Lumbago (acute low back pain)

Lumbago, commonly known in German as 'Hexenschuss', is a sudden, shooting pain in the lower back, usually triggered by an awkward movement. In a video consultation, our physicians assess your symptoms and, based on their medical evaluation, may prescribe short-term pain therapy, for example with non-steroidal anti-inflammatory drugs (NSAIDs), as a private prescription.

Medically reviewed by Adi Zoabi, Approbation als Arzt.
Last reviewed on August 31, 2026. Updated as clinical guidelines change.

Overview

Lumbago – known in German as 'Hexenschuss' and medically as acute low back pain – refers to suddenly occurring, usually one-sided pain in the lower back. Typically, a shooting pain strikes during an everyday movement such as bending over, lifting or twisting the upper body. Many of those affected involuntarily adopt a bent-forward protective posture and can hardly straighten up. In most cases the underlying problem is a painful dysfunction of the muscles and small vertebral joints; there is usually no structural damage. Uncomplicated lumbago often improves noticeably within a few days to weeks. In an OpenClinic24 video consultation, you discuss your symptoms with a physician. Based on the medical assessment, short-term pain therapy, for example with non-steroidal anti-inflammatory drugs (NSAIDs), may be prescribed as a private prescription. If symptoms persist for more than twelve weeks, this is referred to as chronic back pain, which should be evaluated separately and is covered on its own page.

Common causes

Lumbago usually results from a combination of several factors. Frequent triggers are jerky or unaccustomed movements, lifting heavy loads from a bent position, abrupt twisting of the trunk, and prolonged work in an unfavourable posture. Contributing factors include weak core muscles, long periods of sitting, lack of exercise and excess weight. Cold, draughts and muscular tension, for example due to stress, can also play a role. In the majority of those affected, the condition is so-called non-specific back pain, in which there is no serious structural cause. Less commonly, a herniated disc, degenerative changes of the spine or – very rarely – inflammatory diseases, fractures or tumours are behind the symptoms. A careful medical history helps to identify indications of such rarer causes and, if necessary, to arrange further in-person examination.

When to see a doctor

In many cases, uncomplicated lumbago can initially be assessed well via telemedicine. You should seek medical advice if the pain is very severe, does not improve after a few days, or keeps recurring. A prompt examination in a medical practice is advisable if the pain radiates into the leg below the knee, if you experience tingling or numbness, after a fall or accident, in case of fever, unintended weight loss or night-time pain at rest, and if you have known osteoporosis or a tumour disease. Call the emergency number 112 immediately if paralysis occurs in the legs, if you notice numbness in the genital or buttock area, or if you lose control of your bladder or bowel. These can be signs of cauda equina syndrome, which must be treated as an emergency without delay.

Symptoms & Indications

Sudden, shooting pain in the lower back Marked restriction of movement, often a bent-forward protective posture Hardening and tension of the lumbar muscles Pain worsening when bending, straightening up or twisting Pain when coughing, sneezing or straining Radiation into the buttocks, usually not below the knee Difficulty getting up from sitting or lying down

Treatment Options

Based on medical assessment, a private prescription for non-steroidal anti-inflammatory drugs (NSAIDs) for short-term pain therapy
Topical analgesics such as pain-relieving creams or gels
Heat applications, for example heat patches or a hot-water bottle, to relax the muscles
Early movement adapted to the pain instead of strict bed rest
Short-term relief through the supported supine position with raised legs
Guidance on back-friendly behaviour in everyday life
For persistent symptoms, a recommendation for physiotherapy and active core strengthening

Important Notes

A video consultation does not replace a physical examination or imaging; if symptoms are unclear or persistent, a visit to a medical practice may be necessary.
Call the emergency number 112 immediately if you experience paralysis of the legs, numbness in the genital or buttock area, or loss of bladder or bowel control.
In case of fever, unintended weight loss, night-time pain at rest, or symptoms after a fall, a prompt in-person medical examination is advised.
Controlled substances and other strong painkillers are not prescribed via video consultation.

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Medical notice: Not a substitute for an in-person medical examination. The information on this page is intended for general guidance only. In an emergency, please call 112.

Frequently Asked Questions

What is the difference between lumbago and a herniated disc?

Lumbago is usually a painful dysfunction of the muscles and small vertebral joints without involvement of the nerve roots; the pain remains largely confined to the lower back. With a herniated disc, in contrast, the pain often radiates into the leg and may be accompanied by tingling, numbness or muscle weakness. If such signs are present, an in-person physical examination is required.

Can I receive a prescription for the pain in the video consultation?

Based on their medical assessment, the physician may issue a private prescription, for example for non-steroidal anti-inflammatory drugs (NSAIDs) for short-term pain therapy. Whether a medication is suitable for you depends on your pre-existing conditions and current medication and is reviewed during the consultation. There is no entitlement to a specific prescription; strong painkillers are not prescribed via telemedicine.

What does the treatment cost, and will my private health insurance cover it?

Billing is carried out as a private medical service according to the German medical fee schedule (GOÄ). You receive a transparent invoice that you can submit to your private health insurer or Beihilfe; reimbursement depends on your individual plan. Self-paying patients with statutory insurance can also use the service and cover the costs themselves.

How long does lumbago last and what can I do myself?

Uncomplicated lumbago often improves within a few days, at the latest after a few weeks. Movement within a pain-tolerable range, heat, and short-term pain therapy based on medical assessment support recovery; strict bed rest is not recommended. If your symptoms do not improve or worsen, you should seek medical advice again.

When is back pain considered chronic?

Back pain is considered chronic when symptoms persist for more than twelve weeks; at six to twelve weeks it is classified as subacute. Acute lumbago is distinct from this and usually has a good prognosis. For longer-lasting symptoms, you will find further information on our back pain page.