Why does your back hurt: causes and treatment

16 October 2021

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 are not health threatening. Therefore, patients themselves can do a lot to combat back pain, from heating packs to exercises to build back muscles. Learn more about the causes and treatment of back pain in this article.

brief information

Back painThey are among the most common types of pain and mainly affect women. Very 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 physical condition of the patient: blood and urine tests, neurological examination, gynecological examination, electroneurography, etc.
Treatment:Heat treatment, medicinal plants, correct flexion and extension, sports to strengthen the back, training for the back in the workplace, relaxation techniques, acupuncture, possibly medication.

Back pain: description and classification.

Low back pain, lumbago, back stiffness or simply back pain are the names of a symptom. Sometimes he squeezes the cross, sometimes he pulls his 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 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 also manifests itself in other types of pain.

Doctors divide back pain according to different criteria:

Classification by location 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 the 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 of the time 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 often 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, herniated discs or muscle strain.

Classification by duration of back pain.

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

Acute back pain: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 in most victims 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 paino Recurrent chronic back pain: persists for more than three months. The intensity of the pain may vary during this time; sometimes the back pain is weaker, sometimes more severe. Chronic back pain is more common with age.

Classification by 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 next section.

Main reasons

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

Nonspecific 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 lack of physical activity make muscles uneven - some muscles are overloaded, others are underused. As a result, the muscles shorten or stiffen, which can lead to tension and pain. A pinched nerve can also result from muscle tension and cause back pain.
Disc herniation. . . 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 fibrocartica ring. If the gelatin core slides 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.
Spinal abrasion(osteoarthritis of the spinal joints, phase syndrome): with age, the vertebral joints wear out in the body.
Rachiocampsis. . . In so-called scoliosis, the spine bends laterally. This leads to premature wear and tear, which can lead to muscle tension and back pain. Also, with the so-called Scheuermann's disease, the curves of the spine are characteristic. The consequences are hump, back pain, and limited mobility.
Spondylolisthesis(Spondylisthesis): In this condition, the vertebrae are unstable, so they can be easily moved. This happens especially 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(loss of bone). With osteoporosis, the bones become increasingly fragile. Then you can break them even with the smallest loads (eg drops, trips). This often leads to vertebral fractures associated with back pain. Even the harbinger of osteoporosis, osteopenia, may already be associated with back pain.
The pregnancy:many pregnant women have back pain. There are many 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, the center of gravity of the woman changes due to the growth of the fetus. It can also cause back pain. Also, strokes and preterm labor 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.
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 lodge in the ureter. The result is renal colic, which can cause, among other things, burning, crampy back pain, depending on the location of the kidney stone.
Pneumonia(pneumonia): In addition to coughing with fever and back pain, pneumonia is sometimes attributed to him. 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 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 from 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 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. Therefore, some 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. Additionally, social conflicts in the workplace and high work intensity without adequate rewards (in the form of money, recognition, opportunities for promotion) can contribute to back pain.
Social status.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 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 restriction or too much activity.

Back pain therapy

With 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 heat treatments, physical therapy, 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 with your doctor about a technique before trying it.

Exercise and sport:Physical therapy and back exercises are especially recommended for subacute and chronic nonspecific back pain, but not acute back pain.
Relaxation procedures:Targeted relaxation helps against stress and tension (both play a 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 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 lumbago and herniated discs.
Thermal therapy:The application of heat (eg heating pads, thermos, mud baths, mud bags) relaxes the muscles and can relieve non-specific back pain.
Medicinal plants:Combined aspen and ash preparations can relieve back pain. For painful muscle tension, a capsaicin cream or patch can help.
Aromatherapy:If you have lumbago (back pain), you can rub pine, sandalwood, or ginger oil on the affected area. This can help relieve symptoms.
Nutrition that supports the back:bones, joints, muscles, and discs need many 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 the back well, but it also contributes to overall good health.
Drink a lot:The supply of nutrients 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: as they 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 doses, and for how long. Patients must follow these instructions to avoid side effects or addiction.

Even with specific back pain, drug therapy can be helpful and necessary. It's basically only for a short time.

In principle, several 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 the most appropriate in each case:

conventional pain relievers (pain relievers);
very strong painkillers from the group of opiates;
muscle relaxants: not recommended for nonspecific back pain;
some antidepressants, for example for chronic non-specific back pain, when the patient simultaneously suffers from depression or sleep disturbances

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 this, such as muscle tension from 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 complaints:

cardiac catheterization;
joint puncture;
electromyography;
bone scan;
history of diseases;
Computed tomography;
scintigraphy;
ultrasound;
cystoscopy;
arthroscopy.

Back pain: exams

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

Where does back pain occur?
Does your back pain spread to other parts of your body (such as your sides or one leg)?
How long does the current pain attack last?
Have there been previous cases of back pain? How did the pain proceed?
Are there factors that cause, worsen, or relieve back pain (eg, fever, coldness, movement)?
How was back pain treated (medication, massage)? Were the measures 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 any concomitant physical or mental illness?

Examination by a doctor

After a medical history, the doctor can perform several studies to investigate the causes of back pain.

Blood test : 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:Analyzing a urine sample can clarify or strengthen suspicions of kidney disease or acute prostatitis.
Electromyography (EMG):Measuring the electrical activity of a muscle can also be used 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.
Bone scan:A plain X-ray can provide information on several possible causes of back pain, such as pneumonia, pneumothorax, spinal obstruction, spinal inflammation (ankylosing spondylitis), or osteoporosis.
Computed tomography (CT):It is performed when back pain is suspected to be caused by a herniated disc, spinal cord abrasions, aortic aneurysm, pancreatitis, or a lung tumor.
Magnetic resonance imaging (MRI):This test can be used to identify suspected herniated discs or inflammation of the spine (ankylosing spondylitis).
Scintigraphy:This nuclear medicine test determines the activity status of various 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 to diagnose 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, the acute and uniformly chronic back pain is deliberately omitted: too many examinations can make the patient fear that there may be a serious cause behind the back pain that has simply not yet been identified. This can make acute back pain chronic (chronic).