In 2024, roughly one quarter of insured individuals in Germany (24.8 percent) suffer from back pain. (Source: KKH Kaufmännische Krankenkasse)
Are you one of them and want to know how to get rid of these symptoms and prevent pain? Then Juzo has the right information for you. Back pain is the most widespread condition. In most cases, it is only a “temporary health problem”, but very frequently associated with severe pain nonetheless.
There are various reasons for back pain but they can be difficult to determine. In industrialized nations, the lack of movement caused by a lifestyle characterized by office work is frequently the trigger. Back pain is often “home-made” and can be ascribed to wrong or sudden movements, one-sided strain or a lack of exercise. In some cases, however, it may be caused by serious illnesses. Other factors such as stress or excess weight must not be ignored in this context either. Therefore get active today and support your back as much as you can – a strong back is less prone to problems.
The spine is the central axis of the human body, and it connects all parts of the skeleton. It supports the body and is responsible for its movement at the same time, allowing a straight posture and upright gait. Despite its structure including very small parts, the spine is strong enough to bear the load of the head, torso and arms at the same time.
Even the smallest changes in the spine, in the form of misalignments, wear or injuries, can cause severe pain which must be taken seriously. Clarification from a specialist is necessary in order to counteract a worsening or chronification of the condition.
The spine consists of 24 moveable vertebrae, 8 to 10 fused vertebrae (the sacral bone and tailbone (coccyx)) as well as the intervertebral discs. It is stabilised by various ligaments, ligamentous systems and muscles that surround the bony spinal structure.
The intervertebral discs consist of elastic fibres and a soft, gelatinous nucleus pulposus. They are located between each moveable vertebrae and act as elastic links between the vertebral bodies, allowing the mobility of the spine.
The characteristic shape of the spine, the double S shape, helps to absorb impact and to evenly distribute applied forces across the entire body.
Patients perceive acute back pain in very different ways. Some people experience a stabbing pain like a knife, others feel a pulling sensation on their pelvis or pressure on the spine. The intensity varies particularly with chronic pain. Acute pain is generally pronounced.
Lumbago is an acute form of back pain with very pronounced symptoms that frequently leads to a restriction in mobility. Patients are unable to straighten their upper body, or can only do so with severe pain.
Acute back pain can also radiate to the arms or legs. If this is accompanied by feelings of numbness or paralysis in the extremities, a doctor should be consulted immediately because there may be a more serious underlying cause. A doctor should also be consulted if the patient experiences additional problems with the bowels or bladder, fever or chills.
Back pain can be attributed to various causes. The Western lifestyle plays a large role here. Long periods of sitting during work can cause excess strain on the muscles of the cervical spine and trunk. Insufficient movement in daily routines, one-sided strains and excess weight cause overloaded and painfully tight muscles. Increased life expectancy also leads to more frequent wear conditions which can cause pain in turn.
In fact, some cases of back pain cannot be attributed to a clear cause and are therefore referred to as “unspecific” or “non-specific”. Imaging methods for diagnosis are unable to detect structural damages or injuries to the spine or organs. With this type of back pain, the pain comes from the back muscles in most cases. This is because the muscles are weakened, insufficiently trained or cramped. Non-specific back pain becomes rarer with age, but the symptoms are often more severe.
With “specific” back pain, there is a physical trigger. A clear cause can be determined. However, this occurs in very small percentages from roughly four to seven percent. Causes can be disorders of the spine (e.g. herniated discs, deformation of the spine) or inflammatory processes in the spinal region. Hormonal causes and autoimmune diseases are also possible causes. For specific back pain, the underlying cause is treated. In most cases, this also causes the pain to subside. With increasing age, specific back pain occurs more regularly, for example, based on spinal wear.
Frequent causes and risk factors for specific back pain:
Pain in the middle back
Back pain in the area of the thoracic spine is rarely caused by injuries. Functional disruptions in the costal vertebral joints or irritations, diseases or inflammation of large muscle groups in the area of the thoracic spine are generally the cause for mid-back pain.
Pain in the upper back
Pain in the upper spine can be acute (up to six weeks), subacute (up to three months) or chronic. Sometimes pain can radiate into the back of the head, the shoulders and the arms. In particular, neck pain is often triggered by bad posture – for example, sitting at a desk.
Pain in the lower back
Back pain can often be pinpointed to the lower back, since the lumbar spine is much more susceptible to damage and injuries than the thoracic or cervical spine. Reasons can include excessive strain or tension in the muscles, joint blockages or an organic cause such as a herniated disc.
Specific back pain is caused by a disease or injury. You can find the most common causes here:
The lumbar spine is affected very frequently by pain because the force applied to the spine and the load to be supported are largest here. This pain in the lumbar spine, known as low back pain, can range from mild to severe. This back pain can occur for a few days or even permanently (chronic).
Low back pain can have various causes. The trigger is often a sudden movement, a twist or lifting and carrying heavy objects. Back pain can also be caused by excessive stress, incorrect posture, congenital misalignments of the spine, herniated discs or shifting of the vertebral bodies.
A severe kind of low back pain is known as lumbago, where sudden severe and cramp-like pain occurs in the lumbar spine and the back muscles that may even trigger temporary immobility.
If the pain in the lumbar spine persists for several days, it can become chronic and cause permanent problems. In this case, it’s called chronic low back pain.
Osteoarthritis
Osteoarthritis of the spine is a chronic, degenerative disease of the intervertebral joints. A reduction in the joint cartilage due to wear and tear often leads to nerve irritation, which in turn often gives rise to pain.
Herniated disc
With a herniated disc, the disc’s nucleus pulposus (the soft centre of the disc breaches the annulus fibrosus (the tough exterior) and slips out of place. The gelatinous substance can press against the surrounding nerves and cause pain. If nerve structures are constricted more severely, this can cause disruptions in sensitivity and reduced strength or even paralysis.
Osteoporosis
Osteoporosis is a disorder of the bone metabolism. Bone mass declines significantly and this results in changes to the bone structure. This is commonly referred to as “bone loss.” Bones become porous, lose their stability and can break more easily, resulting in pain.
Rheumatoid arthritis
In cases of rheumatoid arthritis, an autoimmune disease, the body’s own defence system attacks the synovial lining of the joints. This results in painful inflammation of the small and large joints in the arms and legs. Especially in the morning, patients find it difficult to move.
Bechterew’s disease
This chronic inflammatory rheumatic disease primarily affects the spine and sacroiliac joints, as well as other body structures. The disease begins with chronic back pain and often occurs in episodes. Typical symptoms include morning stiffness, nighttime pain as well as pain in the lower lumbar spine and sacroiliac joints. When the condition is advanced, pain also occurs in higher sections of the spine. Later on, the spine stiffens, which generally causes the pain to subside.
Fibromyalgia syndrome (FMS)
Fibromyalgia syndrome is a functional somatic syndrome with chronic pain in multiple areas of the body, almost always including the spine. The condition usually appears gradually. In addition, sleep disturbances are common with fatigue and physical or mental exhaustion.
Vertebral slippage (spondylolisthesis)
Vertebral slippage involves one or more vertebrae of the spine shifting position. The reason is generally a loss of volume in the intervertebral disc which reduces the support between the vertebral bodies. Vertebral slippage leads to increased strain and wear of the small intervertebral joints. Increased mobility and the potential constriction of nerves as a result can cause local and radiating pain.
Spinal canal stenosis
Spinal canal stenosis is a narrowing of the canal in the spine through which the spinal cord runs as well as the lumbar and sacral nerves in the lower section. Pressure on the nerves causes back pain that is often sharp. The cause of this narrowing are compensatory bone attachments over a long period of time.
Psychological stress
Psychological stress often plays a decisive role in the development of back pain. Stress and anxiety can trigger muscular tension which can lead to muscle cramps and incorrect or forced posture.
Pain memory
If back pain remains untreated for a long period of time, a “pain memory” can form. Recurring pain experiences result in biochemical, functional and morphological changes in the central nervous system. Then a minimal irritation like contact, slight stretching or heat is enough to trigger a pain sensation. It is a long and laborious process to change this again.
Injuries
Caution is necessary when dealing with back injuries. As soon as the spinal cord is affected, serious neurological consequences can result. If back pain occurs after an accident, the body should be moved as little as possible.
Due to the large diameter of the spinal cord near the cervical spine,injuries there are often associated with neurological consequences such as paralysis or impaired sensation. The thoracic spine is actually protected very well by the ribcage. However, if injuries do occur, caution is necessary because the diameter of the spinal cord is still relatively large. Bone injuries of the spine generally occur in the lumbar spine, because it is subjected to the greatest mechanical stress. The spinal cord has a smaller diameter in this area of the spine. For this reason, neurological disruptions are more rare.
Back pain can have a wide variety of causes. That’s why an individual diagnosis is essential for finding out the true reason for your symptoms. The basis is a thorough medical history. This is followed by a careful medical examination with functional tests. As part of the muscle strength and function diagnosis, your posture and the alignment of your spine are checked and existing pressure points or movement pain points are identified. The subsequent tests indicate your spinal mobility. Neurological examinations allow for conclusions regarding the sensitivity, reflexes, strength of your muscles and thus regarding potentially pinched nerves. If there is suspicion of functional restrictions, targeted testing will be conducted during training and physical therapy.
If there is suspicion of specific pain causes, imaging technology such as X-ray images, core spin or computer tomography are used. If symptoms persist despite initial non-surgical treatment, an X-ray image should be prepared – or core spin tomography, also known as magnetic resonance tomography (MRT), if there is suspicion of pain causes or the involvement of nerve structures. In case of prior accidents with a suspicion of spinal injury, a comprehensive neurological examination is generally essential.
Further examinations such as specific lab tests or bone density measurement are possible.
A holistic examination and precise diagnosis involves many disciplines such as orthopaedics, neurology, pain therapy, psychology and physical therapy. For this reason, interdisciplinary cooperation is generally beneficial.
Back pain often occurs very suddenly. Depending on the cause and symptoms, various therapy methods can be used. Non-specific back pain generally subsides after a few days or weeks with non-surgical treatment such as active kinesiotherapy or short-term administration of painkillers. For specific back pain, therapy is oriented on the underlying condition. Mild injuries of the spine can be treated with non-surgical methods, while serious injuries generally require surgery. In many cases, different therapies are combined.
1. Treatment of back pain without medication
Non-surgical treatments for back pain can be as individual as the pain itself. There are many options that can bring relief.
Physical therapy
For many back pain patients, physical therapy is the right approach, particularly if they are experiencing severe tension and weakened back muscles. During physical therapy, patients are mainly mobilised through active exercises, enhancingmobility and strengthening the muscles. The overarching goal is a strong, flexible muscle corset that supports the spine.
Use of orthoses
Depending on the symptoms and cause of pain, different models are used with a varying range of stabilisation. For weak muscles, an orthosis can help to maintain upright posture, prevent tightening and provide support along with pain relief. Orthoses with compression stimulate the circulation and metabolism. Pads with friction nubs massage the muscles. An orthosis can correct bad posture. Stabilisation rods can be removed after successful therapy.
Manual therapy
In this method, functional disruptions in the musculoskeletal system are examined and treated. The patient takes on a more passive role here. The therapist aims to feel out disruptions in the musculoskeletal system, muscles and joints, and then to loosen them with special hand movements and mobilisation techniques.
Osteopathy
This alternative form of treatment assumes a balance of body, soul and spirit which the osteopath restores. For this purpose, painful blockages are broken down and the balance between all body systems is built up again. A variety of massage, stretching and hand techniques are used. Whether the health insurance provider will pay for the costs must be resolved individually here.
Acupuncture
This treatment method from traditional Chinese medicine aims to achieve a therapeutic effect by placing needles at specific spots on the body. Treatment by an experienced acupuncturist is generally well tolerated. In many cases, health insurance providers will reimburse part of the costs.
Thermal applications
Heat relaxes the muscles, promotes the circulation and metabolism. However, heat can make pain worse for example in case of sciatica irritation. Cooling is required here to slow down the transmission of pain signals. Thanks to pain reduction using heat or cooling, certain types of functional motor physiotherapy can be facilitated, improved or made possible.
Massage
To treat acute low back pain, a massage is not helpful. For chronic symptoms, they are sometimes applied in combination with kinesiotherapy.
Multi-modal pain therapy
Interdisciplinary cooperation is the foundation of multi-modal pain therapy. Here, doctors work hand in hand with specialists from the fields of physical therapy and psychology. Stress and anxiety can cause tension. Relaxation exercises such as progressive muscle relaxation or autogenic training can be helpful. A combination of physical therapies and psychosocial care achieves the best results.
Rehabilitation
Whether inpatient or outpatient therapy is required can be decided by the attending physician. A multi-disciplinary treatment concept for successful therapy generally extends for multiple weeks with intensive daily sessions.
Please note: The most promising therapy for you must be chosen individually may involve a mix of various approaches. The best course of action is to consult your physician.
2. Treatment of back pain with medication
A physical imbalance often can lead to back pain. For instance, this pain may give rise to a relief posture that can trigger further pain. This vicious cycle of pain, restriction of movement and tension can be interrupted by treating pain with medication.
Inflammatory rheumatic diseases such as rheumatoid arthritis trigger specific back pain that can be treated with special medication. Muscle-relaxing medications can also break this vicious cycle, particularly if the tension is the primary cause of pain. You should absolutely consult your doctor before taking medications, since there may be contraindications that argue against the ingestion of such medications depending on the circumstances.
Anyone who takes medication without consulting a physician for longer periods of time or exceeds the recommended dosage is at risk of serious consequences.
In all cases you should consult your physician to find out which medication is most effective and low-risk for your back pain. If you experience side effects, consult a medical professional immediately. The right medication for pain therapy is highly individual and is determined by the attending physician.
3. Surgery for back pain
Surgery is only necessary immediately in exceptional cases such as serious spinal injuries with a risk of spinal cord damage, otherwise plans can be made for the medium term after weighing the necessity and risks.
The most common back surgeries are interventions on the intervertebral disc and for narrowing of the spinal channels (spinal canal stenosis). In the last two decades, minimally invasive microsurgical intervention has become an established practice.
However, surgery alone is not enough. Aftersurgery, physical therapy is important for building muscles and recovering physical sensations. Balance, bending, turning and lifting all need to be trained along with walking exercises. Especially in the first weeks, spine orthoses can help to maintain the results of surgery. Whether outpatient treatment or inpatient rehabilitation is more beneficial must be decided on an individual basis.
Exercises for a healthy and strong back
Often, the reason for pain is that the back muscles are insufficiently developed. This problem is aggravated when the muscles are rested for too long. In order to counteract back pain, you should start with gentle physical activity as soon as the pain permits it.
It is recommended to strengthen the trunk muscles specifically with targeted exercises. A mobile back and well-trained abdominal muscles with strong, stretched muscles, ligaments and fasciae are much less prone to back pain.
In case of acute complaints, consult your doctor to find out if and what exercises are right for you.
Lumbar orthoses support the back in the event of acute as well as chronic pain. With additional stabilisation and support in the lumbar region, pain reduction can be achieved.
In order to counteract recurring pain, they can also be worn when there is strain on the back.
The individual indication forms the basis for selecting the corresponding orthosis. Depending on the product, it can provide relief or correction of relief postures or incorrect postures. JuzoPro Lumbal orthoses combine extraordinary wearing comfort and ease of use with optimum medical effectiveness. Thanks to four different versions from Light to Strong, the required support can be adapted depending on individual needs
and on the diagnosis.
The JuzoPro Lumbal Xtec Light provides patients with gentle and lasting support. Wearing the stabilisation orthosis supports an upright posture and can prevent tension. Particularly if the back muscles in the lumbar area are developed more on one side than the other or if they are too weak, the orthosis can be worn during any everyday activities that put a strain on the back.
Thanks to the firm Xtra fabric of the JuzoPro Lumbal Xtec, the lumbar orthosis exerts gentle to moderate compression on the patient’s lumbar region. A removable sacral pad with firm friction nubs additionally massages the muscles and tissues and loosens hardened fasciae. The orthosis can be used for most lumbar problems and offers relieving and pain-alleviating effect.
The JuzoPro Lumbal Xtec Plus lumbar orthosis is mainly used in cases of severe, persistently recurring pain. At the beginning of treatment, in particular, this orthosis
can offer strong stabilisation. The additional tensioning strap and sacral pad can be removed later corresponding to the progress in treatment. This increases freedom of movement in the lumbar region and supports mobilisation.
The JuzoPro Lumbal Xtec Strong lumbar orthosis is perfect for severe pain based on incorrect posture, joint wear or chronic irritation. Thanks to the high-waist design and its double cross straps, compression is evenly exerted across the entire lumbar region. The very firm stabilisation rods can be removed and re-shaped to provide relief or correction, depending on the requirement.
What can help with back pain?
For back pain, depending on the cause and severity of pain, there are different measures that can provide relief. After consulting with a doctor, possible options to consider are:
Physical therapy, moderate exercise, use of orthoses, warmth, cold, pain relievers, improved ergonomics, relaxation techniques, osteopathy, acupuncture, manual therapy, surgery.
What should you avoid doing if you have back pain?
Neither bed rest nor extreme movement are helpful if you are in pain. If you are able to move, start with light exercises. If the pain severely restricts your mobility, please consult a doctor!
How long does back pain last?
The duration of pain varies depending on the cause. A distinction is made here between acute pain that subsides after several days to a maximum of six weeks. Sub-acute back pain lasts roughly six weeks to three months. More than this, i.e. longer than 12 weeks, is considered chronic back pain. Back pain that occurs repeatedly is referred to as recurring.
What can cause back pain?
Back pain is not usually associated merely with wear of the spinal column and intervertebral discs. However, the precise causes can only be clearly resolved in exceptional cases. Frequently, multiple unfavourable factors converge together when back complaints occur. Possible reasons include excess weight, too little weight, weak core muscles, too heavy or one-sided strain, muscular tension and emotional distress.
What types of back pain are there?
Various types of back pain exist, including non-specific low back pain without a specific cause and specific back pain with a definite cause such as a herniated disc or sciatica complaints.
When should I consult a doctor?
If back pain is unusually severe, does not let up or even becomes worse, you should consult a doctor. If you experience feelings of numbness or paralysis, please seek help immediately. Furthermore, if you experience sudden, severe pain, back injuries or suspect a herniated disc you should be transported immediately to the hospital or a doctor’s surgery.
How can I prevent back pain?
There are some measures that can help to prevent back pain:
Which sleeping position is back-friendly?
Sleeping in prone position causes a hollow back, can lead to tension and pain in the area of the cervical and thoracic spine and should therefore be avoided.
Tip 1: When sleeping on your side, place an extra pillow between your knees so that your pelvis is more straight.
Tip 2: When sleeping on your back, place a pillow under your knees to relieve the lumbar spine.
How many people suffer from back pain?
Back pain is the most widespread condition. Over the course of their life, nine out of ten people suffer from low back pain at least once. At the same time, the pain is caused by an underlying serious illness in the rarest of cases.