Back pain can be classified by duration and cause:

1. Acute back pain: Pain that occurs suddenly and usually lasts less than six weeks.
2. Chronic back pain: Complaints that last longer than three months and are often recurrent.
3. Nonspecific back pain: Pain without a clear organic cause, often due to muscular tension or overload.
4. Specific back pain: Pain with a clear cause such as herniated discs, vertebral fractures, or inflammatory diseases.

The main causes of back pain can be divided into several categories:

• Muscular causes:
  • Tension or strains due to poor posture, heavy lifting, or prolonged sitting.
• Degenerative changes:
  • Wear and tear such as disc wear (osteochondrosis) or osteoarthritis of the facet joints.
• Disc problems:
  • Herniated discs or bulges that compress nerve roots.
• Spinal misalignments:
  • Scoliosis, kyphosis, or hyperlordosis can cause improper loading and pain.
• Inflammatory diseases:
  • Ankylosing spondylitis or other inflammatory spinal diseases.
• Traumatic causes:
  • Injuries from falls, accidents, or vertebral fractures.

The symptoms of back pain depend on the cause and severity of the complaints:

• Local pain: Pain in the lower back, which can be dull or sharp.
• Radiating pain: Pain that radiates into the buttocks, hips, or legs, often in cases of herniated discs.
• Movement restrictions: Problems with bending, turning, or straightening up.
• Muscular tension: Hardening of the back muscles that restricts the range of motion.
• Neurological symptoms: Tingling, numbness, or muscle weakness when nerves are involved.
• Stiffness: Morning stiffness, especially in inflammatory causes.

The diagnosis is made through a combination of medical history, physical examination, and imaging techniques:

- Medical history:

- The doctor inquires about the type, duration, and intensity of the pain as well as possible triggers.

- Physical examination:

- Examination of posture, movement restrictions, and reflexes.

- Imaging techniques:

- X-ray: To assess vertebral changes and misalignments.

- MRI: High-resolution imaging of discs, nerves, and soft tissues.

- CT: Detailed imaging of the bony structures of the spine.

Conservative Therapy

Most back pain can be treated with non-surgical measures:

• Physiotherapy:
  • Exercises to strengthen the back muscles and improve mobility.
• Medication Therapy:
  • NSAIDs for pain relief and anti-inflammation.
• Manual Therapy:
  • Mobilization techniques to relieve the spine.
• Heat or Cold Therapy:
  • Heat packs or ice treatments to relax the muscles.
• Ergonomic Adjustments:
  • Optimization of the workplace and avoidance of poor posture.

Surgical Therapy

In severe or chronic cases that do not respond to conservative measures, surgical interventions may be necessary:

• Disc Surgery:
  • Removal of disc tissue in cases of herniation with nerve compression.
• Fusion Surgery (Spondylodesis):
  • Stabilization of the spine in cases of severe instability or spondylolisthesis.
• Minimally Invasive Procedures:
  • For example, denervation for pain reduction in chronic facet joint arthrosis.

To prevent back pain, the following measures are recommended:

1. Regular exercise: Promote back health through sports such as swimming or yoga.
2. Muscle strengthening: Strengthen the core muscles to stabilize the spine.
3. Ergonomic posture: Optimize sitting and standing postures in everyday life.
4. Weight reduction: Reduce excessive strain on the spine through a healthy body weight.
5. Early detection: Seek medical advice promptly at the first signs of discomfort to avoid chronic conditions.