Lower back pain

introduction

Back pain is one of the most common reasons why a doctor is consulted in Germany. The reasons for this are generally incorrect stresses in everyday life that result from sitting too long in the office or doing heavy physical work. If you experience lower back pain, it affects the lumbar spine, which is the lowest part of the spine.

causes

In the past, back pain often occurred as a result of excessive strain and wear and tear after physical work, today a lack of movement and poor posture, for example when working on the computer, are often causes of pain in the lower back, which can also be noticeable as pulling or burning in the back. If the person does not move sufficiently, stable muscles are not formed around the spine, which results in instabilities.

Read more about sitting pain

The lower back is exposed to high loads because it has to carry a large proportion of the body weight. If the muscular supporting apparatus is not sufficiently developed, numerous clinical pictures can arise that cause pain in the lower back.

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Common diseases are presented below:

Diseases

• Muscle tension

Muscle tension are the most common cause of back pain. They arise when the muscles in the spinal column are overloaded or irritated due to poor posture and are a protective mechanism and a warning signal for the body. Often they also occur due to stress, as stress is associated with increased muscle tension. Due to the pain that the tension brings with it, the body adopts an unnatural relieving posture, which in turn leads to tension and pain, so that the patient is drawn into a vicious circle.

Therapy of muscle tension

In therapy it is important that the vicious circle of pain is broken through consistent action. Taking anti-inflammatory painkillers such as Ibuprofen or Diclofenac for some days. By inhibiting the pain, a natural posture and movements can be carried out again. The application of heat to the lower back can also relieve tension and thus relieve pain.

Other physical applications such as Massages are also helpful. Especially stress-related tension can be targeted with Relaxation exercises be treated. In the long term, it is advisable to build muscle in the spine area. This helps that the supporting apparatus of the spine becomes more robust and that tension due to incorrect posture no longer occurs so easily.

Appointment with a back specialist?

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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:

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• Lumbago (lumbar sciatica)

Lumbago, also known as lumbar sciatica, is characterized by a sudden shooting pain in the lower back. In addition, the pain is passed on to the leg. This pain is caused by the irritation of nerve roots between the Vertebral bodies step out. The cause of this is often tense back muscles. The tensed muscles can put pressure on the nerves and thus cause mechanical irritation. The radiation of pain into the leg also comes about because of such irritation, which is usually the one affected Sciatic nerve at the back of the leg. In addition to tense muscles, there can also be a bulging one Intervertebral disc (see below) or degenerate Intervertebral joints (Facet joint arthrosis, see below) irritate nerve roots in the lower back and cause lumbago.

Therapy of lumboischialgia

Basically, it is important to determine the cause of the symptoms and then to treat them specifically. The therapies presented above are helpful for muscle tension. In the case of severe pain that occurs as part of lumbar sciatica, it is important that adequate drug therapy is used so that the patient can move and does not remain in relieved positions. In this context it is also important that the chronification of pain can be prevented in this way. In order to avoid recurrence of lumbago in the long run, it is important to build muscle. A stable supporting apparatus in the lower back is essential for long-term freedom from symptoms.

• Disc protrusion of the lumbar spine and Herniated disc of the lumbar spine

The intervertebral discs lie between the vertebral bodies and act as shock absorbers for the human body, and they also give the spine its mobility. They consist of a gelatinous core that is surrounded by a fibrous ring of cartilage. With age, the intervertebral discs decrease in flexibility and become less stable, which can lead to problems. Disc problems occur more often in the lumbar spine, which leads to Lower back pain can lead. With every movement, the intervertebral discs are exposed to high pressures. If a disc can no longer withstand this pressure, it can become one Intervertebral disc bulge or one -incident come.

With the protrusion, the fiber ring of the intervertebral disc is only pressed slightly towards the spinal canal. In the event of an incident, the fibrous ring tears and parts of the core leak into the spinal canal. Both clinical pictures can be strong Nerve pain in the back due to nerve entrapment. These pains are often sudden and shooting and radiate into the leg. In the leg it can also lead to sensory disorders and or even reduced strength Signs of paralysis can come in severe cases Urinary and fecal incontinence occur, this requires immediate medical attention to prevent permanent nerve damage.

A Magnetic resonance imaging (MRI) of the lumbar spine performed, which depicts the relationships around the intervertebral disc.

Therapy of disc protrusion and herniated disc
Therapy should initially be conservative. An operation should only be considered in the presence of a herniated disc and after unsuccessful conservative therapy for at least six weeks or severe signs of paralysis. Conservative therapy is carried out with painkillers, physical therapy, physical applications and the like. Local injections into the irritated nerve roots with pain or pain can also be helpful Narcotics be.

In connection with the decision for an operation, it is important to carefully consider whether the disc problems are actually the cause of the pain. Research has shown that a high proportion of the population has a herniated disc without feeling any pain. Conversely, this means that if there is pain, the diagnosed herniated disc does not necessarily have to be the cause. In this case, surgery is useless.

• Herniated disc of the lumbar spine
  and
• Disc protrusion of the lumbar spine

• Facet joint arthrosis

With increasing age there is progressive wear and tear on the spine, a Facet joint arthrosis can be the result. This is the joint wear and tear of the facet joints, which connect the individual vertebrae with one another and are also called intervertebral joints. The degeneration of these joints is accelerated by poor posture, increased stress from being overweight and degenerative disc disease.

The facet joint arthrosis manifests itself symptomatically with back pain that can radiate into the buttocks and legs. The localization of the is important for the attending physician Leg painto differentiate facet joint arthrosis from a herniated disc. As a rule, sensory disorders do not occur with facet joint arthrosis. Back pain can be exacerbated by movements such as hyperextending the spine. An X-ray or MRI image is also helpful diagnostically.

Therapy of facet joint arthrosis

Especially in the early stages of the disease, the use of heat alleviates the symptoms. It can also be used for pain relief Cortisone and locally acting painkillers are injected into the area around the facet joints. This process is called Facet joint infiltration and is performed under X-ray control to ensure that the correct structures are made.

In order to avoid a facet joint osteoarthritis or to stop it from worsening, it is advisable to build up good spinal muscles, as this relieves the joints. If you are overweight, you should counteract this, as with every kilo you lose, the load on the spine decreases.

Strengthening the back muscles

Many diseases that lead to lower back pain can be avoided or alleviated with consistent muscle building. The following are examples of simple exercises that can be performed at home. To achieve a positive effect, strengthening exercises should be done three to four times a week. A certain amount of strain should be felt in the muscles. In addition to strengthening, it also makes sense to be consistent stretching perform so tapes and Tendons stay flexible.

• Quadruped stand with arms and legs raised

For this exercise you stand on four feet with your hands and knees on the floor. First, the right arm is lifted and held horizontally and stretched forward, and the same is done with the left leg. This position is held for about 15 seconds (increase if necessary), after which the arm and leg are put down again. Then the other arm and leg come on. This exercise is carried out for both sides several times in a row.

• bridge

In this exercise, lie on your back with your legs bent so your feet can be on the floor. Now you push the pelvis into the air so that the thighs and upper body form a line, after a short pause in this position, the pelvis is slowly lowered again. Repeat this exercise ten times and then take a short break, then do 10 repetitions twice.