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 endanger health. Therefore, patients themselves can do a lot in the fight against back pain - from heat pads to exercises to develop back muscles. Learn more about the causes and treatment of back pain in this article.
brief information
- Back pain: are among the most common types of pain and affect mostly women. Most often, back pain is nonspecific.
- Classification:duration (acute, subacute, and chronic back pain), position (upper, middle, or lower back), and form (specific and nonspecific back pain).
- Causes:there is no reason for nonspecific back pain. In contrast, specific back pain has a recognizable symptom.
- Polls:depending on the physical condition of the patient: blood and urine tests, neurological examination, gynecological examination, electroneurography, etc.
- Treatment:Heat treatment, herbs, proper bending and stretching, back strengthening sports, back exercises in the workplace, relaxation techniques, acupuncture, possibly medications
Back pain: description and classification
Lower back pain, lumbago, back stiffness or just back pain are the names of one symptom. Sometimes he squeezes the cross, sometimes he pulls his neck. Sometimes back pain radiates to the side, arms or legs. Symptoms may be permanent or only temporary. Sometimes they are so strong that the victims can barely move.
Regardless of the diversity of nature and extent of complaints: back pain can haunt people of any age. They 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 divide back pain according to different criteria:
Classification according to the localization of back pain
- Upper back:Pain in the upper spine (neck area) can be acute or chronic. It is often felt in the shoulders, arms and / or nape of the neck. Neck pain is caused, for example, by poor posture in the workplace, a herniated disc or a mental disorder.
- In the middle of the back:Back pain in the thoracic spine is rarely caused by injury. They are most commonly caused by irritation of large muscle groups in this area or dysfunction of the joints of the costal vertebrae.
- In the lower back:back pain most commonly occurs in the lower back. Because the lumbar spine is more prone to injuries and damage than the neck and thoracic spine. Lower back pain is called "back pain". Possible causes are, for example, a herniated disc or muscle strain.
Classification according to the 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 a maximum of six weeks. The prognosis is generally good: acute back pain disappears in most victims within a few weeks.
- Subacute back pain:if back pain lasts from six weeks to a maximum of three months, they are considered subacute.
- Chronic back painor chronic recurrent back pain: lasts more than three months. The intensity of the pain can vary during this time - sometimes the back pain is weaker, sometimes stronger. Chronic back pain is becoming more common with age.
Classification of causes of back pain
Depending on whether it is possible to determine a clear cause of the disease, doctors distinguish between specific and nonspecific back pain. Read more in the next section.
The main reasons
Back pain can be roughly divided into two main causes: nonspecific and specific back pain.
Nonspecific back pain
For nonspecific back pain, the doctor cannot find a clear cause of the symptoms. The vast majority of all cases of back pain fall into this category.
Specific back pain
Overview of important causes of specific back pain:
- Muscle tension:very often muscle tension is the cause of back pain. Poor posture, one-sided loading or lack of physical activity make the muscles uneven - some muscles are overloaded, others underused. As a result, the muscles shorten or harden, which can cause tension and pain. A pinched nerve can also be the result of muscle tension and cause back pain.
- Disc herniation. . . The discs are placed in the form of a cushion-shaped shock absorber between the individual vertebral bodies. They consist of a soft gelatinous core surrounded by a ring of fibro fatigue. If the jelly core slips and breaks through the fiber sheath, a disc herniation occurs. This causes severe back pain when the gelatinous mass coming out of the sliding disc presses on the nearby nerves.
- Spine abrasion(osteoarthritis of the spine, phase syndrome): with age, the spinal joints wear out in the body.
- Rachiocampsis. . . In so-called scoliosis, the spine is bent laterally. This leads to premature wear, which can cause muscle tension and back pain. In addition, so-called Scheuermann's disease is characterized by spinal curvatures. The consequences are hunchbacks, back pain and limited mobility.
- Spondylolisthesis(Spondylosis): In this condition, the vertebrae are unstable so they can move easily. 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 a displaced spine presses on a nerve root, neurological disorders, such as emotional disturbances or paralysis, are also possible.
- Osteoporosis(bone loss). With osteoporosis, the bones become increasingly fragile. Then you can break them even at the smallest loads (eg when falling, stumbling). This often leads to vertebral fractures associated with back pain. Even the precursor of osteoporosis - osteopenia - may already be associated with 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, a woman's center of gravity shifts due to the growing fetus. It can also cause back pain. In addition, stroke and premature birth may be associated with 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 lasting back pain.
- Kidney stones:Unlike pelvic kidney inflammation, kidney stones are more common in men. Sometimes they are so small (semolina) that they are simply excreted in the urine through the urethra. On the other hand, a large kidney stone can get stuck in the ureter. The result is renal colic, which can cause, among other things, burning, cramps in the back, depending on the location of the kidney stone.
- Pneumonia(pneumonia): In addition to cough with fever and back pain, pneumonia is sometimes attributed. Inflammation is mainly caused by bacteria.
- Inflammation of the pancreas(pancreatitis): Both acute and chronic pancreatitis cause pain in the upper abdomen. It often radiates to the back and is experienced as back pain.
- Swelling of the spine and swelling of the ribs:Back pain can also be caused by a tumor in the spine or chest. Sometimes these tumors are benign, sometimes 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 primarily:
- Job-related factors:Carrying and lifting heavy loads, vibrations (for example, when working with a hammer) and working in awkward positions put stress on the 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 workplace or have to work monotonously from morning to evening (for example, on a treadmill) are more prone to back pain. In addition, social conflicts in the workplace and high work intensity without appropriate rewards (in the form of money, recognition, opportunities for advancement) can contribute to back pain.
- 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, as well as passive or overactive behavior - that is, marked restraint or too much activity.
Therapy of back pain
With specific back pain, the doctor will, if possible, remove the cause of the disease. For example, conservative (non-surgical) therapy, such as thermal treatments, physiotherapy, relaxation techniques, and pain medications or muscle relaxants, is usually sufficient for a herniated disc. Surgery is rarely needed. If your 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 the technique before trying it out.
- Exercises and sports:Physical therapy and back exercises are especially recommended for subacute and chronic nonspecific back pain, but not for acute back pain.
- Relaxation procedures:Targeted relaxation helps fight stress and tension (both play an important role in back pain). If the pain is already chronic, VUR may also be helpful. By the way, there are other relaxation techniques like autogenic training and meditation. Many patients with back pain have also had positive experiences in this area.
- Holistic methods and practices:yoga, qigong and tai chi chuan also have a relaxing effect. These complex exercise methods are suitable for preventing lumbago and herniated discs.
- Thermal therapy:Applying heat (e. g. , heating pads, thermoses, mud baths, fango bags) relaxes muscles and can relieve nonspecific back pain.
- Medicinal plants:Combined preparations of ash and aspen can relieve back pain. A cream or capsaicin patch can help with painful muscle tension.
- Aromatherapy:If you feel lumbago (back pain), you can rub the affected area with pine, sandalwood or ginger oil. This can help relieve symptoms.
- Diet adapted to the back:bones, joints, muscles and discs need a lot of nutrients to function. Make sure you have enough essential fatty acids, calcium, fluoride, vitamins C, D and E, as well as B vitamins, magnesium, boron, selenium and zinc. Not only does it help the back well, but it also contributes to good health in general.
- Drink a lot:The supply of nutrients 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 should and can be reduced: while exercising, patients generally need less medication to move (almost) painlessly. The doctor gives each patient special instructions on when the medicine can be used, in what dose and for how long. Patients should follow these instructions to avoid side effects or addiction.
Even with specific back pain, drug therapy can be helpful and necessary. Basically it’s just a short time.
In principle, different groups of active ingredients are available for the treatment of back pain. Depending on the type and severity of symptoms, it depends on which drug is most appropriate in each case:
- conventional painkillers (analgesics);
- very strong opiate analgesics;
- muscle relaxants: not recommended for nonspecific back pain;
- some antidepressants, for example, for chronic nonspecific back pain, when the patient is suffering from depression or sleep disorders at the same time
When should you see a doctor?
Back pain is not always a sign of a more or less serious medical condition that requires a visit to the doctor. Often behind this are relatively harmless causes, such as muscle tension due to lack of exercise or poor posture. However, in the following cases, for safety reasons, you should see a doctor:
- atypical back pain
- persistent back pain
- intensification of back pain
Important research
These studies help clarify the causes of complaints:
- cardiac catheterization;
- joint puncture;
- electromyography;
- radiography;
- medical history;
- CT scanner;
- scintigraphy;
- ultrasound;
- cystoscopy;
- arthroscopy.
Back pain: reviews
To explain your back pain, your doctor will first talk to you to compile your medical history. Possible questions:
- Where does back pain occur?
- Does back pain spread to other parts of the body (such as the hips or one leg)?
- How long does the current attack of pain last?
- Have there been any previous cases of back pain? How did the pain come about?
- Are there factors that cause, worsen, or alleviate back pain (e. g. , fever, chills, movement)?
- How were back pain treated (medication, massage)? Were the measures successful? Are there any side effects?
- What is the (daily) time course of back pain?
- How severe is back pain? Do daily activities interfere with you?
- Do you have any concomitant mental or physical illness?
Examination by a doctor
After a medical history, the doctor may conduct various studies to investigate the causes of back pain.
- Blood tests:measuring different blood counts can be, for example, evidence of spinal cord abrasion, inflammation (such as pleurisy, prostatitis, pyelitis) or heart attack as a trigger for back pain.
- Urine analysis:Urine sample testing may eliminate or increase suspicion of kidney disease or acute prostatitis.
- Electromyography (EMG):Measurement of electrical muscle activity also serves to identify disc herniation as a possible cause of back pain.
- Ultrasound procedure:if your back pain is caused by pyelonephritis or kidney stones, an ultrasound can help determine the cause.
- X-ray:a simple X-ray can provide information on various possible causes of back pain, such as pneumonia, pneumothorax, spinal obstruction, spinal inflammation (ankylosing spondylitis), or osteoporosis.
- Computed tomography (CT):it is performed when there is a suspicion that back pain is caused by a herniated disc, spinal cord abrasion, aortic aneurysm, pancreatitis or lung tumor.
- Magnetic resonance imaging (MRI):this test can be used to identify suspected disc herniation or spinal inflammation (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 (lung scintigraphy: suspected pulmonary embolism).
When 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 recommended only if specific back pain is suspected. In the first clarification, acute and uniformly chronic back pain are intentionally omitted: too many examinations can cause the patient to fear that there may be a serious cause behind the back pain that is simply not yet identified. This can make acute back pain chronic (chronic).