Therapy for chronic back pain - what works best?
- Heat and cold
- Chiropractic (straightening)
- bed rest
- massage
- Standardized training programs (back school)
- physiotherapy
introduction
Back pain must be treated early and sufficiently to avoid chronification. For chronic back pain, common painkillers are often no longer effective on their own because a pain memory has developed, i.e. the back pain has become independent in the psyche of the person affected. Therapy for back pain is then much more difficult. An interdisciplinary approach by orthopedists, anesthetists, neurologists, psychologists and physiotherapists in the context of multimodal pain therapy is then often indicated in the therapy of back pain.
Read more on this topic at: chronic disease
Further information about the use of pain therapy in the treatment of back pain can be found at: Pain therapy for the back
Therapy options
Adequate movement:
The best way to prevent and treat Back pain is the appropriate one MOVE. In everyday life, use the stairs instead of the elevator or just leave the car parked for activities that are nearby.
Appointment with a back specialist?
I would be happy to advise you!
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:
- Lumedis - your orthopedic surgeon
Kaiserstrasse 14
60311 Frankfurt am Main
Directly to the online appointment arrangement
Unfortunately, it is currently only possible to make an appointment with private health insurers. I hope for your understanding!
Further information about myself can be found at Dr. Nicolas Gumpert
Once back pain has occurred, the same applies to simple back pain: Move! Long bed rest should be avoided in any case. Reconsider your exercise habits to get (again) fit. According to your individual level of performance, it applies through the right thing Back training, the Back muscles to strengthen. Especially the trend sports walking or Nordic walking can help. That too swim and / or cycling are considered suitable sports for strengthening the back muscles.
Since it is difficult to get up to move, especially in acute phases of pain, a pain medication may be given initially at the start. The targeted athletic load ensures better muscle relationships and mobility. The entire spine is significantly relieved by the structure of the body's own support corset.
Painkiller
As mentioned above, the mobilization of the patient is of the utmost importance in the therapy of back pain. Acute painful states, however, tempt you to "take it easy" longer than perhaps necessary. In order to shorten this possibly longer-lasting "state of health" and to get the patient moving again as quickly as possible, severe back pain can be temporarily relieved with painkillers.
It is important to mention, however, that painkillers only reduce the pain, but do not treat or eliminate the cause of the pain. They should really only serve to get the patient pain-free as quickly as possible so that he can move again.
The attending physician should determine the intake of pain medication as part of the correct therapy. He can individually decide on site which medication and which dosage appear sensible.
In addition to pain reliever medication (e.g. paracetamol, Aspirin®, Diclofenac, Ibuprofen, muscle relaxants (muscle relaxants) such as Sirdalud® can be administered.
Please also read our article on this: Muscle relaxants
It must always be pointed out that drugs have not only effects but also side effects. Some of the pain relievers in particular can cause stomach bleeding. A first indication of this is: black stool. In such cases, you should consult a doctor immediately and stop taking any further medication for the time being. Last but not least, because of the side effects, long-term therapeutic use of pain medication is not recommended. They are only intended to help the patient "get back on their feet" as quickly as possible.
Natural Remedies / Devil's Claw
Natural remedies, special is the Devil's claw to call. The devil's claw can be used alone for mild pain and to support the existing therapy for more severe pain. The devil's claw is supposed to Symptoms of back pain Reduce.
Further information is also available at: Chronic back pain and homeopathy.
Heat and cold
While in the acute initial stages cold is still perceived as beneficial, after the end of the initial stage, warmth is generally preferred in the therapy of back pain.
In general, warmth is very good for painful conditions. Warmth can be achieved permanently through appropriate clothing, such as wearing an undershirt or windproof and warm clothing!
Measures that have an external effect on the areas, such as bathing, saunas, mud packs, red light or drugs that promote blood circulation (ABC - plasters, heat generating ointments) can generate heat.
The measures described (suitable clothing, external measures, blood circulation-enhancing medication) are often combined with one another, not least because the effectiveness of warmth on existing back pain has now also been scientifically confirmed.
Please pay attention to possible side effects in all forms of application. When using rheumatoid ointments and ABC plasters, allergic skin reactions have repeatedly occurred. In particular, burns can occur from red light, for example.
There are other therapeutic measures that are listed below under "Other measures".
Read more on the topic: ThermaCare - heating patches
Other measures for back pain
Chiropractic (straightening)
Chiropractic is a healing method of back therapy recognized by conventional medicine, which is based on various handgrip techniques. Chirotherapy (Manipulation treatment; manual therapy) can adjust entrapment caused by displacement of the vertebrae. Since the form of treatment is not without risk, it should only be carried out by experienced therapists (trained chiropractors or doctors with the additional designation “chiropractic or manual therapy”). For uncomplicated back pain that does not reach the foot or toe, chiropractic therapy is usually carried out within the first 6 weeks.
Read more on the topic: Adjust vertebrae
bed rest
Bed rest in the form of absolute rest is not a suitable treatment for your back. It should therefore only be considered in exceptional cases and even then you should endeavor to mobilize within the next two days. As already mentioned above, a pain medication can help.
In any case, the goal should be to move as actively or more actively as before the pain began.
If your amount of movement was reduced to a minimum before the illness, it is time to think about (new) sports activities. Redesign your behavior in everyday life so that you become more active yourself. Remember: physical restraint is always associated with a decline in muscles, which must be prevented.
massage
Even if a soothing massage is very popular with patients with back pain, its lasting effectiveness in the form of pain relief has not been proven.
Here, too, it must be stated again: passive treatment cannot be replaced by initiative in the form of movement!
Standardized training programs (back school)
A "back school" is the learning of exercises to build muscle in the back area. In addition, you will be informed about the structure and function of the back.
In this therapy for back pain, special attention is paid to the various stressful situations in order to ensure that the patient's posture is consciously corrected. There you learn techniques to relieve the spinal column, including in extreme situations in which the patient has to carry heavy loads. For example, you will learn how heavy loads (Water boxes) lifted off the ground, etc.
Scientific studies have shown that the best results (changes in behavior) are achieved when a so-called intensive program of three to five weeks has been completed. can be achieved.
There are different training programs that are also offered by health insurance companies, among others. As a rule, these programs are suitable for patients with more chronic back pain, i.e. for patients who suffer from back pain over a longer period of time (approx. 6 weeks).
physiotherapy
As part of physiotherapy (exercise therapy, physiotherapy), similar to the back school, attempts are made to reduce the wrong movement patterns. Exercises are performed that reduce the damage to the musculoskeletal system. The most important thing here is that the patient himself learns various forms of exercise for therapy, which he can then continue to do on his own at home. It is a utopia to believe that back pain will disappear permanently with one-off physiotherapy. Here, too, the patient's initiative is required.
The forms of physical therapy include exercises for stretching, tensing, relaxing, .... In addition - as in the context of the back school - everyday movement sequences should be rehearsed in order to achieve daily / everyday protection of the back.
You can only count on pain relief if YOU continuously perform these learned exercises at home! The strengthening of the back muscles is based on the constant execution of the exercises.
You might also be interested in: CT-guided pain therapy
Acupuncture for back pain
In many medical fields, acupuncture is becoming an alternative to traditional forms of treatment. Under the acupuncture one understands an old Chinese treatment method from the field of Traditional Chinese Medicine (TCM) based on a philosophical concept.According to this philosophical concept, every illness of the human body is based on an imbalance between the two opposing forces "Yin and yang". There are different techniques, with all techniques sticking the needles in different depths of the so-called Meridians (=) is mean. This is to achieve that energetic disturbances within the organism are balanced.
Even if studies carried out to date have been conducted on the benefit of acupuncture with back pain were without result, that means: some studies have proven effectiveness, others not, most patients feel an improvement in pain symptoms.
More information about the Acupuncture therapy in the Orthopedicum Frankfurt can also be obtained from: acupuncture
Transcutaneous electrical nerve stimulation (TENS)
Under the transkutane eelectrical NconvinceS.timulation (TENS) one understands the treatment of muscle tension by a Stimulation current treatment. The aim is to relieve muscle tension and thereby achieve improved mobility. Usually the TENS used as an accompanying measure and thus in combination with other therapeutic measures. In particular for Chronic back pain treatment (lasting more than 6 weeks) TENS is used.
Behavior therapy
As part of behavior therapy, which is a form of psychotherapy the aim is to try to influence and change long-established habits and attitudes through discussions and forms of exercise. The reason for the use of such a procedure lies in the fact, already briefly described above, that physical stress and mental stress often appear together.
This form of therapy is often considered in patients who have already gone through various therapy options without profound improvement.
Operations
The treatment from back pain takes place only in exceptional cases operational. This is usually only the case if a serious disc procedure must be assumed.
In these cases there are three options for performing the surgical procedure:
- the classic Removal of the intervertebral disc, so an open operation on the spine,
- the Intervertebral disc removal using microscopic methods (endoscopic) through a small incision on the spine,
- or the Dissolution of the intervertebral disc by means of chemical substances that are injected into the intervertebral disc.
The chemical dissolution of the intervertebral disc is gentler, but not as effective as the classic operation. - as an alternative to intervertebral disc removal, the Intervertebral disc prosthesis in question. The intervertebral disc prosthesis now offers an alternative for damaged intervertebral discs. It is not yet clear what role the intervertebral disc prosthesis will play in the future.
- Racz catheter is a 1982 by Texas anesthetist and pain therapist Prof. Gabor Racz developed procedure. The Racz catheter technique is a minimally invasive procedure for the treatment of chronic back pain of various origins. This is a special catheter (thin tube) which, in contrast to conventional catheters, has a metal guide wire and can be precisely directed to the location of the pain and the pain can be treated directly on site.
Corset treatment (orthotics)
Under one Corset treatment (Lumbar belts, orthoses) one understands them "Splint" of the back with the aim of stabilization. This form of stabilization is also intended to reduce pain. A major disadvantage, however, is that the relieving posture reduces the muscles in the back area, so that an additional weakening of the back muscles can lead to further pain. So that the muscles are not permanently deteriorated, wearing a corset should be limited to a minimum period of time.
Self-therapy / exercises
What can you do yourself?
Take the old saying, "Movement brings blessings" to your heart. Try to find out from your relieving posture. Learn important rules of conduct for the physical handling of everyday life, for example in the back school and carry out these exercises continuously at home, thus on your own. The freedom from pain in your back depends in particular on your commitment.
If you were one of those people before the back pain who moved very seldom, then use this "warning shot" and move around.
- Shorter distances can be covered on foot or by bike instead of by car.
- Walking, swimming (or aqua fitness) and cycling also train the muscles without putting any strain on the back.
- Think about targeted back training
- To get going again, you can take a pain reliever initially.
In particular, you have to learn to take care of your back during stressful activities (heavy lifting and carrying, sitting for long periods, one-sided strain ...).
If you are one of those people who deal with many tasks while sitting, you should always relieve your back in various phases:
- Loosening and stretching exercises help relieve and relax the back.
- Avoid one-sided loads
- Wear weights only evenly, not on one side
- Never stay longer than 30 minutes. in the same position
- Do not carry or lift with your back bent, but with your back straight
- Reduce any excess weight, because this weight also puts a strain on your back.
- Exercise. On the one hand, sport offers the possibility of building muscles, but it also offers the possibility of weight loss.
Figure back pain
A - neck pain
B - upper back pain
C - lumbar spine pain
Lumbago (lumbago)
D - lumboglutealgia
(Radiating into the buttocks)
E - Lumboischialgia
(Radiating into the leg)
- First cervical vertebra (carrier) -
Atlas - Seventh cervical vertebra -
Vertebra prominent - Trapezius -
Trapezius muscle - Broad back muscle -
Muscle latissimus dorsi - First lumbar vertebra -
Vertebra lumbalis I - Fifth lumbar vertebra -
Vertebra lumbalis V - Sacrum - Sacrum
- Tailbone - Os soccygis
- Iliac crest -
Iliac crest - Gluteus Middle -
Muscle gluteus medius - Gluteus Muscle -
Muscle gluteus maximus - Big Dresser -
Adductor magnus muscle - Two-headed hamstrings -
Biceps femoris muscle
a - Disc prolapse -
Nucleus pulposus prolapse (from above)
b - vertebral fracture
(Vertebral fracture)
c - spinal osteoarthritis -
(Joint wear)
You can find an overview of all Dr-Gumpert images at: medical illustrations
