The lumbar spine is a highly compensatory part of the vertebral column, capable of compensating for lower limb deformities as well as spinal deformities itself. Consequently, its ligaments and joints are prone to strain, leading to low back and leg pain.

bubble_chart Etiology

There are many causes of postural lumbago and leg pain, such as various congenital or acquired deformities of the lower limbs. Common examples include congenital or acquired dislocation or ankylosis of the hip joint, limb shortening or developmental deformities, congenital or acquired spinal deformities, spinal subcutaneous nodules, fractures, various congenital or acquired scoliosis, and juvenile kyphosis. To maintain trunk balance and prevent the weight-bearing line from excessively deviating from the center of gravity, while compensating for lower limb shortening, the lumbar spine must frequently alter its original curvature, increasing lumbar lordosis or lateral bending to compensate for postural deficiencies. As a result, patients gradually experience soreness in the lower back, developing chronic strain-induced lumbago, and may even develop traumatic arthritis of the lumbar spine.

bubble_chart Clinical Manifestations

Initially, there is pain during lumbar movement, which lessens after rest. Later, the lumbago worsens when starting activity after rest, and it only subsides after continuing slow movement for several minutes. However, prolonged activity leads to lumbar pain and weakness, making it impossible to continue working. No position can be maintained for too long, requiring frequent changes in posture. As symptoms worsen, the lumbar muscles become tense, function becomes limited, and even lumbar movement becomes difficult. Even a grade I injury can exacerbate the existing lower lumbago.

The lumbar spine loses its inherent physiological curvature, exhibiting scoliosis and increased physiological lordosis. There is narrowing of the intervertebral spaces, lip-like hyperplasia at the edges of the vertebral bodies, and thickening of bone density. In severe cases, adjacent bone spurs may fuse, leading to spinal ankylosis.

bubble_chart Treatment Measures

Prevention is the priority. For those with combined trauma, it can be managed as acute traumatic lumbago. The definitive solution is to correct lower limb shortening or other deformities, eliminating the causes of poor posture. For patients with uncorrectable deformities, to prevent posture-related lumbago, it is best to engage in work that involves minimal walking.