Back pain – What can you do?
On Sunday evening, Peter went to bed satisfied. He used the past weekend extensively to carry out the famous spring cleaning and do necessary work around the house. In addition, he has benefited from the good weather to dig out his bike, which dressed in dust over the winter, and to go for a ride.
When Peter woke up on Monday, he felt an uncomfortable sensation in the area of his lumbar vertebra and when he wanted to get up he noticed that his movement is restricted. He goes into the bathroom looking at him in the mirror and sees that he holds himself crooked and does not stand upright as usual. At this moment, he realizes that he has problems in the lower back. For him, the complaints are inexplicable, he had fit and lively yesterday. Peter decides to see a doctor to ask where the back pain comes from and what he can do about it.
A short time later, Peter is sitting with Dr. Schubert, an orthopedist, to find out more about his back pain. Dr. Schubert would like to know how Peter’s day-to-day life runs out to determine the cause of back pain.
Peter is an employee of a bank. Most of the time, he sits up to 9 hours a day in front of his PC, noting that he is often stressed and under pressure during work. After work, he usually goes home and wants to rest and enjoy his free time with his family. After these long days, he does not find the energy to go to the gym or exercise, Peter is usually too tired and lacking the motivation.
After this little description of his everyday life, Dr. Schubert first explains to him, in general, what back pain is and how it is caused.
Back complaints can have quite many causes. Misalignments of the spine, mental conflicts or occupational stress and lack of movement can cause back pain, just to name a few.
However, there are many different types of back pain:
- Acute back pain, is the pain that occurs after at least 6 painless months and lasts for a maximum of 6 weeks
- Subacute back pain is the back pain that remains more than 6 weeks but less than 12 weeks.
- Pain lasting more than 12 weeks is categorized as chronic back pain.
The pain can lie in the lower back, then the cross is mostly affected and one speaks of lumbar back pain. Lumbar refers to the region of the lumbar spine, which is the most burdened part. Here, muscle tension or disc discomfort often occurs. In addition, special inflammatory changes can occur in the pelvic area and the back is thus additionally loaded.
In the upper back or neck, in the area of the neck and upper thoracic spine, muscle tension and hardening frequently occur which are caused by an unfavorable posture during work. The pain often radiates from the back, into the shoulders or arms. They sometimes cause severe headaches and restrict movement.
In the middle spine, at the level of the thoracic spine, the symptoms are usually caused by changes in the rib-vertebral joints and skeletal deformities.
Furthermore, the back pain can also be categorized differently. One also speaks of specific and nonspecific back pain. The division is not always welcomed; however, it helps to organize the numerous complaints.
The most common is the nonspecific back pain. These manifest themselves through muscular tensions, shortened or over-stretched muscles, or hardened fascia. In this case, no damage to the backbone is detectable, as it is the case with specific back pain.
The main problem with back pain comes from the chronic nonspecific pain. In 80% of cases, muscles, fascia, tendons and ligaments are affected, when we talk about acute and chronic back problems. These are often caused by overloading during heavy physical work or as a result of unilateral movements. In addition, lack of movement can also be the cause, since different muscle groups are underused. Underused muscles develop back, according to the motto – what is not needed, one does not need – and it comes to muscular imbalances that must be corrected again. Moreover, extreme overweight, smoking and increased alcohol consumption is not conducive to a healthy back.
Ergonomic problems, such as unfavorable attitudes of equipment at work or while doing sport, psychosocial problems, such as personal or professional conflicts, stress, dissatisfaction, can have a negative impact on the back health.
For specific back problems, back pain itself or other diseases are responsible. The attrition of the spine and discs is the most common cause of specific back pain. Disc hernias that press on a nearby nerve are not among the most common causes of specific back pain, as is often suspected. Rather, there are complaints about the musculoskeletal system, such as osteoporosis, chronic inflammatory diseases such as spondylolisthesis, rheumatoid disease, scoliosis, or metabolic bone diseases, that trigger specific back problems, just to name a few. In order to diagnose specific back pain, if unspecific back pain has not subsided after 4 to 6 weeks, it is advisable, to carry out further examinations.
The diagnosis should be carried out in all cases by specialized personnel. Orthopedists, rheumatologists or neurologists are recommended for further examinations and may also recommend treatments with a physiotherapist, chiropractor or osteopath.
After Dr. Schubert has now given a detailed general explanation about back pain, Peter would like to know where his back pain originates. Dr. Schubert explains to him that his back pain is highly probable, as is the case with most people, in the category of nonspecific acute back pain. Because of the limited amount of movement and the possibility of the equipment at Peter’s work is wrongly adjusted to his posture, his back muscles are not sufficiently pronounced. In addition, he has worked hard during the weekend, and has after a long time rode his bike again, to which position and the associated physical stance he was no longer used to.
Peter is relieved, because he was afraid that his back pain could be chronic and that the discomfort could turn into specific back problems. To prevent this, he now wants to know what he can do about it.
Dr. Schubert, suggests that Peter strengthens his musculature by means of a targeted workout to reduce the imbalances. In addition, he recommends that Peter sets up his workspace ergonomically and often moves during the day and begins to do sports again. Thus it is very important to stretch the muscles regularly in order to relieve the back muscles. Furthermore, Dr. Schubert advises that Peter undergoes specific therapy.
There are many different approaches. Massages, heat therapy and relaxation procedures are used to get hardened or tense muscles loose again. In the case of physiotherapy, under the guidance of a physiotherapist, the exercises help to train and improve muscular strength and coordination, endurance and mobility. Manual therapy can easily be combined with physiotherapy. In addition, it is important to analyze the body posture and, if necessary, to perform postural corrections.
To support the physical therapies just described, one can also use painkillers or anti-inflammatory medication to prevent inflammation, but this does not cure the cause of the problem but only combats the symptoms. These medicines usually have side effects that may cause other complaints. In this case, Dr. Schubert advises Peter not to take any medication.
The specialist is drawing the attention to a different metaphysical topic and points out to Peter that his mental and psychological state can also influence his complaints and advises him to avoid stress and conflicts and to clarify existing conflicts.
After this enriching consultation, Peter leaves the practice of Dr. Schubert with a transfer to a competent physiotherapist, who carries out in a first phase a heat therapy and massages to relax the tense muscles. In a second phase, he will help him strengthen his back so that he can work in his garden and ride his bicycle unworried again. Peter is determined to look after his back in the future and follow Dr. Schubert’s advices.