Back Pain

13. August 2018

The basics explained.

Back pain can manifest itself in a variety of forms –

The basics

If a patient goes to a doctor with back pain, he or she is fully reliant upon the subjective impressions and experiences of the person affected. The precise localisation of the pain cannot be performed with certainty using laboratory tests or technical procedures. Whenever back pain is referred to, a civilisation disease can be spoken of, to a certain extent – 100 to 150 years ago, dorsopathies, which back pain and spinal disorders are also referred to as, were only reported on to a minor extent.

For understanding: Back problems, which naturally include back pain, are classified on the basis of their duration. Statistically, around four out of five people in Germany will be confronted with back pain during the course of their life, the lumbar spine causes us problems most frequently.

The definition of back pain

In the currently valid version of ICD-10, the globally accepted compendium of medical diagnoses, back pain is referred to with M54. This number, introduced by the World Health Organisation, ensures that the disease is defined internationally and can be recognised. However, for treatment success, the therapy approach etc., the definition of back pain according to the duration is more relevant.

  • Acute back pain: less than six weeks
  • Sub-acute back pain: six to twelve weeks
  • Chronic back pain: more than twelve weeks

The types of back pain referred to differ significantly with regard to their degree of severity, as well as the impairments that are actually associated with this in daily life. In addition to this, every person has a different sense of pain, which once again explains why as precise a description as possible is so important for the treating doctor, as false diagnoses and unnecessary treatments can be avoided.

Please find remarks below, which are required for obtaining an understanding of this clinical picture. Let’s go!

Specific or non-specific, that is the question here!

1. Non-specific back pain

At every age, impairments of the spine are basically conceivable, as there are various factors, which need to be taken into consideration. Most persons affected suffer from so-called non-specific back pain, in medical communities, synonyms also circulate, such as non-specific or functional back pain. If a well-founded diagnosis starts here and the determination of the pain does not occur and chronic back pain dues not manifest itself, in technical jargon, a “temporary health disorder” is referred to – non-specific back pain is therefore not explicitly regarded as a disorder, but as a mainly harmless, only temporary health impairment.

This involves tenseness, hardening or irritations, possibly also shortening or distension – particularly from the back muscles, where the soft active motion elements are situated, no bones. In several cases, affected persons also report impairments of the bands, tendons or fascia.

The causes for non-specific back pain are usually excessive strain, caused by being overweight, lifting and carrying heavy loads, lack of exercise, regular overhead work (such as with painters, etc.) or work activities, which require frequent bending over or the upper body needs to bend over. Anyone who works in an office can potentially cause improper pain, if the office furniture is considerably insufficient.

2. Specific back pain

The entire situation is different, if it involves spinal disorders, concrete deformations or infectious diseases of the muscles or the connective tissue – specific back pain is referred to, if it occurs particularly with advancing age (ergo: excessive strains).

Specific professional groups are affected considerably more frequently than others, due to one-sided regular strains. However, it must be clarified that a certain degree of joint wear is completely normal over the years and is usually only associated with minor pain. Diagnoses, such as spondylarthrosis, i.e. arthrosis of the spine, can only be made with considerable effort as back pain due to wear.

Specific back pain is always pathological, which means that an integral treatment is essential. If additional accompanying symptoms occur, such as swollen joints, rashes, fever, fatigue or others, this may be an indication of back disorders – or that the back is also being involved.

Digression: The lumbar syndrome (lower-back pain)

If back pain occurs in the lower back, i.e. in the lumbar spine and the sacroiliac joints, lower-back pain is also referred to in the vernacular. It affects people in every age group and, particularly also with young adults, it is particularly caused by sitting for too long and manifested posture damage.

There are three different stages of the lower-back pain referred to as lumbar syndrome:

  • Local lumbar syndrome: Lower-back pain is restricted to the lumbar spine.
  • Lumbar root syndrome: Radiation of the pain into the leg.
  • Alarming lumbar syndrome: Additional symptoms, including paralysis, urinary and stool incontinence and others occur concurrently.

The causes for lower-back pain can be diverse, however, with rising age, it mainly involves signs of wear in the spine. Psychosomatic causes are also conceivable, such as the association with other diseases or diseases since birth. Anyone, who puts their spine and discs under strain over the long term, which also includes walking upright, contributes significantly to the creation of lower-back pain. Safeguarding of the spine in combination with strengthening of the back muscles and a constant switch between strain and relief of the back promises integral prevention.