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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 lifetime. Fortunately, in about 90% of cases, the causes do not threaten health. Therefore, patients themselves can do a lot to fight back pain - from heat compresses to exercises for developing back muscles. Learn more about the causes and treatment of back pain in this article.

backache

brief information

  • Backache: 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 in itself for non-specific back pain. In contrast, specific back pain has a detectable symptom.
  • Surveys:depending on the physical condition of the patient: blood and urine tests, neurological examination, gynecological examination, electroneurography, etc.
  • Treatment:Heat treatment, herbs, proper flexion and extension, sports to strengthen the back, workouts for the back in the workplace, relaxation techniques, acupuncture, possibly medication

Back pain: description and classification

Back pain, lumbago, stiffness of the back or just back pain are the names of a symptom. Sometimes squeeze the cross, sometimes pull the 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 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 in all age groups are more likely to report back pain than men. This phenomenon also appears in other types of pain.

Doctors classify 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 on the shoulders, arms and / or back of the head. Neck pain is caused, for example, by poor posture, a disc herniation 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 coastal vertebral joints.
  • In the lower back:back pain is most often seen in the lower back. Because the lumbar spine is more prone to injuries and injuries than the neck and thoracic spine. Low back pain is called "back pain". Possible causes are, for example, disc herniation or muscle strain.

Classification according to the duration of back pain

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

  • Acute back pain:is back pain that appears 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 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: persists for more than three months. The intensity of the pain can change during this time - sometimes the back pain is weaker, sometimes stronger. Chronic back pain is more common with age.

Classification for causes of back pain

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 rest.

The main reasons

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

Nonspecific back pain

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

Specific back pain

A summary of the important causes of specific back pain:

  • Muscle tension:very often muscle tension is the cause of back pain. Poor posture, unilateral load or lack of physical activity make the muscles uneven - some muscles are overloaded, others are unused. As a result, muscles contract or tighten, which can cause tension and pain. A crushed 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 bursts 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 nearby nerves.
  • Spinal erosion(osteoarthritis of the spine joints, stage syndrome): with age, the vertebral joints are consumed in the body.
  • Rachiocampsis. . . In so-called scoliosis, the back is bent sideways. This leads to premature consumption, which can cause muscle tension and back pain. In addition, with Scheuermann's disease, spinal curves are characteristic. The consequences are cracking, back pain and limited mobility.
  • Spondylolisthesis(Spondylistics): In this condition, the vertebrae are unstable so that they can move easily. This is especially true in the lumbar region. Many patients have little or no complaints. But exercise and some movement 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, obstruction). This often leads to vertebral fractures that are associated with back pain. Even the warning sign 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, the woman’s center of gravity shifts due to fetal growth. It can also cause back pain. In addition, strokes and premature birth can be associated with back pain.
  • Pyelonephritis:Inflammation of the pelvic kidney 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 (oatmeal) that they are simply excreted in the urine through the ureter. Large kidney stones, on the other hand, can be placed in the ureter. The result is renal colic, which can cause, among other things, burns, back pain, depending on the location of the kidney stone.
  • Pneumonia(pneumonia): In addition to coughing with fever and back pain, it is sometimes attributed to pneumonia. 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 back 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 mainly:

  • Work-related factors:Carrying and lifting heavy loads, vibrations (for example, when working with a hammer) and working in uncomfortable positions put stress on the back, joints and muscles. This can lead to back pain in the long run. Therefore, some back diseases are known as occupational diseases.
  • Work-related psychosocial conditions:People who are dissatisfied with their job or have to work monotonously from morning to evening (for example, on a fitting line) are more prone to back pain. Moreover, 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 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, expressive content or too much activity.

Therapy for back pain

With specific back pain, the doctor, if possible, will eliminate the cause of the disease. For example, for a disc herniation, conservative (non-surgical) therapy is usually sufficient, such as thermal 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 for a technique before trying it.

  • Exercises and sports:Physical therapy 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. 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 methods of exercise are suitable for the prevention of lumbago and disc herniation.
  • Thermal therapy:Applying heat (e. g. heating pads, thermoses, mud baths, fango bags) relaxes the muscles and can relieve nonspecific back pain.
  • Medicinal plants:combined preparations of ash and aspen can relieve back pain. For painful muscle tension, a capsaicin cream or a patch can help.
  • Aromatherapy:If you are experiencing lumbago (back pain), you can rub pine oil, sandalwood or ginger on the affected area. This can help relieve symptoms.
  • Back-friendly food:bones, joints, muscles and discs need a lot of nutrients to function. Make sure you have plenty of 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 overall health.
  • Drink lots:Nutrient supply to the intervertebral discs only works with large amounts of fluid.

Medications for back pain

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 specific instructions on when the medicine can be used, in what dose and for how long. Patients should follow these guidelines to avoid side effects or addiction.

Even with specific back pain, medication therapy may be helpful and necessary. It is basically just 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 the symptoms, it depends on which medicine is best for you:

  • conventional pain relievers (analgesics);
  • very strong analgesics from the opiate group;
  • muscle relaxants: not recommended for non-specific back pain;
  • some antidepressants, for example, for chronic nonspecific back pain when the patient is suffering from depression or sleep disturbances at the same time

When do you need 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 it, 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
  • growing back pain

Important research

These studies help to clarify the causes of complaints:

  • cardiac catheterization;
  • joint puncture;
  • electromyography;
  • radiography;
  • disease history;
  • CT scan;
  • scintigraphy;
  • ultrasound;
  • cystoscopes;
  • 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 do back pain appear?
  • Does back pain spread to other parts of your body (like the sides or one leg)?
  • How long does the current pain attack last?
  • Has there been any previous case of back pain? How did the pain continue?
  • Are there factors that cause, worsen or relieve back pain (e. g. , fever, chills, movement)?
  • How was back pain treated (medication, massage)? Were the measures successful? Are there any side effects?
  • What is the time course (daily) of back pain?
  • How bad is your back pain? Do they interfere with daily activities?
  • Do you have any concomitant mental or physical illness?

Examination by a doctor

Following a medical history, the doctor may conduct various studies to investigate the causes of back pain.

  • Blood tests:measuring different blood numbers can be, for example, evidence of spinal cord erosion, inflammation (such as pleurisy, prostatitis, pyelitis) or heart attack as the cause for back pain.
  • Urine analysis:testing a urine sample may clear or strengthen suspicions of acute kidney or prostate disease.
  • Electromyography (EMG):Measuring the electrical activity of a muscle also serves to identify a disc herniation as a possible cause of back pain.
  • Ultrasound procedure:if 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):performed when there is a suspicion that back pain is caused by disc herniation, spinal cord erosion, aortic aneurysm, pancreatitis, or lung tumor.
  • Magnetic resonance imaging (MRI):this test can be used to identify suspicions of a disc herniation or inflammation of the spine (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 what research is needed

Physical examination and laboratory tests (blood, urine) are common in diagnosing back pain. In contrast, X-rays - namely X-rays, computed tomography (CT) and magnetic resonance imaging (MRI) - are only recommended if specific back pain is suspected. At first clarification, acute and chronic chronic back pain is deliberately removed: many examinations may make the patient 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).