks. But it returns in 30% within a year. The cause remains untreated. MIBRAR® eliminates the cause and prevents recurrences.
Lumbago — pain only in the lower back. Sciatica — pain from lower back down the leg to the foot (sciatic nerve compression). Lumbosciatica — combination of both.
Lumbar MRI — primary. Mandatory for recurrent episodes. For first episode without red flags — conservative treatment can be started first, MRI if no improvement in 4-6 weeks.
1) Eliminate the cause (MIBRAR®). 2) Strengthen the muscle corset. 3) Workstation ergonomics. 4) Maintain normal weight. 5) Regular physical activity (swimming, walking, Pilates).