Hexenschuss (Acute Lumbago)
What is lumbago?
Hexenschisis is a sharp and severe pain in the lower back, which is caused by a sudden wrong movement. In Hungarian it is called “witch shot”. The patient can hardly move and assumes a so-called pain-avoiding posture.
Dr. Dóra Mihola
Rheumatologist specialist
What causes lumbago?
A sudden, wrong movement causes a nerve to pinch and come under pressure. The pressure causes sterile inflammation around the nerve root , so the pain and the restriction of movement cannot go away by itself. Because of the pinching, every movement causes severe and sharp pain. Hexenschisis usually affects the nerve roots near the spine, so it is typically a low back pain.
When should you see a doctor?
Hexenshot usually causes very severe pain and restriction of movement, which normal painkillers have little effect on. Because of the internal inflammation, it does not improve with rest and ointment alone, so it is essentialto see a rheumatologist orspecialist in orthopedics .
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Dr. Éva Bordán
Rheumatologist general practitioner
How can lumbago be treated?
The rheumatologist or specialist in orthopedics makes the diagnosis of Hexenschuss on the basis of a thorough interview and physical examination. Treatment can be divided into two phases: acute pain relief and long-term movement therapy.
The first step in acute treatment is local analgesia and anti-inflammatory treatment. This is usually a local steroid injection to help reduce pain and reduce internal sterile inflammation. In addition to the injection, a prescription non-steroidal oral anti-inflammatory tablet is often recommended. 1-2 days of rest and non-strict bed rest are recommended, after which gentle exercise is necessary.
The anti-inflammatory drugs reduce the inflammation around the pinched nerve, giving space for the segments to re-grow and release the pinch. However, this requires further therapy. This is where longer-term movement-focused therapy begins. To relieve the nerve root pressure , the spinal segments need to re-align. This is assisted by specific nerve mobilisation physiotherapy. In addition to physiotherapy, therapeutic massage and physiotherapy treatments ( ultrasound, TENS, laser) are also recommended to relax the muscles, reduce pain and promote healing.
How can you prevent the problem from returning?
A pinched nerve, hexenschisis, is always caused by some kind of spinal instability. In order to stabilise the spinal column, it is necessary to create a muscular brace by strengthening the deep back muscles. This can be achieved by regularly performing specific exercises tailored to the individual. The exercises are taught by a qualified physiotherapist. Long-term use of gymnastics can be accompanied by appropriate exercise, sport and a healthy, spine-conscious lifestyle.
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Dr. Katalin Bán
Rheumatologist specialist
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Rheumatologist general practitioner
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Rheumatologist specialist
Dr. Bence Moravcsik
Orthopedic-Traumatologist
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