Back problems refer to pain that occurs in various regions of the back. Common causes of back problems are damage due to excessive strain or a combination of mechanical damage (e.g. pinched nerve) and degenerative damage (signs of wear) as well as psychosomatic factors.
Back pain is caused by physical (organic) and/or psychosomatic factors as well as malpositions and incorrect weight bearing. Possible causes include:
- Injuries such as a vertebral body fracture, vertebral body displacement or a torn nerve root
- Wear (degeneration) Clinical pictures include osteoporosis, Morbus Bechterew, herniated discs, instability of the spine, muscular imbalances or leg length differences with resulting disturbances of body statics.
No specific cause is found for nearly 90% of all back pain cases. Diagnostic procedures include X-rays and magnetic resonance tomography.
Back pain is differentiated by radicular pain, in which a nerve root is irritated – for example by a herniated disc – and pseudo-radicular pain. In the latter case, back pain is caused by changes in the small joints of the spine.
Other distinguishing features can include:
- Lumbago: suddenly occurring back pain
- Chronic back pain: back pain that has been occurring for more than three months
- Lower back pain and radiating pain in the legs
- Loss of control over leg functions
- Impaired bladder function
60 to 70% of women aged 30 to 60 suffer from back pain, as do 65 to 80% of men. More than 75% of all back pain originates from the lumbar region. Back pain is the second-most common reason for a hospital stay. It is the leading factor for the approval of inpatient medical curative treatment in pension insurance and also a reason for physical and occupational disability. Nearly 50% of all applications for early pensioning are related to this problem.
Treatment depends on the cause of the complaints and is often conservative initially, i.e. without an operation. Surgery is only performed in rare cases. The prognosis for most people with back pain is good. In more than half the cases, the pain goes away within one week and approximately 80% of patients have largely recovered after two weeks through adequate treatment with pain therapy, orthopaedic medical aids such as back orthoses/supports and physiotherapy treatment. The guidelines published by the orthopaedic specialist association and the Drug Commission of the German Medical Association emphasise that only measures that incorporate the patient's active participation (e.g. active physiotherapy, the use of functional orthoses, back-friendly behaviour in the workplace etc.) will be useful in the long term.
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