An almost perfect construction of nature: the spine. Thanks to their mobility, people do not walk rigidly through life, but are extremely flexible in their torso. The spine can twist more than 90 degrees right and left, bend down and back, all without pain – usually. In 42% of all Germans, the spine no longer functions optimally. Then regular back problems are normal. The most common reasons for this: too little movement and occasional overload, caused for example by sitting for too long. The pain, for example in an acute herniated disc, is often hellish and almost unbearable.
When do I have to go to the doctor with back pain?
Our back often heals itself on its own. As a rule, it takes 6 to 12 weeks for symptoms caused by a herniated disc, for example, to go away on their own. These often very stressful weeks should ideally be bridged with immediate pain relief measures (for example over-the-counter painkillers) and with gentle treatment methods as soon as these are possible without complications. However, if after 3-4 days your pain has not eased but worsened, you should consult a doctor. They can give you an injection, for example, which will relieve your pain immediately.
When is back surgery worthwhile?
Many sufferers ask their doctor for an operation quickly. Around 230,000 spinal operations are performed in Germany every year. What many patients do not know: “A third of all operations do not have the desired effect,” says orthopedist and spine specialist Dr. Martin Marianowicz from Munich. According to the experts, 80% of all back operations are superfluous. It often looks bad what you see on x-rays or images with a magnetic resonance tomograph (MRT). However, this does not mean that a herniated disc really needs to be operated on. The decisive factor is how much it actually hurts, and above all: whether it still hurts at all after a few weeks. Expert Marianowicz confirms: “A study by the universities of Freiburg and Tübingen shows that a herniated disc in 75% of all non-operated patients is no longer detectable on an MRI image after 2 years. In 25% you can still see something, but the patients are still pain-free. ”
8 ways to manage back pain
Physiotherapy can be set up very variably. In addition to muscle building and coordination exercises, physical stimuli such as heat, cold or pressure are part of the spectrum of treatment options. The results are also very different. “It depends less on the therapy method than on the therapist,” says expert Marianowicz. Don’t hesitate to change the practitioner if you don’t feel good. Check with friends and sports buddies about good physical therapists.
Pricking the patient specifically with wafer-thin needles is no hocus-pocus. Numerous studies have shown positive effects. “At many acupuncture points, vessels and nerves are particularly close to the skin surface,” says Marianowicz. Scientists explain the healing properties of acupuncture by the fact that needle tips trigger the release of tissue hormones and other pain-relieving messenger substances.
Helps to make immobile joints mobile again. There are 2 approaches:
- Mobilizing technique. The chiropractor (often called a chiropractor) stretches tendons and muscles several times until movements are possible again.
- Manipulative technique. Adjusts bones with jerky movements.
A good education and a lot of experience are necessary for a good chiropractor. “It is extremely important to carry out a detailed examination beforehand in order to precisely identify damage to the spine,” says Marianowicz. Otherwise it can lead to vascular injuries, for example in the area of the cervical spine. Since the term chiropractor is not protected in Germany, you should only go to a graduate chiropractor who has completed several years of specialist training. You can find such specialists at the German Chiropractor Society. Alternatively, you can see a chiropractor. This is a doctor with appropriate additional training.
Osteopathy aims to restore mobility. With this method, however, joints are less likely to be corrected by jerky movements. The fact is that every weekend course graduate can call themselves an osteopath. That means: the quality differences in the treatments are enormous, you should look very carefully to see who is kneading you. “A real osteopathic training takes 4 to 5 years, it is reserved for doctors, alternative practitioners and physiotherapists,” explains spine specialist Marianowicz. You can find professionals in your area at the Association of Osteopaths and the Federal Working Group on Osteopathy.
5. Painkillers without a prescription
Many common drugs that you can find in pharmacies fall into this category, for example acetylsalicylic acid (ASA), paracetamol, ibuprofen and diclofenac. They are mostly taken as tablets. There are also ointments and gels that can be massaged into the skin on affected areas. Do you refuse such funds? Remember: Pain is not good for the back, leads to more tension, more immobility, delays the healing process and burns itself into the memory. “Don’t play the hero,” warns Marianowicz. “Pain should be relieved as soon as possible.”
The body produces cortisone itself. As a stress hormone, it stimulates our metabolism and also puts the organism in a kind of alarm state. In drugs, cortisone is more concentrated and has additional effects, above all it inhibits inflammatory processes in the tissue. This reduces swelling, and the situation can be significantly relaxed for a pinched nerve. “However, the correct dosage is important,” explains orthopedist Marianowicz. “With targeted treatment, you can get by with very small doses.” Then there are fewer side effects. But caution is advised: if cortisone is administered for a longer period of time, it can damage the bones and cause diabetes!
7. Muscle Relaxants
Medicines of this kind relieve tension. They have a paralyzing effect on nerve connections and thus indirectly on those muscles that would normally receive impulses from the paralyzed nerves. The muscles relax, which can be very beneficial for acute problems. But: side effects are sometimes very severe. The most common consequences are drowsiness and fatigue. Much worse, however, is the potential for addiction. “Some of these drugs are addictive within a very short time,” warns Marianowicz. “Then stopping it suddenly can lead to severe withdrawal symptoms.”
If you have mild back problems, you can give a herbal ingredient a try. There are a number of phytotherapeutic agents that have a decongestant or even anti-inflammatory effect or are able to relieve tension. Ointments and oils with arnica, which are gently massaged into painful areas, have proven their worth. Comfrey extract, borage oil, fenugreek seeds, nettle extract, cayenne pepper, chilli peppers, St. John’s wort oil, devil’s claw and willow bark also have beneficial effects.
What types of back pain are there?
- Cervical spine : Office work and other sedentary activities put a lot of strain on the back. Tension in the shoulders and neck usually causes problems.
- Lumbar spine: This is where it pinches particularly often in men. The 5 lowest vertebrae carry most of the weight, for example when you haul boxes. Discs in the region are often crushed.
- Intervertebral disc: Consists of a soft core with firm connective tissue around it. Serves as a buffer between neighboring vertebrae – otherwise bones would rub against each other.
- Spinal cord: If an intervertebral disc slips out, it presses on the spinal cord or on smaller nerves that branch off directly from the spinal cord.
5 exercises to prevent back pain
Of course, better than treating back pain is not to let it arise in the first place.
- Bridge with raised arm and leg: support on toes and forearms, stretch right arm forward, lift left leg. Hold for 10 seconds, switch arm and leg. 10 repetitions per side
- Leaning forward with a barbell: grasp the barbell wider than shoulder width, place it behind your neck. Bend your upper body forward as far as possible with your back straight. 2 sets of 10 repetitions each
- Neck press: Sit on a Swiss Ball, hold 2 dumbbells next to your head (palms facing forward). Push the dumbbells up until your arms are almost straight. Keep your back straight. 2 sets of 10 repetitions each
- Lateral raise: Adjust the seat so that the shoulders are level with the machine’s axes of rotation. Bring elbows at shoulder level. 2 sets of 10 repetitions each
- Lat pulldowns: Grip the bar wider than shoulder width. Pull down, almost to your neck. Bring your elbows back as far as you can. 2 sets of 10 repetitions each
Back pain is a widespread disease. Almost everyone is plagued by them at least once in a lifetime. But there are many therapy options, some of which are covered by statutory health insurances. Even better: Don’t let back problems arise in the first place and prevent them with targeted exercises. If your pain doesn’t go away on its own, see a doctor quickly.