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Why your back hurts: 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, patients themselves can do a lot to combat back pain, from thermal packs to exercises to develop 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 not specific.
  • Classification:duration (acute, subacute and chronic low back pain), location (upper, middle or lower lumbar) and form (specific and non-specific low back pain).
  • Causes:there is no reason per se for non-specific back pain. Conversely, 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 and so on.
  • Treatment:Thermal treatments, medicinal plants, correct flexion and extension, sports to strengthen the back, back training in the workplace, relaxation techniques, acupuncture, possibly drugs

Back pain: description and classification

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

No matter how varied the nature and extent of the ailments, 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 also manifests itself in other types of pain.

Doctors divide back pain based on several criteria:

Classification by 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 the back of the head. Neck pain is caused, for example, by poor posture at work, a slipped 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 by 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 prone to injury and damage than the neck and thoracic spine. Back pain is called "back pain". Possible causes are, for example, a herniated disc or muscle strain.

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:it is back pain that occurs for the first time or after at least six months without pain and lasts for up to six weeks. 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 up to three months, they are considered subacute.
  • Chronic back paino chronic recurrent back pain: it persists for more than three months. The intensity of the pain can vary during this period: sometimes the back pain is weaker, sometimes more severe. Chronic back pain is more common with age.

Classification for the causes of back pain

Depending on whether the clear cause of the disease can be determined, doctors distinguish between specific and non-specific back pain. Read more in the next section.

Main reason

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

Nonspecific back pain

For non-specific back pain, the doctor cannot find a clear cause of 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 load 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 result from muscle tension and cause back pain.
  • Slipped disc. . . The discs are found in the form of cushion-shaped shock absorbers between the individual vertebral bodies. They consist of a soft gelatinous core surrounded by a fibrocartiguous ring. If the gelatin core slips and breaks through the fiber sheath, a herniated disc occurs. This causes severe back pain when the jelly-like mass coming out of the sliding disc presses on nearby nerves.
  • Spine abrasion(osteoarthritis of the joints of the spine, phase syndrome): with age, the vertebral joints wear out in the body.
  • Rachiocampsis. . . In so-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, the folds of the spine are characteristic. The consequences are humpback, back pain and limited mobility.
  • spondylolisthesis(Spondylisthesis): In this condition, the vertebrae are unstable so they can be easily moved. This occurs mainly in the lumbar region. Many patients have little or no complaints. But exercise and some 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. So you can break them even with the smallest loads (e. g. falling, tripping). 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 the 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 the growth of the fetus. It can also cause back pain. Also, stroke and premature birth can be associated with back pain.
  • pyelonephritis:Pelvic kidney inflammation is usually caused by bacteria and especially in women. Especially if it is a chronic condition, it can cause long-term back pain.
  • Stones in the kidneys: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 lodge themselves in the ureter. The result is renal colic, which can cause heartburn and back cramps, among other things, depending on the location of the kidney stone.
  • Pneumonia(pneumonia): In addition to coughing 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 perceived as back pain.
  • Spinal swelling 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 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 jackhammer) and working in awkward positions strain the spine, joints and muscles. This can lead to long-term back pain. Therefore, some back diseases are recognized as occupational diseases.
  • Work-related psychosocial conditions:People who are dissatisfied with their jobs or have to work monotonously from morning to night (for example, on an assembly line) are more prone to back pain. Additionally, 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.
  • Welfare state.Back pain is more common in people with low social status in terms of education, profession 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 hyperactive behaviors, i. e. expressed restraint or too much activity.

Back pain therapy

With a specific back pain, the doctor, if possible, will eliminate 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, pain relievers, or muscle relaxants. Surgery is rarely needed. If your back pain is caused by pyelonephritis, your doctor usually prescribes antibiotics. Most bacteria are the cause of the inflammation.

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

  • Exercise and sport:Physiotherapy and back exercises are especially recommended for subacute and chronic nonspecific back pain, but not for acute back pain.
  • Relaxation procedures:Targeted relaxation helps with 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 back pain patients 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 low back pain and herniated disc.
  • Spa therapy:The application of heat (e. g. heating pads, thermos, mud baths, mud bags) relaxes the muscles and can relieve non-specific back pain.
  • Medical plants:Combined preparations of ash and poplar can relieve back pain. For painful muscle tension, a capsaicin cream or patch may be helpful.
  • Aromatherapy:If you have low back pain (back pain), you can rub pine, sandalwood, or ginger oil on the affected area. This can help relieve symptoms.
  • Supportive 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. Not only does it help your back well, it also contributes to overall good health.
  • Drink a lot:The supply of nutrients to the intervertebral discs only works with large amounts of fluids.

Back pain medications

Medicines reduce back pain to such an extent that physical activity is again possible. Over time, the dose of the drug should and can be reduced: during exercise, 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 dosage and for how long. Patients should follow these instructions to avoid side effects or addiction.

Even with specific back pain, drug therapy can be useful and necessary. Basically it is only for a short time.

In principle, various 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 drug is most appropriate in each case:

  • 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 non-specific back pain, when the patient is simultaneously suffering from depression or sleep disturbances

When is it necessary 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 due to lack of exercise or poor posture. However, in the following cases, you should consult a doctor for safety reasons:

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

Important research

These studies help clarify the causes of the complaints:

  • cardiac catheterization;
  • joint puncture;
  • electromyography;
  • radiography;
  • history of the disease;
  • CT scan;
  • scintigraphy;
  • ultrasound;
  • cystoscopy;
  • arthroscopy.

Back pain: examinations

To clear up your back pain, your doctor will first talk to you in detail to fill out your medical history. Possible questions:

  • Where does back pain occur?
  • Does your back pain spread to other parts of your body (such as your hips or leg)?
  • How long does the current pain attack last?
  • Have there been any previous cases of back pain? How did the pain continue?
  • Are there factors that cause, worsen, or relieve back pain (eg, fever, cold, movement)?
  • How was back pain treated (medication, massage)? Were the measures successful? Are there any side effects?
  • What is the (daily) course of back pain?
  • How severe is your back pain? Do they interfere with daily activities?
  • 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 analysis :Measurement of various blood counts may 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:testing a urine sample can eliminate or reinforce suspicions of kidney disease or acute prostatitis.
  • Electromyography (EMG):Measuring the electrical activity of a muscle also serves to 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.
  • 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 back pain is suspected to be caused by a herniated disc, spinal cord abrasions, aortic aneurysm, pancreatitis, or lung cancer.
  • 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 scan: suspected ankylosing spondylitis) or lung tissue (lung tissue scan: 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 only recommended if specific back pain is suspected. In the first clarification acute and uniformly chronic back pain is deliberately omitted: too many examinations can make the patient fear that behind the back pain there may be a serious cause that simply has not yet been identified. This can make acute back pain chronic (chronic).