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 to combat back pain - from heat compresses to exercises to develop back muscles. Learn more about the causes and treatment of back pain in this article.
short information
- Back pain: are among the most common types of pain and mainly affect women. Most often, back pain is nonspecific.
- Classification:duration (acute, subacute and chronic back pain), position (upper, middle or lower back) and shape (specific and non-specific back pain).
- Reasons:there is no reason alone for nonspecific back pain. In contrast, specific back pain has a noticeable symptom.
- Polls:depending on the patient's physical condition: blood and urine tests, neurological examination, gynecological examination, electroneurography, etc.
- Treatment:Heat treatment, medicinal plants, proper bending and stretching, sports to strengthen the back, back training in the workplace, relaxation techniques, acupuncture, possibly medication
Back pain: description and classification
Low back pain, lumbago, back stiffness or just back pain are the names of one symptom. Sometimes she squeezes her waist, sometimes she pulls her neck. Sometimes back pain radiates to the sides, arms or legs. Symptoms may be permanent or only temporary. Sometimes they are so strong that the victims can barely move.
No matter how diverse the nature and extent of the complaints: back pain can haunt people of almost any age. They are among the most common problems of modern man. Women of all ages are more likely to report back pain than men. This phenomenon is manifested in other types of pain.
Doctors divide back pain by different criteria:
Classification by localization of back pain
- Upper back:The pain in the upper part of the spine (neck area) can be acute or chronic. It is often felt in the shoulders, arms and / or back of the head. 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. Most often they are 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 is most commonly seen in the lower back. Because the lumbar spine is more susceptible to injury 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 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 a maximum of six weeks. The prognosis is generally good: the 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 more common with age.
Classification of the causes of back pain
Depending on whether it is possible to establish the 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 non-specific back pain, the doctor cannot find a clear cause for the symptoms. The majority of all cases of back pain fall into this category.
Specific back pain
An overview of the important causes of specific back pain:
- Muscle strain: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 are 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 arranged in the form of shock absorbers in the form of a cushion between the individual vertebral bodies. They consist of a soft gelatinous core surrounded by a fibrous ring. If the core of the jelly slides and pierces the fiber sheath, a herniated disc is formed. This causes severe back pain when the gelatinous mass coming out of the sliding disc presses on the nearby nerves.
- Abrasion of the spine(osteoarthritis of the joints 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 and tear, which can cause muscle tension and back pain. In addition, the so-called Shoyerman's disease is characterized by curvatures of the spine. The consequences are hump, back pain and limited mobility.
- Spondylolisthesis(Spondylosis): In this condition, the vertebrae are unstable so they can be easily moved. This happens especially in the lumbar region. Many patients have little or no complaints. But exercise and certain movements can cause back pain. When the displaced vertebra compresses the nerve root, neurological disorders, such as emotional disorders or paralysis, are also possible.
- Osteoporosis(bone loss). With osteoporosis, the bones become increasingly fragile. You can then break them even with the smallest loads (eg falling, tripping). This often leads to spinal fractures, which are associated with back pain. Even the harbinger 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 sagging tendons and ligaments in the pelvic floor. 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, strokes and premature birth may be associated with back pain.
- Pyelonephritis:Inflammation of the pelvic kidneys is usually caused by bacteria and especially in women. Especially if it is a chronic condition, it can cause long-term 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 ureter. Large kidney stones, on the other hand, can linger 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): Acute and chronic pancreatitis cause pain in the upper abdomen. It often radiates to the back and is perceived 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 latter case, these are almost always secondary tumors of cancerous tumors 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 above all:
- Work-related factors:Carrying and lifting heavy loads, vibrations (for example when working with a hammer) and working in awkward positions put a strain 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.
- Psychosocial conditions related to work:People who are dissatisfied with their workplace or have to work monotonously from morning to evening (for example on a production line) are more prone to back pain. In addition, social conflicts in the workplace and high labor intensity without adequate rewards (in the form of money, recognition, promotion opportunities) 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 influenced by adverse conditions such as psychological factors. These include, for example, unrealistic fears of back pain, depression, and passive or overactive behavior - that is, extreme restraint or too much activity.
Therapy for back pain
In case of specific back pain, the doctor will, if possible, eliminate the cause of the disease. For example, conservative (non-surgical) therapy, such as thermal procedures, physiotherapy, relaxation techniques, and painkillers or muscle relaxants, is usually sufficient for a herniated disc. Surgery is rarely required. If your back pain is caused by pyelonephritis, your doctor will usually prescribe antibiotics. Most bacteria cause inflammation.
It is best to always consult your doctor about a technique before trying it.
- Exercises and sports:Physical therapy and back exercises are recommended especially 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. By the way, there are other relaxation techniques such as autogenic training and meditation. Many patients with back pain also have a positive experience in this area.
- Holistic methods and practices:yoga, qigong and tai chi chuan also have a relaxing effect. These sophisticated exercise methods are suitable for preventing lumbago and disc herniation.
- Thermal therapy:Applying heat (eg heating pads, thermoses, mud baths, fango bags) relaxes the muscles and can relieve non-specific back pain.
- Medicinal plants:combined preparations of ash and aspen can relieve back pain. A cream or patch with capsaicin can help with painful muscle tension.
- Aromatherapy:If you are experiencing lumbago (back pain), you can rub pine, sandalwood or ginger oil on the affected area. This can help relieve the symptoms.
- Acceptable nutrition for 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. It not only helps the back well, but also contributes to good health in general.
- Drink a lot:The supply of nutrients to the intervertebral discs works only with large amounts of fluid.
Medicines for back pain
Medications reduce back pain so much that physical activity is possible again. Over time, the dose of the drug should and can be reduced: while exercising, patients usually need fewer drugs to move (almost) painlessly. The doctor gives each patient specific 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. In principle, this is only for a short time.
In general, 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 for each case:
- conventional painkillers (analgesics);
- very strong analgesics from the group of opiates;
- muscle relaxants: not recommended for non-specific back pain;
- certain antidepressants, for example for chronic non-specific back pain when the patient is suffering from depression or sleep disturbance at the same time
When should you see a doctor?
Back pain is not always a sign of a more or less serious illness that requires a visit to the doctor. Relatively harmless causes, such as muscle tension from lack of exercise or poor posture, are often behind it. However, in the following cases you should see a doctor for safety reasons:
- atypical back pain
- constant back pain
- increased back pain
Important research
These studies help to clarify the causes of complaints:
- cardiac catheterization;
- puncture of the joints;
- electromyography;
- radiography;
- medical history;
- CT scan;
- scintigraphy;
- ultrasound;
- cystoscopy;
- arthroscopy.
Back pain: examinations
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 there been previous cases of back pain? How does the pain go?
- Are there factors that cause, worsen or alleviate back pain (eg fever, cold, movement)?
- How to treat back pain (medication, massage)? Were the measures successful? Are there any side effects?
- What is the (daily) course of back pain?
- How bad is your back pain? Do they interfere with daily activities?
- Do you have a concomitant mental or physical illness?
examined by a doctor
After a medical history, the doctor may perform various tests to investigate the causes of back pain.
- Blood tests:the measurement of various blood pictures 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:examination of a urine sample may clear or increase the suspicion of kidney disease or acute prostatitis.
- Electromyography (EMG):Measuring the electrical activity of a muscle also serves to identify the herniated disc 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-rays: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):is performed when there is a suspicion that back pain is caused by a herniated disc, abrasions of the spinal cord, aortic aneurysm, pancreatitis or lung tumor.
- Nuclear magnetic resonance imaging (MRI):this test can be used to identify suspected disc herniation or spinal inflammation (ankylosing spondylitis).
- Scintigraphy:This test for nuclear medicine determines the state of activity of various tissues, such as bone tissue (bone scintigraphy: suspected ankylosing spondylitis) or lung tissue (pulmonary scintigraphy: suspected 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 recommended only if specific back pain is suspected. In the first explanation, acute and evenly chronic back pain is deliberately omitted: too much research can lead the patient to fear that there may be a serious cause behind the back pain that simply has not yet been identified. This can make acute back pain chronic (chronic).