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Why back pain: causes and treatment

Back pain is a popular disease of modern civilization: almost everyone suffers from back pain at least once in their life. Fortunately, in about 90% of cases, the causes do not pose a health risk. Therefore, patients themselves can do a lot in overcoming back pain - from heat compressions to exercises to develop back muscles. Learn more about the causes and treatment of back pain in this article.

back pain

short info

  • Back pain: are among the most common types of pain and primarily affect women. Most often, back pain is not specific.
  • Classification:duration (acute, subacute, and chronic back pain), situation (upper, middle, or lower), and form (specific and non-specific back pain).
  • Cause:there is no cause of nonspecific back pain per se. In contrast, specific back pain has a detectable symptom.
  • Surveys:depending on the patient's physical condition: blood and urine tests, neurological examination, gynecological examination, electroneurography, etc.
  • Treatment:Heat treatment, herbs, proper bending and stretching, sports to strengthen the back, training on the back at work, relaxation techniques, acupuncture, possibly medication

Back pain: description and classification

Low back pain, lumbago, stiffness, or just back pain is the name of one of the symptoms. Sometimes he squeezes the cross, sometimes he pulls his neck. Sometimes the back pain radiates to the side, arms or legs. Symptoms can be permanent or only temporary. Sometimes they are so strong that the victims can barely move.

No matter how varied the nature and extent of the complaints: back pain can accompany almost any age group. These are among the most common problems of modern man. Women in all age groups are more likely to report back pain than men. This phenomenon is also manifested in other types of pain.

Doctors classify back pain according to different criteria:

Classification according to the localization of back pain

  • Upper back:Upper spine (neck area) pain can be acute or chronic. It is often felt in the shoulders, arms and / or the back of the head. Neck pain is caused by, for example, poor posture at work, a disc herniation, or a mental disorder.
  • In the middle of the back:Back pain in the chest spine is rarely caused by injury. It is most often caused by irritation of large muscle groups in this area or dysfunction of the joints of the ribs.
  • In the lower back:back pain is most commonly seen in the lower back. Because the lumbar spine is more prone to injuries and injuries than the neck and chest spine. The lower back pain is called "back pain. "Possible causes include disc herniation or muscle tension.

Classification by duration of back pain

Depending on the duration of symptoms, doctors distinguish between acute, subacute, and chronic back pain:

  • Acute back pain:it is a back pain that occurs for the first time or after at least six months without pain and lasts for up to six weeks. The prognosis is generally good: acute back pain disappears within a few weeks in most victims.
  • Subacute back pain:if the back pain lasts from six weeks to a maximum of three months, they are considered subacute.
  • Chronic back painor chronic recurrent back pain: lasts for more than three months. The intensity of the pain can vary during this time - sometimes the back pain is weaker, sometimes more severe. Chronic back pain is more common with age.

Classification of the causes of back pain

Depending on whether it is possible to determine a clear cause of the disease, doctors distinguish between specific and non-specific back pain. More in the next section.

Main reason

Back pain can be roughly divided into two main causes: non-specific and specific back pain.

Non-specific back pain

In the case of non-specific back pain, the doctor will not find a clear cause for the symptoms. The vast majority of back pain cases fall into this category.

Specific back pain

An overview of important causes of specific back pain:

  • Muscle tension:very often muscle tension causes back pain. Poor posture, unilateral exertion, or lack of physical activity make muscles uneven - some muscles are overloaded, others are underutilized. As a result, the muscles shorten or harden, which can cause tension and pain. A pinched nerve can also result from muscle tension and cause back pain.
  • Disc herniation. . . The discs are arranged in the form of cushioned shock absorbers between each vertebral body. They consist of a soft gelatinous core surrounded by a fibrocartigue ring. If the gel core slips and breaks through the fibrous sheath, a disc herniation will form. This causes severe back pain when the gelatinous mass exiting the sliding disc presses on nearby nerves.
  • Spine wear(arthrosis of the joints of the spine, phase syndrome): as you age, the vertebral joints wear out in the body.
  • Rachiocampsis. . . In what is called scoliosis, the spine is bent laterally. This leads to premature wear, which can cause muscle tension and back pain. In addition, the so-called Scheuermann's disease is characterized by curvature of the spine. The consequences are bulging, back pain, and limited mobility.
  • Spondylolisthesis(Spondylisthesis): In this state, the vertebrae are unstable so they can be easily moved. This is especially true in the lumbar region. Many patients have little or no complaints. But exercise and certain movements can cause back pain. When the displaced vertebrae press the nerve root, neurological disorders such as emotional disturbances or paralysis are also possible.
  • Osteoporosis(bone loss). In osteoporosis, the bones become more and more fragile. You can then break them even at the slightest load (eg falling, tripping). This often leads to vertebral fractures with back pain. Even the precursor to osteopenia can be linked to back pain.
  • Pregnancy:many pregnant women have back pain. There are several reasons for this. For example, hormonal changes in pregnant women lead to relaxation of tendons and ligaments in the pelvic floor area. As a result, they become unstable, which can cause pain in the pelvis and lower back. In addition, the woman’s center of gravity shifts due to the growing fetus. It can also cause back pain. In addition, stroke and preterm birth can cause back pain.
  • Pyelonephritis: Inflammation of the pelvic kidney is usually caused by bacteria, especially in women. Especially if it is a chronic condition, it can cause long-term back pain.
  • Stones in the kidneys:In contrast to pelvic nephritis, kidney stones are more common in men. Sometimes they are so small (semolina) that they are simply excreted in the urine through the urethra. Large kidney stones, on the other hand, can get into the ureter. The result is renal colic, which can cause, among other things, burning, cramping back pain, depending on the location of the kidney stone.
  • Pneumonia(pneumonia): In addition to feverish and back pain coughs, pneumonia is sometimes attributed. Inflammation is mainly caused by bacteria.
  • Inflammation of the pancreas(inflammation of the pancreas): Acute and chronic inflammation of the pancreas causes pain in the upper abdomen. It often radiates to the back and can be perceived as back pain.
  • Swelling of the spine and ribs:Back pain can also be caused by a tumor of the spine or chest. Sometimes these tumors are benign, sometimes they are malignant. In the second case, these are almost always secondary cancers in other parts of the body, such as breast cancer or lung cancer.

Risk factors for back pain

There are several factors that increase the risk of back pain. This is mainly:

  • Work-related factors:Carrying and lifting heavy loads, shocks (such as when working with a hammer) and working in an awkward position put stress on your spine, joints and muscles. This can lead to back pain in the long run. Therefore, some back diseases are recognized as occupational diseases.
  • Work-related psychosocial conditions:People who are dissatisfied with their job or have to work monotonously from morning to night (such as on a treadmill) are more prone to back pain. In addition, social conflicts at work and high work intensity can contribute to back pain without adequate rewards (in the form of money, recognition, promotion opportunities).
  • Social status.Back pain is more common in people with low social status in terms of education, occupation, and income than in people with high social status.

The course of existing back pain can be affected by adverse conditions such as psychological factors. These include, for example, unrealistic fears of back pain, depression, and passive or hyperactive behavior — that is, pronounced restraint or too much activity.

Back pain therapy

With specific back pain, the doctor will, if possible, eliminate the cause of the disease. For example, in the case of a disc herniation, conservative (non-surgical) therapy, such as thermal treatments, physiotherapy, relaxation techniques, and analgesics or muscle relaxants, are usually sufficient. Surgery is rarely needed. If the back pain is caused by pyelonephritis, your doctor will usually prescribe antibiotics. Most bacteria are the cause of inflammation.

It is best to always consult your doctor about a technique before trying it.

  • Practice and sports:Physiotherapy and back exercises are especially recommended for subacute and chronic non-specific back pain, but not for acute back pain.
  • Relaxation procedures:Targeted relaxation helps against stress and tension (both play an important role in back pain). If the pain is already chronic, VUR may also be helpful. Otherwise, there are other relaxation techniques such as autogenic training and meditation. Many patients with back pain also have positive experiences in this area.
  • Holistic methods and practices:yoga, qigong and tai chi chuan also have a relaxing effect. These complex training methods are suitable for the prevention of lumbago and disc herniation.
  • Heat therapy:Applying heat (e. g. , heating pads, thermoses, mud baths, fango bags) relaxes muscles and can relieve nonspecific back pain.
  • Herbs:ash and poplar combined preparations can relieve back pain. Capsaicin cream or patch may help with painful muscle tension.
  • Aromatherapy:If you experience lumbago (back pain), you can rub pine, sandalwood or ginger oil on the affected area. This can help relieve symptoms.
  • Back-friendly nutrition:a lot of nutrients are needed for bones, joints, muscles and plates to function. Make sure you have enough essential fatty acids, calcium, fluoride, vitamins C, D and E, and vitamin B, magnesium, boron, selenium and zinc. Not only does it help your back well, but it also contributes to good health in general.
  • He drinks a lot:The nutrient supply to the intervertebral discs only works with large amounts of fluid.

Back pain medications

Medications reduce back pain so much that physical activity is possible again. Over time, the dose of medication must and can be reduced: during exercise, patients usually need less medication to move (almost) painlessly. The doctor will give each patient specific instructions on when, in what dose and for how long to use the medicine. Patients should follow these instructions to avoid side effects or addiction.

Even in the case of specific back pain, drug therapy may be useful and necessary. Basically only for a short time.

In principle, different groups of drugs are available for the treatment of back pain. Depending on the type and severity of the symptoms, the most appropriate medication in each case depends on:

  • conventional analgesics (painkillers);
  • very potent analgesics from the opiate group;
  • muscle relaxants: not recommended for non-specific back pain;
  • certain antidepressants, such as chronic, non-specific back pain, when the patient is suffering from depression or sleep disturbances

When to see a doctor?

Back pain is not always a sign of a more or less serious medical condition that requires a doctor. There are often relatively harmless reasons behind it, such as muscle tension due to lack of exercise or poor posture. However, for safety reasons, you should consult a doctor in the following cases:

  • atypical back pain
  • persistent back pain
  • increasing back pain

Important research

These studies help clarify the causes of complaints:

  • cardiac catheterization;
  • joint defect;
  • electromyography;
  • radiography;
  • medical history;
  • CT scan;
  • scintigraphy;
  • ultrasound;
  • cystoscopy;
  • arthroscopy.

Back pain: tests

To clarify your back pain, your doctor will first talk to you in detail to compile your medical history. Possible questions:

  • Where does back pain occur?
  • Does the back pain spread to other parts of the body (such as the sides or one leg)?
  • How long does the current pain attack last?
  • Have you had a previous back pain? How did the pain continue?
  • Are there factors that cause, aggravate or alleviate back pain (e. g. , fever, cold, exercise)?
  • How was your back pain treated (medication, massage)? Were the measures successful? Do you have any side effects?
  • What is the (daily) time course of back pain?
  • How much does your back hurt? Do they interfere with daily activities?
  • Do you have an accompanying mental or physical illness?

Examination by a doctor

After a medical history, your doctor may perform various studies to examine the causes of your back pain.

  • Blood collection:For example, measuring different blood counts may be evidence of spinal cord wear, inflammation (e. g. , pleurisy, prostatitis, pyelitis), or heart attack as a cause of back pain.
  • Urine analysis:examination of a urine sample may clear or confirm the suspicion of kidney disease or acute prostatitis.
  • Electromyography (EMG):Measuring the electrical activity of a muscle also serves to identify the disc herniation as a possible cause of back pain.
  • Ultrasound procedure:if the back pain is caused by pyelonephritis or kidney stones, ultrasound may help determine the cause.
  • X-ray:A simple x-ray can provide information on various possible causes of back pain, such as pneumonia, pneumonia, spinal cord obstruction, ankylosing spondylitis, or osteoporosis.
  • Computed tomography (CT):it is performed when back pain is suspected to be caused by a disc herniation, spinal abrasions, aortic aneurysm, pancreatitis, or lung cancer.
  • Magnetic resonance imaging (MRI):this test can be used to identify suspicions of disc herniation or ankylosing spondylitis.
  • Scintigraphy:This nuclear medicine test determines the state of activity of various tissues, such as bone tissue (bone scintigraphy: suspected ankylosing spondylitis) or lung tissue (pulmonary scintigraphy: pulmonary embolism).

When what research is needed

Physical examination and laboratory tests (blood, urine) are common in diagnosing back pain. In contrast, X-rays — that is, X-rays, computed tomography (CT), and magnetic resonance imaging (MRI) — are only recommended if specific back pain is suspected. In the first clarification, acute and evenly chronic back pain is intentionally omitted: due to too many tests, the patient may fear that there may be a serious cause behind the back pain that has simply not yet been identified. Because of this, acute back pain can be chronic (chronic).