Back pain: What really helps? Symptoms and treatment

Almost everyone has had back pain at one time or another. They often improve through more movement and specific back exercises. Here you can find tips for relieving and preventing back pain.

Back pain is a widespread disease
Almost everyone suffers from back pain at least once in their life. Even school children are affected more and more often. Only rarely are there serious diseases or orthopaedic problems behind it. In many cases, tension and hardening are the cause. The good thing is that such pain can very often be relieved relatively easily through back exercises and more movement. But why do we suffer more and more from back problems? And what exactly can be done to prevent it? As I myself was affected by it in the past, I would like to give you some background information and share some tips with you.

Facts and figures on back pain
Two out of three people in this country have suffered from back problems in the last twelve months (1). Every tenth person has regular pain. Back pain in children used to be very rare. Today, however, more and more school children are affected. To this end, the Robert Koch Institute has conducted the largest children’s study in Europe, KiGGS, with over 17,000 children (2). Three out of four children between the ages of 11 and 17 regularly suffered from pain (headaches, stomach aches, back pain). Almost half of them had back pain.

The lower back (the cross), or more precisely: the lumbar spine, is particularly often affected by back pain. This part of the back is subject to particularly heavy loads, especially for people who sit a lot or lift or carry loads in the wrong posture. Also quite common are tensions and pain in the upper back and neck, i.e. in the area of the cervical spine. If you have frequent back pain, you should definitely do something about it. Otherwise the pain can become chronic. There are various definitions, but usually we talk about chronic back pain if it lasts longer than three months.

What causes can back pain have?
There are of course reasons why back pain is becoming increasingly common today. The main reason is that children and adults sit too long and move too little. In addition, stress, overweight and an unbalanced diet also play a role. So you could say that the back is the mirror of our lifestyle. If you look more closely at the causes, doctors often distinguish between specific and non-specific back pain.

Specific back pain with known causes
If the trigger for back pain is known, it is called specific back pain. I don’t want to deal with this here for too long, because depending on the cause and disease, very different therapies may be necessary. Common illnesses that lead to back pain are a herniated disc, wear and tear of the spine or irritation, damage or bruising of nerves such as the sciatic nerve. Sometimes pain can radiate into the back from other places. It is not uncommon to feel pain in the back, but it is often caused by inflammation of the stomach lining, esophagus, kidney, lungs, heart or pancreas.

Non-specific back pain without direct trigger
The vast majority of cases of back pain are non-specific. This means that they cannot be attributed to any direct trigger. The typical “unspecific back pain”, which is becoming more and more common in our society, is usually triggered by a whole range of causes that interact: Lack of exercise, one-sided strain, incorrectly set up workplaces, poor posture and overweight all contribute to this. Stress can have a reinforcing effect. This causes tension that causes pain. Unfortunately, this often leads to a vicious circle. Pain leads to the fact that affected persons take up relieving postures out of fear and move less. This leads to even stronger pain (3).

Most frequent trigger: lack of movement
Many of our civilisation diseases are associated with a lack of movement. Often bad nutrition and stress are added to this. On average, people in this country only take between 800 and 1500 steps a day. According to sports physicians, however, this is far too little. Recommended are 10,000 steps per day. Stretching, mobilisation of the back and building up the trunk muscles are also often neglected.

But why is exercise so important to prevent back pain? Several very important effects come together here:

Good core muscles (trunk muscles) support the back like a corset, ensure good posture and prevent back pain. Improper posture such as a hunchback (“hump” with shoulders hanging forward) or a hollow back is prevented.
The intervertebral discs can be imagined as elastic gel cushions with a firm cover, which lie between the individual vertebrae of the spine. During movement they act as shock absorbers and are easily compressed. This movement also stimulates cell regeneration, blood circulation and nutrient supply to the intervertebral discs and keeps them elastic.
Tension and hardening of the muscles and fasciae in the back are caused by a lack of movement. They can lead to pain and sometimes also cause inflammation.
Incorrect strain and long periods of sitting
At the end of my studies, after finishing my diploma thesis, I received a book with back exercises as a present from my dear colleagues. Why? Because for several weeks I sat for about 12 hours a day at the computer and compiled my laboratory results, on a chair that was actually unsuitable (in student times a better one was available but not possible). Sport also came too briefly, since I had no time besides writing. I got increasingly back pain. Today I know that back then, instead of taking a 10 minute coffee break, I should have included some stretching, strengthening and mobilisation exercises for my back. But later you are always wiser.

Sitting for too long and incorrect sitting postures lead to muscle tension and put a very one-sided strain on the intervertebral discs. But other incorrect postures can also affect the back: Incorrect lifting and carrying of loads, a generally poor or incorrect posture, stressful high-performance sport or incorrect execution of sports exercises can be harmful to the back. Even children with a satchel that is too heavy can get back pain, especially if the satchel is only carried on one shoulder. Mothers are often affected at the time when they carry their toddler on one arm a lot.

Other causes of back pain
One factor that promotes back pain is overweight. Every kilo more puts a strain on the joints and the back. But that also means that every kilogram of weight loss has a relieving effect. Some people suffer more from back pain when they are under stress. The reason is that when we are under stress, we are not only under psychological strain, but our muscles can also tense up.

How is back pain diagnosed?
If you have very severe or long-lasting back pain, it is better to consult a doctor to clarify the cause and rule out more serious diseases. The doctor will first ask you how long, where and how often the pain has been present and how severe it is. Often the doctor then recommends a conservative treatment with more exercise. Sometimes physiotherapy or massage treatment is prescribed. If acute pain is very severe, painkillers (cf. MSM preparations) can help to ensure that normal movement is possible and a relieving posture is avoided. Because relieving postures can cause even more tension.

Only in cases of severe pain or suspicion of serious causes does an X-ray or an examination using computed tomography (CT) or magnetic resonance imaging (MRI) become necessary. Even if a conservative therapy does not bring about any improvement, further diagnostic procedures are often initiated. If the pain indicates nerve involvement, an examination by a neurologist can provide clarification.

What can you do yourself against back pain?

You can do a lot yourself to prevent back pain from occurring in the first place or to relieve existing pain. However, sudden, severe or long-lasting back pain should always be clarified by a doctor.

First aid for back pain: More exercise
Back pain is mostly caused by tense, shortened muscles and hardened fasciae. Even if back pain often feels very unpleasant and one instinctively spares the back, exercise is generally the better alternative. Even after a herniated disc, movement has a positive effect and contributes to the fact that in nine out of ten cases no surgery is required (4).

In any case, you should be aware that some exercises do more harm than good if they are performed incorrectly or with an attitude that is not very easy on the back. If you are not sure, it is best to start training under the guidance of a good coach, physiotherapist or sports doctor.

Suitable sports and exercises for back pain
Back school and special courses: adult education centres, health centres and fitness centres often offer special back courses (“back school”). Always make sure you have a trainer who is medically trained and who is able to deal well with the particular problems of the individual participants. Health insurance companies can provide information on where special health courses for the back are offered. By the way, the insurance company often pays or subsidises such courses.
Yoga or Tai-Chi: I myself have had great experiences with Yoga and Tai-Chi to relax, improve posture and strengthen the back. Below you will find some book and DVD tips.
Core Training: Core training is ideal for strengthening the body’s core. But be careful: Many exercises (for example in Youtube workouts) are not ideal for beginners and people with back problems. Here too, it is best to practice under supervision and make sure that the exercises are done in a way that is easy on the back.
10,000 steps a day: I mentioned above that the official recommendation is to take 10,000 steps a day. This strengthens circulation, joints and also the back. I have put this into practice by becoming a dog owner. Of course I have my two dogs not only because of that. But that way I have no excuse and have to do my rounds in nature every day.
Endurance training: The back also benefits from many endurance sports like jogging, hiking, Nordic walking, cross-country skiing, swimming and cycling. These sports not only strengthen the cardiovascular system, but also put strain on the muscles throughout the body.
Strength training: Strength training is ideal for specifically strengthening abdominal, lateral and back muscles. If you have back pain, a trained trainer should show you equipment and exercises that are suitable for your complaints and suitable for your back.
Mobilisation and mobility exercises: Short stretching and flexibility exercises during work are especially helpful. I try to take a short break every hour at work and stretch and move my neck, shoulders and back. You can find suitable exercises in the book 5-Minute Back Training*, which is also listed below in the book tips. This is an effective way to avoid muscle tension.
More tips for preventing and relieving back pain
In everyday life, a few more tips have proven to be effective in relieving or preventing back pain (5):

Overweight promotes back pain. Losing weight therefore also means taking the strain off your back.
Workplaces should be ergonomically designed.
Avoid stress and ensure calmness and relaxation.
Make sure your back is straight when bending, lifting and carrying.
Eat a balanced diet and drink enough fluids to keep your spinal discs elastic.
Certain food supplements can support joints and back with enzymes or natural enzymes.
A heat lamp (infrared lamp), massages or a hot bath can relieve acute back tension.

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