Is your back giving you trouble? You’re not alone. Over 80% of the Swiss population experiences lower back pain at least once in their lives. We explain what the most common back problems are and which specialists can help.
Not all back pain is the same. Most people with acute back pain will be pain-free again within a few weeks. However, around 30% of patients develop chronic complaints.
85% of back pain does not have a clearly identifiable cause. Non-specific pain often doesn’t last long, and goes away on its own.
Pain caused by tension, irritation or tight muscles is due to a functional impairment of the body. Sitting for hours, lack of exercise, poor posture and weak muscles are all causes. To release the tension, you should adjust your habits and focus on strengthening specific muscles.
Lumbago is characterised by sharp pain in the back that occurs out of the blue, usually in the lumbar vertebrae. Due to the pain, those affected have very limited movement. Medication, thermal treatments and active therapies can help.
If the pain in the lower back area spreads to the leg, this is often linked to the sciatic nerve. Sciatica is nerve pain that occurs when part of the sciatic nerve gets pinched or irritated – from a herniated disc, for example. Medication and physiotherapy can help alleviate the pain, and sometimes an operation is required.
Our health consultation advisors will show you can relieve back pain. They’ll also give you tips to keep your back healthy in everyday life.
If the pain has an identifiable cause, this is called specific back pain, and it accounts for 15% of all back pain.
Tissue leaks out from the inner core of the intervertebral disc through the outer ring and can put pressure on the nerve roots. Depending on the severity, sensory disturbances such as tingling, numbness or even paralysis can occur alongside the pain. Most of the time, an operation can be avoided. In the case of persistent pain or paralysis, a surgical procedure is advisable or perhaps even necessary.
The wearing down of a joint, i.e. damage to the cartilage, causes inflammation, which leads to severe pain and restricted movement. Depending on the severity, it can require physiotherapy, medication, joint injections or an operation.
Osteoporosis causes the bones to degrade. They become porous, unstable and can break. In addition to age, illnesses or medicinal therapies can be the cause. Breaking a bone is often the first symptom. If osteoporosis affects the spine, it can lead to kyphosis and back pain. Medication promotes bone formation or can slow down its degradation.
A spinal curvature can be due to age, or can develop in children and adolescents. The cause of scoliosis in young people is often unknown. Back pain and muscle tension, as well as knee and neck pain, can be caused by the crooked posture. Scoliosis is often harmless. Depending on its severity, cause and age, back exercises, a back support brace or a corrective operation are required.
This chronic rheumatic illness usually occurs in under 40s. It mostly affects the spine and the sacroiliac joints, and is usually noticed due to pain at night and stiffness in the morning. Over time, the intervertebral joints ossify and the spine gets stiffer. The cause is unknown. The goal of treatment is to alleviate the pain and to maintain the spine’s mobility.
In a representative survey, 8% of respondents said that an accident or fall was the cause of their back pain.
Whiplash is a sprain in the cervical spine. The injury occurs when the head suddenly bends and hyperextends – in a car or sport accident, for example. Typical symptoms include headaches, muscle tension, concentration and memory problems, dizziness and nausea. The treatment depends on the severity of the injury. Pain medication, muscle relaxants and physiotherapy can be used.
You can treat many back ailments yourself, and the pain will get better after a short period of time. A medical examination of your back pain is necessary if:
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Sometimes treating back pain by yourself doesn’t work. We explain which specialists can help with back pain.
Your GP is the first port of call for back pain. They will have a detailed discussion with you about your symptoms and the type and duration of the pain. They will assess your general condition, check your reflexes and examine your back. In the best case, your GP can give you a clear diagnosis. Otherwise, they will refer you to a specialist for further examinations. If required, they will prescribe you medication. In some cases, they will also prescribe physiotherapy.
Physiotherapists are experts on movement problems in the body. They help you to regain your ability to move and function. Your physiotherapist will also help you to strengthen the muscles that stabilise your back and guide you through active exercises, incorporating medical aids such as balls or bands. Physiotherapists also work with passive exercises, such as stretching and massaging. The aim of physiotherapy is to alleviate or eliminate pain. For pain that persists, your physiotherapist will help you to manage it as well as possible.
A spine specialist will explain where your back pain comes from. They first have a detailed discussion with you to find out your entire history of the problem. Then, they examine your back and look at your x-rays. Together with you, a spine specialist will decide if conservative treatment is enough or if an operation can alleviate your symptoms. Most of the time, an operation is not required. However, if this is the case, the specialist will discuss the risks and chances of success with you. They are also the person who will operate on your back. In the best case scenario, you’ll be pain-free afterwards.
Osteopaths are experts in the musculoskeletal system. They stretch, press, move and massage the affected parts of the body to try and alleviate your symptoms. They take a holistic approach and do not just take the skeleton into account during treatment, but also the organs, the tissues and the central and autonomic nervous systems. An osteopath will aim to activate your body’s self-healing powers, and also improve the natural flexibility of your entire body.
Chiropractors are specialists in disorders and pain in the musculoskeletal system, with a focus on the spine. With targeted, fast rotations or movements, chiropractors correct disorders in the spine and joints. It’s not uncommon to hear some cracks while they do this. These are harmless and don’t hurt. Chiropractors release blocked joints and tension. They also provide advice on posture and show you exercises that you can do at home to strengthen your body.
Pain therapists are doctors who have specialised in pain therapy. They can help chronic back pain through a variety of treatment methods. Pain therapists aim to understand the cause of your pain. Occasionally, they’ll give local injections to alleviate your pain. The goal is to reduce your pain and improve your quality of life.
Good to know: treating back pain is a team effort. The best results are achieved when a team comprising a variety of specialities work together. This includes the specialists mentioned above, but can also include neurologists, rheumatologists and psychologists, for example.
Dr Guy Waisbrod is senior consultant for spinal surgery at the Swiss Paraplegic Centre, Nottwil. He also heads the project of an interdisciplinary back centre. Dr Waisbrod gave the editorial team advice and input for this article.