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Why back aches: causes and treatment

Back pain is a widespread 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, patients can do a lot against back pain themselves - from heat compresses to exercises to build up the back muscles. Learn more about the causes and treatment of back pain in this article.

Back pain

Brief info

  • Back pain: are among the most common types of pain and mainly affect women. Back pain is mostly unspecific.
  • 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 for unspecific back pain per se. In contrast, specific back pain has a detectable symptom.
  • Survey:depending on the patient's physical condition: blood and urine tests, neurological examination, gynecological examination, electroneurography, etc.
  • Treatment:Heat treatment, medicinal plants, correct flexion and extension, sport to strengthen the back, back training at work, relaxation techniques, acupuncture, possibly medication

Back pain: description and classification

Low back pain, lumbago, back stiffness or just back pain are the names of a symptom. Sometimes she squeezes the back, sometimes she pulls her neck. Sometimes back pain radiates to the side, arms, or legs. Symptoms can be permanent or temporary. Sometimes they are so strong that the victims can barely move.

As different as the nature and extent of the complaints may be: Back pain can afflict people of almost any age. They are among the most common problems faced by modern humans. Women of all ages report back pain more often than men. This phenomenon also manifests itself in other types of pain.

Doctors classify back pain according to various criteria:

Classification according to the location of back pain

  • Upper back:Pain in the upper spine (neck area) can be acute or chronic. It can often be 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 area:Back pain is most common in the lower back. Because the lumbar spine is more prone to injuries and damage than the cervical and thoracic spine. Lower back pain is known as "back pain". Possible causes are, for example, slipped discs or muscle strains.

Classification according to the duration of the back pain

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

  • Acute back pain:it is 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 within a few weeks for most people.
  • Subacute back pain:if back pain lasts six weeks to a maximum of three months, it is considered subacute.
  • Chronic back painor chronic recurrent back pain: persists for 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 according to causes of back pain

Depending on whether the clear cause of the disease can be determined, doctors differentiate 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: non-specific and specific back pain.

Nonspecific back pain

In the case of unspecific back pain, the doctor cannot find a clear cause for the complaints. The vast majority of all back pain cases fall into this category.

Specific back pain

The most important causes of specific back pain at a glance:

  • Muscle tension:Very often, muscle tension is the cause of back pain. Bad posture, one-sided stress or a lack of physical activity make the muscles uneven - some muscles are overworked, others are underused. As a result, the muscles shorten or harden, which can lead to tension and pain. A pinched nerve can also be caused by muscle tension and cause back pain.
  • disc prolapse. . . The intervertebral discs are located in the form of cushion-shaped shock absorbers between the individual vertebral bodies. They consist of a soft gelatinous core surrounded by a fibroc-like ring. When the jelly core slips off and breaks through the fiber jacket, a herniated disc occurs. This leads to severe back pain when the gelatinous mass emerging from the sliding washer presses on nearby nerves.
  • Abrasion of the spine(Arthrosis of the joints of the spine, phase syndrome): With increasing age, the vertebral joints in the body wear out.
  • Rachiocampsis. . . In so-called scoliosis, the spine is bent to the side. This leads to premature wear and tear, which can lead to muscle tension and back pain. In addition, curvatures of the spine are characteristic of so-called Scheuermann's disease. The consequences are humpbacks, back pain and limited mobility.
  • Spondylolisthesis(Spondylisthesis): In this condition, the vertebrae are unstable so they can be moved easily. This mainly occurs in the lumbar region. Many patients have little or no discomfort. But exercise and certain movements can cause back pain. If the displaced vertebra presses on the nerve root, neurological disorders such as emotional disorders 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 (e. g. falling, stumbling). This often leads to vertebral fractures, which are associated with back pain. The harbinger of osteoporosis - osteopenia - can already be associated with back pain.
  • Pregnancy:Many pregnant women have back pain. There are mutliple reasons for this. For example, hormonal changes in pregnant women lead to relaxation of the tendons and ligaments in the pelvic floor area. This makes them unstable, which can lead to pelvic and lower back pain. In addition, the woman's center of gravity shifts as the fetus grows. It can also cause back pain. In addition, strokes and premature births can be linked to back pain.
  • Pyelonephritis:Inflammation of the pelvic kidney is usually caused by bacteria, especially in women. Long-term back pain can occur, especially if it is a chronic disease.
  • Stones in the kidneys:In contrast to pelvic kidney inflammation, kidney stones are more common in men. Sometimes they are so small (semolina) that they are simply excreted with the urine through the ureter. Large kidney stones, on the other hand, can become lodged in the ureter. The result is renal colic, which, depending on the location of the kidney stone, can cause burning, cramp-like back pain, among other things.
  • lung infection(Pneumonia): In addition to a cough with fever and back pain, pneumonia is sometimes attributed. The 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 into the back and is perceived as back pain.
  • Swelling of the spine and ribs:Back pain can also be caused by a tumor in the spine or chest. Sometimes these tumors are benign, sometimes malignant. The second case is almost always secondary to 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 your risk of back pain. This is primarily:

  • Work-related factors:Carrying and lifting heavy loads, vibrations (e. g. when working with a jackhammer) and working in uncomfortable positions strain the spine, joints and muscles. In the long run, this can lead to back pain. Therefore, some back diseases are recognized as occupational diseases.
  • Work-related psychosocial conditions:People who are dissatisfied with their job or who have to work monotonously from morning to evening (for example on the 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, opportunities for advancement) can contribute to back pain.
  • Social status.Back pain is more common in people of low social status in terms of education, occupation and income than in people of high social status.

The course of existing back pain can be influenced by adverse circumstances such as psychological factors. These include, for example, unrealistic fears of back pain, depression and passive or overactive behavior - that is, extreme reluctance or too much activity.

Back pain therapy

In the case of specific back pain, the doctor will, if possible, eliminate the cause of the disease. For example, in the case of a herniated disc, conservative (non-surgical) therapy is usually sufficient, such as heat 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 cause inflammation.

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

  • Movement and sport:Physiotherapy and back exercises are particularly recommended for subacute and chronic non-specific back pain, but not for acute back pain.
  • Relaxation method:Targeted relaxation helps against stress and tension (both play an important role in back pain). If the pain is already chronic, VUR can 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 exercise methods are suitable for preventing lumbago and herniated discs.
  • Heat therapy:The use of heat (e. g. heating pads, thermos flasks, mud baths, fango bags) relaxes the muscles and can alleviate non-specific back pain.
  • Medicinal plants:Combination preparations made from ash and aspen can relieve back pain. A capsaicin cream or plaster can help with painful muscle tension.
  • Aromatherapy:If you suffer from lumbago (back pain), you can rub the affected area with pine, sandalwood or ginger oil. This can help relieve symptoms.
  • Back-friendly nutrition:Bones, joints, muscles, and intervertebral discs all 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 your back well, it also contributes to overall health.
  • Drink a lot:The supply of nutrients to the intervertebral discs only works with large amounts of fluid.

Back pain medication

Medicines relieve back pain so much that physical activity is possible again. In the course of time, the drug dose should and can be reduced: Patients usually need fewer drugs during exercise in order to move (almost) painlessly. The doctor gives each patient specific instructions as to when and how long the medicine can be used. Patients should follow these instructions to avoid side effects or addiction.

Drug therapy can also be helpful and necessary for specific back pain. Basically only for a short time.

There are basically different groups of active substances available for the treatment of back pain. Depending on the type and severity of the symptoms, it depends on which drug is most suitable:

  • 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, if the patient is simultaneously suffering from depression or insomnia

When do you need to see a doctor?

Back pain is not always a sign of a more or less serious illness that requires a doctor's visit. This often conceals relatively harmless causes, 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 to clarify the causes of complaints:

  • Cardiac catheterization;
  • common puncture;
  • Electromyography;
  • Roentgen;
  • Medical history;
  • CT scan;
  • Scintigraphy;
  • Ultrasonic;
  • Cystoscopy;
  • Arthroscopy.

Back pain: examinations

To clarify back pain, your doctor will first speak to you in detail in order to draw up your medical history. Possible questions:

  • Where does back pain occur?
  • Is your back pain spreading to other parts of your body (such as your sides or a leg)?
  • How long does the current pain attack last?
  • Have there been previous cases of back pain? How did the pain go?
  • Are there any factors that cause, aggravate, or relieve back pain (e. g. fever, cold, exercise)?
  • How was back pain treated (medication, massage)? Were the measures successful? Are there any side effects?
  • What is the (daily) chronological course of back pain?
  • How bad is your back pain? Are they interfering with daily activities?
  • Do you suffer from a psychological or physical concomitant illness?

Examination by a doctor

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

  • Blood tests:The measurement of different blood counts can, for example, indicate abrasions of the spinal cord, inflammation (such as pleurisy, prostatitis, pyelitis) or heart attack as a trigger for back pain.
  • Urinalysis:Testing a urine sample can clarify or increase suspicions of kidney disease or acute prostatitis.
  • Electromyography (EMG):Measuring the electrical activity of a muscle is also used to identify a herniated disc as a possible cause of back pain.
  • Ultrasonic method:If your back pain is caused by pyelonephritis or kidney stones, an ultrasound can help determine the cause.
  • Roentgen:A simple x-ray can reveal several possible causes of back pain, such as: B. pneumonia, pneumothorax, spinal obstruction, spinal inflammation (ankylosing spondylitis) or osteoporosis.
  • Computed Tomography (CT):performed when back pain is suspected to be caused by a herniated disc, spinal cord abrasion, aortic aneurysm, pancreatitis, or a lung tumor.
  • Magnetic resonance imaging (MRI):This test can be used to detect suspicion of a herniated disc or an 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. On the other hand, x-rays - i. e. x-rays, computed tomography (CT) and magnetic resonance tomography (MRT) - are only recommended if specific back pain is suspected. In the first assessment, acute and consistently chronic back pain is deliberately avoided: Too many examinations can make the patient fear that there is a serious cause behind back pain that has simply not yet been identified. As a result, acute back pain can become chronic (chronic).