Back pain - recognize and treat optimally


Back pain (low back pain) have a wide variety of causes - therefore almost everyone knows them.

However, it is now important to find out the cause of the pain in order to be able to initiate targeted therapy. The cause does not necessarily have to be in the back area. Often they are based on other (urological, gynecological, ...) causes that have to be clarified during the examination.

In the following, the back pain is classified according to location and quality.

Where is your back pain?

Appointment with a back specialist?

I would be happy to advise you!

Who am I?
My name is dr. Nicolas Gumpert. I am a specialist in orthopedics and the founder of .
Various television programs and print media report regularly about my work. On HR television you can see me every 6 weeks live on "Hallo Hessen".
But now enough is indicated ;-)

The spine is difficult to treat. On the one hand it is exposed to high mechanical loads, on the other hand it has great mobility.

The treatment of the spine (e.g. herniated disc, facet syndrome, foramen stenosis, etc.) therefore requires a lot of experience.
I focus on a wide variety of diseases of the spine.
The aim of any treatment is treatment without surgery.

Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

You can find me in:

  • Lumedis - your orthopedic surgeon
    Kaiserstrasse 14
    60311 Frankfurt am Main

Directly to the online appointment arrangement
Unfortunately, it is currently only possible to make an appointment with private health insurers. I hope for your understanding!
Further information about myself can be found at Dr. Nicolas Gumpert

Lower back pain

Back pain in the lumbar spine (lumbar spine) area is common because this area of ​​the back is exposed to high loads. They affect all age groups. Colloquially, pain in this area is referred to as lumbago or lower back pain, in technical language it is called Lumbar pain. They are also known as the lumbar spine syndrome and include a blockage of the vertebral joints, irritation in the joint capsule, general overload and tension in the muscles and ligaments of the spine.

In most cases, pain medication is necessary as a therapy, which, in combination with physiotherapy, should lead to the tense situation being released and the muscles being properly trained.

Possible causes can be the following:

  • In most cases, the pain is due to changes in the intervertebral discs. These pains usually radiate to the buttocks or even to the leg. A herniated disc is the sudden or slowly increasing displacement of tissue from the soft core of a disc into the spinal canal (spinal canal) or laterally (Nerve root). As a result, nerve root compression with pain, paralysis and / or sensory disturbances can occur.
  • A lumbago (lumbago) is characterized by sudden, severe pain, often after a sudden movement, e.g. occur from lifting a heavy weight. Muscles may be pulled or there may be a herniated disc.
  • But also irritated and tense muscles due to permanent incorrect strain can lead to severe pain.
  • Another cause is rapid, violent movements that lead to sudden pain.
  • Vertebral fractures due to osteoporosis
  • Tumors in the lumbar spine
  • Kidney pain is also often misinterpreted and perceived as back pain. Most of the time, the pain is one-sided and not dependent on movement, as is usually the case with back pain. The pain increases and decreases periodically. You will find detailed information further down the page.
  • Patients with degenerative changes in the back area due to wear and tear are more likely to experience back pain. This includes the hollow back (Hyperlordosis) or the hollow back (Hyperkyphosis), as well as weak back muscles
  • Pregnancy causes the spine to curve and increase the weight to be carried. The pain usually disappears after the birth.

Middle back pain

Back pain that occurs in the middle of the back can have several causes. For one, introduces Herniated disc of the thoracic spine often to this symptom. Depending on the location of the affected Intervertebral disc the pain can be in the upper, middle, or lower back and radiate to the arms or legs.

Another possible cause is inflammation of the Vertebral bodieswhose pain is aggravated by long periods of sitting. Bending forward usually reduces the pain.
Also one Arthrosis of the vertebral joints can cause central back pain. This pain is then usually felt as dull and is worse when you stand, sit or lie down for long periods of time. It can also be through the Irritation of a nerve root pain in the middle of the back occurs, which then radiates to the buttocks or legs. This pain can also be triggered by strong muscle tension.

In addition, gynecological problems can also lead to central back pain. These are mostly noticeable in the sacrum and buttocks area. Usually these occur in combination with other symptoms, such as abdominal pain or problems urinating.

Left back pain

If the back pain is focused on one side, this can be triggered by incorrect or excessive strain. This can be caused by a muscle strain from fast movement during exercise, heavy lifting over the side, or other things. This results in a temporary imbalance of the back muscles, which should not be compensated for by relieving yourself. If this is attempted, the poor posture can become permanent and cause long-term problems with the spine.

A herniated disc can also cause unilateral back pain, depending on the direction in which the disc bulges. If there is a herniated disc, the unilateral pain is often accompanied by unilateral numbness or paralysis in the arms or legs.

If you have inflammatory kidney disease, such as pelvic inflammation that affects only the left kidney, the back hurts in the left flank. Here, the cause must be clarified and, if necessary, antibiotic therapy initiated.

Back pain or kidney pain?

Kidney pain is often accompanied by nausea and vomiting.

Kidney diseases can also lead to back pain. Most of the time, it is pain that occurs in the area of ​​the flanks, i.e. in the area of ​​the lower back, and it can radiate into the groin area. Kidney-related back pain is either unilateral or bilateral, depending on which kidney is affected.

In order to differentiate between back pain and kidney pain, freedom of movement can be checked. In the case of kidney pain, this is usually less restricted and the pain is dull and not dependent on movement. It is typical of kidney pain that they do not have the same intensity throughout, but are sometimes worse and sometimes less severe. Pain that gets worse when you tap lightly on the back about two fingers' widths above the iliac crest indicates problems with the kidneys.

To find out whether the kidney is the cause of the back pain that occurs, a blood test should be carried out to detect any inflammation in the body and a urine test to check whether blood is being excreted. Various causes can trigger kidney pain. The most common is inflammation of the kidney or renal pelvis caused by an infection. If there is an inflammation, the patient usually also complains of a poor general condition, fever and fatigue. Pain when urinating is also common. Inflammation due to an infection is treated with an antibiotic.

Obstructed urine flow can also lead to kidney pain. This can be caused by urinary stones that lodge in the kidney or ureter.

Kidney stones can lead to renal colic, which is accompanied by very severe cramp-like pain. The pain is often so severe that nausea and vomiting appear as accompanying symptoms.Here, antispasmodics in conjunction with painkillers help. The pain usually arises from the fact that the kidney stone has loosened and the ureter is blocked. There are several methods to remove kidney stones. They can be destroyed by shock waves, removed through the ureter or, if they are too large, removed surgically.

In addition, kidney pain can occur during pregnancy if the unfavorable position of the child causes the urine to back up in the kidney.

Kidney cancer can also be the cause of kidney pain that radiates into the back. The pain usually only occurs at an advanced stage.

Please also read: Burning in the lower back


The pain can be acute or chronic.

More than half of back pain affects the lower back, but back pain can generally occur in or radiate out to all areas. In addition to the pain in the affected area, other symptoms can also appear or be already noticeable as harbingers, for example through muscle tension or morning stiffness. Back pain can either come on suddenly or develop slowly over several days.

If the back pain is caused by muscle tension, the symptoms should subside on their own after a few days. If this is not the case, however, a doctor should be consulted. Back pain that occurs suddenly is usually expressed in stabbing pain that may radiate into the leg. Depending on the location of the back pain, it can also radiate into the neck. Often this acute back pain is triggered by lifting too heavily or by incorrect movement. Because of the pain, mobility is limited and the patient cannot straighten up.

If in addition to the back pain Numbness or a tingling sensation in the arms or legs, symptoms of paralysis or Incontinence added, these are warning signs that point to a Herniated disc of the lumbar spine indicate. In this case, a doctor should be consulted quickly. A herniated disc can occur at different levels and cause different symptoms and pain depending on the location. Depending on whether he has a Pinched nerve or not, there will only be pain or additional symptoms.
If you suffer from numbness and suspect a herniated disc of the lumbar spine as the cause, we recommend our topic: Is a herniated disc causing my numbness?

But back pain can also be chronic. Then they are characterized by a constant increase and decrease in pain intensity, which alternates in phases. This can be done by Wear-related protrusions of the intervertebral disc arise when nerves are permanently irritated, or through wear and tear of the vertebral joints, which rub against each other when moving.

Frequency distribution of back pain

Back pain

Back pain apply in Germany as Common disease, which, from a purely statistical point of view, are the second most common reason for visiting a doctor. As already mentioned, back pain is often chronic and therefore keeps recurring. Most of the time, the lumbar spine is affected by back pain.

In many cases it is extremely difficult to determine the root cause of the "chronic " Back pain to detect.
It was already pointed out above that many causes can be organic and / or psychological in nature. The causal components can always influence one another and, under certain circumstances, also reinforce one another.
The task of the doctor is to find the cause of the back pain and to clarify the syndromes through differential diagnosis. This is not always easy.
You can obtain differential diagnostic measures in our practice in Frankfurt am Main. To homepage.

Appointment with a back specialist?

I would be happy to advise you!

Who am I?
My name is dr. Nicolas Gumpert. I am a specialist in orthopedics and the founder of .
Various television programs and print media report regularly about my work. On HR television you can see me every 6 weeks live on "Hallo Hessen".
But now enough is indicated ;-)

The spine is difficult to treat. On the one hand it is exposed to high mechanical loads, on the other hand it has great mobility.

The treatment of the spine (e.g. herniated disc, facet syndrome, foramen stenosis, etc.) therefore requires a lot of experience.
I focus on a wide variety of diseases of the spine.
The aim of any treatment is treatment without surgery.

Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

You can find me in:

  • Lumedis - your orthopedic surgeon
    Kaiserstrasse 14
    60311 Frankfurt am Main

Directly to the online appointment arrangement
Unfortunately, it is currently only possible to make an appointment with private health insurers. I hope for your understanding!
Further information about myself can be found at Dr. Nicolas Gumpert

Cause of back pain

common causes of back pain

Based on the various clinical pictures that were described above, one can see that the underlying causes of back pain are complex.

Degenerative, wear-related changes in the area are a common cause of back pain Spine and Intervertebral disc. Individual changes must always be taken into account in the causes. For example, patients are with Hollow back (Hyperlordosis) or Hollow back (Hyperkyphosis), as well as patients with weak Back muscles etc. may suffer from back pain more often.

Regardless of the individual factors, there are potential causes for the development of back pain. The most important ones are mentioned and described below.

Possible causes for the development of back pain are:

  • Wear and tear, osteoarthritis, wear and tear and degeneration
  • Mechanical causes
  • Injuries to the spine
  • Neoplasms, neoplasm and tumor
  • Congenital causes
  • Nerve irritation
  • Compression of the nerve root
  • inflammation

Since the causes of back pain can be so diverse, we have outsourced all possible causes to a separate topic.
You can find out more about this under our topic: Causes of back pain

Back pain from pregnancy?

Back pain is particularly common in the latter part of pregnancy.

Over half of all pregnant women Women suffer from back pain during their pregnancy. These are usually harmless and can be attributed to the increased stress on the back due to the increasing weight. This can lead to tension in the muscles, which are painful.

The back pain during pregnancy can be divided into two groups: the real back pain and the pelvic pain. The real back pain is the same as that experienced by non-pregnant women and men. They are caused by an overload of ligaments, Muscles and Joints and are often triggered by lifting too heavy loads or incorrect movements. If pain occurs that radiates into the back leg, irritation of the Sciatic nerve be responsible for this. While this rarely occurs during pregnancy, it can be caused by the back pressing on the nerve.

The majority of back pain during pregnancy is what is known as pelvic pain.

To avoid or prevent back pain during pregnancy, it is important to be well trained Move- and Abdominal muscles to have. Back exercises at home or a visit to the gym can help here.

During pregnancy you can Pregnancy gymnastics or aqua courses are attended to strengthen the muscles and relieve or prevent pain.

In the case of existing back pain, heat can be used in conjunction with Massages prove effective. Here the gynecologist should be asked for advice. A support belt that takes over part of the baby's weight can also be helpful.

For lower back pain that occurs in the first trimester of pregnancy, a doctor should be consulted, as kinking of the cervix is ​​a possible cause. But also complications of the Early pregnancy, at worst one Miscarriage, can cause this.

In the further Course of pregnancy The contraction of the uterus or the pressure of the child's head on pelvic nerves can lead to back pain. Kidney disease can also be a cause. Changing the posture of the pregnant woman often leads to a hollow back, which leads to improper strain on the back and pain.

Another reason for back pain during pregnancy is the onset of it Labor pains. These cause severe pulling in the lower back area.

The most common diseases

At this point, back pain is discussed, the cause of which is to be found in the area of ​​the spine and neck. Some diseases were selected as examples from which patients are affected more than average.

These back pain include:

  1. The lumbago (lumbago)
    Lumbago is generally understood to mean sudden, severe pain in the lumbar spine to the tailbone. This back pain can also radiate into neighboring areas, among other things. In some cases, significant restrictions on movement, combined with sharp pain in the back, are the result. The cause of lumbago is caused, for example, by damage to the intervertebral disc, pressure pain in the area of ​​the spinous processes and much more. The specific causes of lumbago must be determined and investigated individually.
    For more information on this topic, see: Lumbago
  2. lumbalgia, lumbar sciatica, lumboglutealgia
    As soon as pain radiating to back problems occurs, for example in the leg, one speaks of lumbar sciatica or sciatica.
    For more information on this topic, see: Lumboischialgia
  3. The herniated disc
    A herniated disc is the sudden or slowly increasing displacement, or the emergence of tissue of the nucleus pulposus (NPP, gelatinous core of the intervertebral disk) of an intervertebral disk backwards into the spinal canal (Spinal canal) or rear side (Nerve root). Pressure on nerve roots can lead to pain, paralysis and / or sensory disorders.
    For more information on this topic, see: Herniated Disc

The various diseases and injuries that lead to back pain

Other diseases and injuries that lead to back pain:

  • Intervertebral disc bulge
  • Cervicobrachialgia
  • degenerative changes in the spine
  • Inflammation of the intervertebral disc
  • Facet syndrome
  • Cervical spine syndrome
  • Lumbar spine syndrome
  • ISG - blockage
  • KiSS syndrome
  • Lumboischialgia
  • Baastrup's disease
  • Forestier's disease
  • Scheuermann's disease
  • Sacroiliitis
  • Whiplash
  • Spinal stenosis
  • Spinal fusion
  • Spondylodiscitis
  • Vertebral fracture
  • Vortex sliding

Illustrations on the subject of back pain

Figure back pain

Figure back pain: causes and areas of pain points

A - neck pain
B - upper back pain
C - lumbar spine pain
Lumbago (lumbago)
D - lumboglutealgia
(Radiating into the buttocks)
E - Lumboischialgia
(Radiating into the leg)

  1. First cervical vertebra (carrier) -
  2. Seventh cervical vertebra -
    Vertebra prominent
  3. Trapezius -
    Trapezius muscle
  4. Broad back muscle -
    Muscle latissimus dorsi
  5. First lumbar vertebra -
    Vertebra lumbalis I
  6. Fifth lumbar vertebra -
    Vertebra lumbalis V
  7. Sacrum - Sacrum
  8. Tailbone - Os soccygis
  9. Iliac crest -
    Iliac crest
  10. Gluteus Middle -
    Muscle gluteus medius
  11. Gluteus Muscle -
    Muscle gluteus maximus
  12. Big Dresser -
    Adductor magnus muscle
  13. Two-headed hamstrings -
    Biceps femoris muscle

    a - Disc prolapse -
    Nucleus pulposus prolapse (from above)
    b - vertebral fracture
    (Vertebral fracture)
    c - spinal osteoarthritis -
    (Joint wear)

You can find an overview of all Dr-Gumpert images at: medical illustrations

Figure spine

Figure intervertebral disc

Figure spinal cord

Figure herniated disc

Figure lumbar spine syndrome

Figure vertebral fracture

Back pain development

As already described above, the causes that can be blamed for back pain are very diverse.

However, they are very often through Muscle tension triggered. As a result of this tension, the muscle parts appear hardened and disturb the nerves surrounding them in a sometimes sensitive manner. Since some nerve tracts also radiate into more distant areas of the body (e.g. legs), it is very often possible to Pain in other areas Back pain causally trace back. A targeted diagnosis of the back and abdominal muscles helps to reveal deficits and imbalances in the trunk muscles and to initiate targeted therapy options. To Back diagnostics

However, pain is not always caused solely by the muscle tension mentioned above. It is also possible that a patient is under a so-called Root syndrome suffers. This syndrome is due to disposition, age, wear and tear and / or stress. A shifted one pushes Intervertebral disc on the surrounding nerves and causes back pain.
Which cause can be blamed for the development of the back pain is always up to the doctor's diagnosis.

The subjective perception of pain / back pain must be pointed out again and again. It has been shown time and again that people's pain tolerance limits are sometimes very far apart.

There are people who diagnostically suffer from the most severe signs of wear and tear, but subjectively feel no pain. However, the reverse is also possible. So it can be said that often no relationship between the severity of the pain and the diagnosis of back pain exists.

As already mentioned above, it is possible for patients to get a grip on their painful back through a so-called relieving posture. This relieving posture usually causes tension again, as other muscle parts are overused than is normally the case.

Around Back pain long term To prevent this, you should decide for yourself to exercise more. This is easily possible in everyday life (stairs instead of a lift) and can also be supplemented with other sporting activities. See also Back training.

Back pain diagnosis

An MRI gives sectional images through the entire back.

Since there are different causes for the development of back pain, and it has been proven that there is also a close relationship between Pain and psyche exists, a careful anamnesis appears (= Medical history survey) inevitable.

When diagnosing back pain, the focus is quite often initially directed towards Occupation of the patient. Knowing the occupation can already identify possible risk factors (Professions that are practiced "almost" exclusively while standing or sitting, which stand out by lifting heavy loads, ...) or, if not applicable, exclude them.

To record the severity, so-called "Pain diaries"Can be used to find the diagnosis. As part of a pain diary, the patient documents his (subjective) perceived pain using an analog scale. The evaluation is usually carried out by the doctor.

In principle it can be X-ray image of the spine as a basic diagnosis for Back pain describe. The attending doctor receives an insight into the X-ray images Spine Posture. In addition, bony changes can be recognized.

The sectional image diagnostics (CT and MRI, either with or without contrast agent) also enables the pain to be assigned to a specific one annoy or one Herniated disc. Due to the different diagnostic methods, one can and wants to obtain extensive information with regard to therapeutic measures to be taken. It should be noted at this point that an additional administration of a contrast agent is usually only carried out if there is a suspicion of inflammation or a tumor.

To rule out nerve damage or to be able to determine the degree of possible nerve damage, more far-reaching examinations must be carried out. This can be done on the one hand by means of neurological examinations

The Myelography describes an examination in which the patient injects contrast medium into the dural sac. The dural sac is the area that surrounds the beginning of a nerve before it leaves the spinal canal. By mixing nerve water and contrast agent, specific questions relating to the Spinal cord better clarify.

Back pain when breathing

Breathing is a vital process for human beings that can in no way be avoided. Therefore, despite back pain, care should be taken not to keep breathing shallow so that the body is supplied with sufficient oxygen.

The respiratory pain can have various causes. If you have a severe cold or bronchitis, breathing in and out can cause temporary back pain. If these get worse or do not get better, a doctor should be seen to clarify possible causes. However, injuries to the ribs or the spine caused by violence can also lead to breathing-related back pain.

Since the back muscles as well as the abdominal and respiratory muscles are attached to the spine, there is a close connection here. If the back muscles are damaged, breathing passively moves them, which can lead to pain. Inflammation of the muscles (Myositis) can manifest itself as pain when breathing. This can result from an insufficient supply of the muscles with oxygen and should be treated as soon as possible in order to preserve the muscles.

The pleura, which surrounds both lungs, can become inflamed in the course of pneumonia or other influences. This inflammation (pleurisy) can cause severe pain, which is usually more painful when you inhale than when you exhale.

Breathing-related back pain is treated with painkillers in the acute state and then, depending on the cause, appropriate therapy is carried out.

Read more about this on our website Pain in the back when breathing.

Therapy / treatment of back pain

Since back pain can have many different causes, it is first necessary to narrow down the cause as precisely as possible in order to be able to treat it accordingly. When choosing a suitable therapy, the extent of the pain and any impairments or symptoms of paralysis should be taken into account.

Painkillers (e.g. ibuprofen) are usually used to relieve acute back pain. These are freely available in pharmacies, but should not be taken without medical advice, especially if you have persistent back pain. Anti-inflammatory drugs (e.g. paracetamol) can also help against acute pain. In addition, anti-inflammatory drugs, such as cortisone, can be injected directly into the painful area using a cortisone syringe for rapid pain relief. If the pain is very pronounced, opioids may have to be used for a few weeks. These have a numbing effect and can be combined with anti-inflammatory drugs.

Back pain often leads to tension due to a relieving posture, which can cause additional pain. Muscle relaxing drugs, so-called muscle relaxants, help against this. However, these are rarely prescribed by a doctor because they have severe side effects and, among other things, can lead to temporary inability to drive.

Although back pain entails a certain amount of rest and restriction in many activities, enough exercise is still important for the healing process. Sitting or standing for too long and lifting heavy should be avoided, but light activities should still be carried out as far as possible.

Back pain is often caused by instability of the spine or a permanent incorrect load. That is why physiotherapy is often part of the standard therapy for back pain. Since the spine is not only held by the back muscles but also by the abdominal muscles, shoulder and neck muscles and hip muscles, the goal of physiotherapy is to stabilize this entire holding apparatus in order to achieve optimal support for the back.
But massages can also be part of physiotherapy. This relieves tension and stimulates blood flow to relieve pain. In addition, heat patches, e.g. ThermaCare®, help to relax the muscles. In the case of inflammatory processes, however, we usually find cold to be more pleasant, so cold therapy (cryotherapy) is recommended. In addition, electrotherapy can be carried out, in which electrical currents are supplied from the outside, which are intended to promote blood circulation and initiate the healing process.
In addition, the so-called Blackroll, a self-massage roller, can provide relief from back pain. Another option for mild back pain is to apply some horse ointment to the affected area to treat the symptoms.

In the case of chronic back pain that has no identifiable cause and lasts longer than 12 weeks, multimodal therapy should be initiated. That means doctors, pain therapists, physical therapists, occupational therapists, psychotherapists, and psychiatrists work together to identify and treat a possible psycho-social cause.

In the long term, if you have back pain, you should ensure that the workplace is ergonomically designed. Desks that can be adjusted in height are often helpful in order to be able to do some of the work while standing.

If there is back pain due to a herniated disc and the conservative methods do not provide pain relief, surgery should be considered. Various methods are possible here.

Read much more extensive information on this topic at: Back pain treatment

Back pain in the lower back

Since this topic is so extensive, we also have a separate page on the topic Lumbar spine pain written.

Causes back pain of the lumbar spine

Bad posture is a common cause of back pain in the lumbar area.

To the so-called lower back counts the Lumbar spine, which consists of 5 vertebrae and closes the spine at the bottom. There are back pain in this area frequentlywho have favourited treatment tedious. A distinction is made between chronic and acute complaints of the lower spine as well as complaints from the upper spine and those arising in the lower spine.

Acute complaints to the lower spine are less common and mostly on Accidents and Contortions bound. If vertebrae of the lower spine are damaged by falls or accidents, the lower vertebrae can become very strong Pain.

Furthermore, it can happen that by quickly lifting large loads and turning around in the Spine Dislocations develop, which acutely cause severe pain in the spine area. It is often said that a nerve has jammed, but in reality it is rather about Irritation from nerves that run close to the muscles and are stimulated by the muscles that are tensed up by the sprain.

The chronic Causes of back pain are primarily related to the lower back Posture damagethat grow over a long period of time and can cause severe discomfort. Especially patients who sit down for long periods of time or who have been unbalanced since childhood Bad posture are particularly at risk of getting back pain in the lower part of the back.

Today it is assumed that a not inconsiderable proportion of back pain in the lower back actually occurs in the upper area of ​​the back and then down into the lumbar spine radiate. The causes here can also be chronic damage but also acute ones.

Ask here too Bad posture the most common cause of chronic complaints, while injuries and lifting tend to be acute complaints. Back pain from slipped discs is also common. In almost all cases, they come from chronic postural problems. In a herniated disc, the core of the disc slips out.
The Intervertebral disc slips out between both corresponding vertebral bodies and causes pain. Herniated discs are mostly caused by postural damage, mainly in the area of ​​the middle spine (Thoracic spine) and can radiate down into the lower spine and cause discomfort there. In some cases arise But also herniated discs in the lower spine (Lumbar spine) and cause pain.

Forms of back pain

The following diseases affect the spinal area (especially causes of chronic neck pain):

  • Vegetative pain
  • Cervicalgia, cervical syndrome
  • Brachialgia, dorsalgia
  • Lumbago, low back pain
  • Sciatica
  • radicular pain
  • pseudoradicular pain.

Low back pain is particularly common.
This back pain, also known as low back pain, can under certain circumstances radiate to other areas of the body. This is, for example, in the clinical picture of lumboglutealgia (Radiation into the buttocks) or lumbar sciatica (Radiate into the leg) the case.

Since repetitive occurrence is typical for these types of pain, it is often referred to as a chronic pain disorder. As a rule, there are no neurological symptoms.

The pain in the back can also be a hardening of the muscles. How to recognize this can be found in the following article: What is muscle hardening?


Lower back pain can be triggered by a variety of causes. In the diagnosis, it is crucial to distinguish the major causes from the minor causes.

At the beginning of the diagnosis there is the patient survey, in which the patient is asked about the type and duration of the pain, as well as movements that are intended to reduce or increase the pain. If the person concerned describes sensory disturbances in the legs in the form of numbness or tingling, quick action is required, as the causes of the back pain described are most likely to be related to a problem with the nerves of the spine. If the patient describes a new incontinence, it is a neurological emergency.

In the diagnosis of untreatable back pain, imaging is of crucial importance. An x-ray of the spine can show fractures in the vertebral bodies. A further step is to carry out a magnetic resonance tomography, which can also show soft parts and, among other things, make herniated discs visible. In addition to the imaging tests, an extensive blood test can also provide information about what is causing the back pain. Inflammation of the vertebral bodies or the intervertebral discs can be shown by increasing the inflammation values.


The therapy depends on the cause of the discomfort. Uncomplicated back pain, which in most cases arises from poor posture, can in most cases be treated conservatively.

The conservative therapy options include, on the one hand, adequate pain therapy, which usually consists of medication, and, on the other hand, appropriate physiotherapy, which can consist of applying heat or cold or learning certain back exercises. If the back pain cannot be controlled with the conservative treatment options, and if the cause is in principle operable, an invasive procedure must be considered.

In many cases, herniated discs can be treated conservatively, unless the pain is so severe and cannot be controlled with medication, or neurological disorders such as numbness or paralysis as well as incontinence are already occurring. In this case, surgical therapy must be planned and carried out immediately, as this situation can quickly lead to a neurological emergency. If neurological symptoms are present, it is already a nerve compression that must be relieved by an operation on the spine. Herniated discs are removed and the two successive vertebral bodies are often stiffened.

When it comes to fractures of the vertebral bodies, the decisive factor is whether it is a stable fracture or an unstable fracture. In most cases, stable fractures are treated conservatively with painkillers or with immobilization in the form of a corset. Unstable fractures must be operated on and stabilized using screw connections. The surgical interventions described are carried out in neurosurgery departments. Often, minimally invasive surgical procedures using the so-called keyhole technique are sufficient.

Read a lot more information under our topic: Therapy of back pain and pain therapy for the back

Summary back pain

Back pain of the lower back are frequently and have different causes. A distinction is made between chronic and acute complaints as well as those arising in the lower back and radiating from the upper back.

Acute causes are mostly Fractures, Herniated discs or sprains and injuries to the spine Accidents. Chronic causes are in most cases based on postural defects that have been exercised over a long period of time.
Sometimes the causes of back pain arise in the area Thoracic spine and pull down into the Lumbar spine, where they are then perceived as painful, sometimes the core sits right in the Lumbar spine.

In addition to the patient survey in the case of severe back pain, there is always a diagnostic Imaging be performed. This can consist of a X-ray the spine through which fractures of the vertebral bodies can be seen or through a MRI-Examination through which one Herniated discs etc. can see. If the patient describes neurological symptoms, it is imperative to hurry, as the nerves of the spine are apparently impaired in some way. The uncomplicated back pain is treated in most cases conservative. This is understood to be a treatment concept consisting of adequate drug pain therapy and a supplementary one physical therapy.

Physiotherapy can also try treatment with warmth, cold or Stimulation current respectively. Complicated back pain can be treated surgically, depending on the cause. If neurological causes are present, surgical efforts must be made to reduce the compression of the nerves.
This happens in departments of the Neurosurgery in many cases in minimally invasive interventions using the so-called keyhole technique, in which only a few cuts are necessary and the actual operation is carried out through a microscope. Back pain can have many causes, each of which requires a specific treatment approach.