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Why hurt your back: 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 threaten health. Therefore, there is a lot that patients themselves can do to combat back pain - from heat packs to exercises to build back muscles. Learn more about the causes and treatment of back pain in this article.

Back ache

brief information

  • Back ache: 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).
  • Causes:there is no reason per se for nonspecific back pain. In contrast, specific back pain has a detectable symptom.
  • Surveys:depending on the patient's physical condition: blood and urine tests, neurological examination, pelvic examination, electroneurography, etc.
  • Processing:Heat treatment, herbal remedies, correct flexion and extension, sports to strengthen the back, back training at work, relaxation techniques, acupuncture, possibly medication

Back pain: description and classification

Low back pain, lumbago, stiff back or simply back pain are the names of a symptom. Sometimes she hugs the cross, sometimes she 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.

No matter 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 age groups are more likely to report back pain than men. This phenomenon manifests itself in other types of pain as well.

Doctors divide back pain according to different criteria:

Classification by location of back pain

  • Upper back: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 the back of the head. Neck pain is caused, for example, by poor posture at work, 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 often seen in the lower back. Because the lumbar spine is more prone to injury and damage than the neck and thoracic spine. Low back pain is called "back pain". Possible causes are, for example, herniated discs or muscle tension.

Classification by duration of back pain

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

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

Classification of back pain causes

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

Main reasons

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

Non-specific back pain

For nonspecific back pain, the doctor cannot find a clear cause for the symptoms. The vast majority of all back pain cases fall into this category.

Specific back pain

An overview of the important causes of specific back pain:

  • Muscle tension: very often muscle tension is the cause of back pain. Poor posture, one-sided loading, or a lack of physical activity make muscles uneven - some muscles are overworked, others are underused. 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.
  • Herniated disc. . . The discs are located in the form of cushion-shaped shock absorbers between the individual vertebral bodies. They consist of a soft gelatinous nucleus surrounded by a fibrocartigue ring. If the jelly core slips and passes through the fiber sheath, a herniated disc occurs. This causes severe back pain when the gelatinous mass coming out of the sliding disc puts pressure on 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 what is called scoliosis, the spine is bent sideways. This leads to premature wear, which can cause muscle tension and back pain. In addition, with the so-called Scheuermann's disease, curvatures of the spine are characteristic. The consequences are hunchback, back pain and reduced mobility.
  • Spondylolisthesis(Spondylisthesis): In this condition, the vertebrae are unstable so that they can be easily moved. This mostly happens in the lumbar region. Many patients have few or no complaints. But exercise and certain movements can cause back pain. When the displaced vertebra presses on the nerve root, neurological disorders, such as emotional disturbances or paralysis, are also possible.
  • Osteoporosis(bone loss). With osteoporosis, the bones become more and more fragile. Then you can break them even with the smallest loads (eg drop, trip). This often leads to vertebral fractures associated with back pain. Even the first sign of osteoporosis - osteopenia - can 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 cause the tendons and ligaments in the pelvic floor area to relax. 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 growth of the fetus. It can also cause back pain. Additionally, strokes and premature births can 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 illness, it can cause long term back pain.
  • Stones in the kidneys:Unlike inflammation of the pelvic kidneys, 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 lodge in the ureter. The result is renal colic, which can cause, among other things, burns, back cramps, 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 causes 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 second case, they 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

Several factors increase the risk of back pain. These are mainly:

  • Work-related factors:Carrying and lifting heavy loads, vibrations (for example, when working with a jackhammer), and working in awkward positions put pressure on the spine, joints and muscles. This can lead to long term back pain. Thus, certain back diseases are recognized as occupational diseases.
  • Psychosocial conditions related to work:People who are unhappy with their workplace or have to work monotonously from morning to night (for example, on an assembly line) are more prone to back pain. In addition, social conflicts in the workplace and high work 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, as well as passive or hyperactive behavior - that is, expressed restraint or too much activity.

Back pain therapy

With specific back pain, the doctor, if possible, will rule out the cause of the disease. For example, for a herniated disc, conservative (non-surgical) therapy is usually sufficient, such as spa treatments, physiotherapy, relaxation techniques, and pain relievers or muscle relaxants. Surgery is rarely necessary. 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 a technique before trying it.

  • Exercises and sports:Physiotherapy and back exercises are particularly recommended for subacute and chronic nonspecific back pain, but not for acute back pain.
  • Relaxation procedures:Targeted relaxation helps combat stress and tension (both play an important role in back pain). If the pain is already chronic, VUR can also help. By the way, there are other relaxation techniques such as 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 the prevention of lumbago and herniated discs.
  • Thermal therapy:Applying heat (eg, heating pads, thermos, mud baths, mud bags) relaxes muscles and can relieve non-specific back pain.
  • Medicinal plants:combined preparations of ash and aspen can relieve back pain. For painful muscle tension, a capsaicin cream or patch may help.
  • Aromatherapy:If you suffer from lumbago (back pain), you can rub pine, sandalwood, or ginger oil on the affected area. It can help relieve symptoms.
  • Nutrition respectful of 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.
  • Drinks a lot:Supplying nutrients to the intervertebral discs only works with large amounts of fluid.

Medicines for back pain

Medication reduces back pain so much that physical activity is possible again. Over time, the dose of the medicine should and can be reduced: when exercising, patients generally need less medicine to move (almost) painlessly. The doctor gives each patient specific instructions as to when the medicine can be used, at 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 only for 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 the most appropriate drug in each case:

  • conventional pain relievers (pain relievers);
  • very strong analgesics from the group of opiates;
  • muscle relaxants: not recommended for non-specific back pain;
  • certain antidepressants, for example, for chronic nonspecific back pain, when the patient simultaneously suffers 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 visit to the doctor. There are often relatively harmless causes behind this, such as muscle tension from lack of exercise or poor posture. However, in the following cases, you should see a doctor for safety reasons:

  • atypical back pain
  • persistent back pain
  • increased back pain

Important research

These studies help to clarify the causes of complaints:

  • cardiac catheterization;
  • joint puncture;
  • electromyography;
  • radiography;
  • history of illness;
  • computed tomography;
  • scintigraphy;
  • ultrasound;
  • cystoscopy;
  • arthroscopy.

Back pain: examinations

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

  • Where does back pain occur?
  • Is your back pain spreading to other parts of your body (like your sides or a leg)?
  • How long does the current pain crisis last?
  • Have there ever been cases of back pain? How did the pain go?
  • Are there factors that cause, worsen, or relieve back pain (eg fever, cold, movement)?
  • How was the back pain treated (medication, massage)? Have the measures been successful? Are there any side effects?
  • What is the (daily) evolution of back pain?
  • How bad is your back pain? Do they interfere with daily activities?
  • Do you have a concurrent 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: measurement of various blood counts can be, for example, evidence of spinal cord abrasion, inflammation (such as pleurisy, prostatitis, pyelitis) or a heart attack as a trigger for back pain.
  • Urine analysis :testing a urine sample may clear or reinforce suspicions of kidney disease or acute prostatitis.
  • Electromyography (EMG):Measuring the electrical activity of a muscle can also identify a 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.
  • Radiography:a simple x-ray can provide information about various possible causes of back pain, such as pneumonia, pneumothorax, obstruction of the spine, inflammation of the spine (ankylosing spondylitis) or osteoporosis.
  • Computed tomography (CT):performed when back pain is suspected to be caused by a herniated disc, spinal cord abrasions, aortic aneurysm, pancreatitis or lung tumor.
  • Magnetic Resonance Imaging (MRI):this test can be used to identify suspicions of a herniated disc or inflammation of the spine (ankylosing spondylitis).
  • Scintigraphy:This nuclear medicine test determines the activity state of different tissues, such as bone tissue (bone scan: suspected ankylosing spondylitis) or lung tissue (lung scan: suspected pulmonary embolism).

When what research is needed

Physical examination and laboratory tests (blood, urine) are common in the diagnosis of 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 uniformly chronic back pain is intentionally omitted: too many examinations can cause 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 back pain acute chronic (chronic).