Low back pain: diagnosis and treatment in Lisbon and Almada

When to seek urgent help

Most low back pain has no serious cause. See a doctor the same day, or go to A&E, if the pain comes with:

• weakness in one or both legs;

• numbness in the genital area or between the legs;

• difficulty passing urine or controlling your bladder or bowels;

• fever, unexplained weight loss or a history of cancer;

• pain after a fall or an accident;

• pain that doesn't ease with rest and wakes you at night.

How we assess you at Clínica Myalgia

In the pain consultation, the doctor takes your history, carries out a physical and neurological examination and assesses how you move. The aim is to understand where the pain comes from: the facet joints, the muscles, the disc or a compressed nerve root.

Tests such as MRI are only requested when they could change the treatment. Many findings on scans, such as dehydrated discs or small herniations, are also seen in people without pain.

Treatment: moving is part of the solution

With low back pain, prolonged rest delays recovery. Depending on the case, treatment combines:

• Physiotherapy with exercise: strengthening the muscles that stabilise the spine and correcting the movement patterns that overload the lower back, in one-to-one sessions.

• Ultrasound-guided procedures: when pain gets in the way of rehabilitation, a precisely placed injection can control the pain so you can get back to exercise. Options include facet joint blocks, epidural injection and radiofrequency.

• Movement analysis: for people with recurring pain when running, lifting weights or working at a desk.

• Nutrition: when body weight is adding to the load.

Frequently asked questions about low back pain

Do I need an MRI?

In most cases, not at first. MRI is useful when there are warning signs, weakness, radiating pain that isn't improving, or when a procedure is being considered.

How long does low back pain take to settle?

Most acute episodes improve within a few weeks. If the pain lasts more than six weeks or keeps coming back, it is worth finding the cause and treating what keeps it going.

Should I rest?

No. Staying active within what the pain allows speeds up recovery. Your physiotherapist will help you choose the right movements at each stage.

Is pain going down my leg a herniated disc?

It may be, but not always. Radiating pain can come from a compressed nerve root, the facet joints or the hip muscles. A clinical examination tells these causes apart.

Will my health insurance cover it?

We are a private practice, but most insurance policies with reimbursement cover will refund part of the cost. See how in Insurance and reimbursements.

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