Causes and risk factors of back pain - what you can do about it

Back pain is very individual and always feels different to those affected. As back pain cannot be measured, the sensation and the ability of those affected to communicate is very relevant for the correct treatment.

Back pain can be categorised according to various criteria. Depending on the duration, frequency, severity, the affected area, the type and also the origin of the pain, they differ from one another.

It can be acute and last a few days to weeks, subacute over a period of more than six weeks or chronic or chronic recurrent if it lasts longer than twelve weeks. The regularity of the pain can manifest itself in one-off acute episodes, recurring episodes or episodes that persist over a longer period of time. The intensity of the back pain varies from barely noticeable to moderate to alternately severe or even unbearable, which can be assessed using pain scales or questionnaires.

Depending on the region affected, the pain can be localised in the upper back and neck area (cervical spine to upper thoracic spine), in the middle back (middle to lower thoracic spine) or in the lower back (lumbar spine, pelvis, “low back”). A distinction is made between non-specific back pain, where no clear cause is recognisable, and specific back pain, where a clear cause can be identified.

The origin of the pain can be radicular, which means that it is triggered by irritation of the nerve root, for example due to inflammation or a prolapse of the intervertebral disc. Alternatively, the pain can be spondylogenic, which in turn means that it does not originate in the nerve, but in the surrounding structures such as the intervertebral joints, muscles or fasciae.

Typical pain in the lower back is not always associated with illnesses to be taken seriously in the first instance. Classically, this pain is often caused by incorrect posture or overloading. However, if the pain is perceived as chronic, it should be monitored more closely. Back pain can be accompanied by a variety of symptoms that indicate different causes and degrees of severity. Symptoms such as numbness in the legs or arms or a tingling sensation in the affected areas are common side effects that can also indicate nerve irritation. A feeling of weakness or even paralysis can also occur and should be taken seriously. Pain that spreads from the back to the legs or genital area and intensifies with movement, coughing or sneezing should be monitored more closely.

Other alarming symptoms associated with back pain include difficulty holding urine or faeces, which may indicate impaired nerve function. Unusual weight loss, loss of appetite, nausea, dizziness and a tendency to faint may also occur. These symptoms should never be ignored as they could indicate serious conditions that require specific treatment.

As a rule, more than 90% of back complaints are caused by incorrect, repetitive strain, which can trigger muscle tension.

A common cause is a lack of movement, which can lead to a loss of the muscles that normally support and stabilise the spine. On the other hand, too much movement, especially if the muscles are overloaded, can also cause back pain. Incorrect movements and strain caused by unfavourable movement sequences can put a lot of strain on the back muscles and spine and cause pain.

Poor posture over a long period of time also puts strain on the back and can lead to pain. Finally, mental strain plays a role that should not be underestimated. Stress, anxiety and other psychological strains can be transferred to the body and favour or even exacerbate back pain. All of these factors, individually or in combination, can lead to back pain, which can significantly reduce quality of life.

As our body ages, our spine also ages, causing the intervertebral discs to lose water and become thinner, which in turn leads to increased strain on the small vertebral bodies and can cause signs of wear and tear. As this, and the reduction of bone and muscle mass, is a very natural process in our lives, there is not always necessarily a disease behind it. To be on the safe side, have it checked by a doctor and go for an examination to see where the recognisable changes and acute symptoms are located.

Basically, back pain can be divided into three groups within their body regions. At the level of the cervical vertebrae, we speak of cervicalgia, in the lumbar vertebrae of lumbago and pain in the centre of the back is referred to as dorsalgia.

The former is usually due to poor posture or stress and usually disappears within a few days and is generally harmless.

Lumbago occurs in the area of the lower back and is noticeable even with the slightest movements. It is often caused by repetitive strain or long-term incorrect posture. Lumbago is the most common type of back pain.

The last type, dorsalgia, is pain that radiates from the centre of the back and extends into the neck. It often feels like a blockage or “disorder”.

As the causes and types of back pain are varied, several forms of treatment can be considered. In addition to manual therapy, medical or even surgical treatment can also be considered. Which treatment makes sense depends on the causes of the pain. In the case of specific back pain, treatment is based on the rules of the underlying disease. Non-specific back pain, on the other hand, is usually treated with exercise therapy and possibly painkillers.

Non-medicinal back pain treatment

Just as excessive strain can be harmful to our body, so can a completely relaxed posture. For this reason, active movement is more beneficial for back pain than a complete standstill of our body.

Physiotherapy & functional training

A relieving posture for back pain may reduce the pain at first, but it also leads to further tension in the long term, as it is an unnatural posture of the body. If you are already in this state, various exercises can help you regain your body’s flexibility. For example, the aim of physiotherapy is to mobilise the body and increase muscle strength.

Manual therapy

In manual therapy, the passive elements predominate, with your massage therapist looking for disorders in your musculoskeletal system and trying to alleviate the problems by feeling and sensing your muscles and joints. If you suffer from chronic pain, a medical massage can significantly alleviate your symptoms. In a prior anamnesis consultation, you will discuss with your therapist exactly where the pain is located and which individual treatment can be considered in your case. You can find more information and book a medical massage here: Medical massage Zurich.

By the way: Our therapists are recognised by health insurance companies – just check our website to see who is covered by your health insurance.

Osteopathy

Osteopathy is another form of treatment that does not involve medication. A central aspect of this is the belief that structure (i.e. the body’s tissues such as bones, muscles and connective tissue) and function (the way the body works) are closely linked. If a structure in the body is out of balance, whether due to injury, poor posture or other influences, this can impair function and lead to pain or other complaints, often resulting in blockages. Osteopaths like to use various massages, stretching and grip techniques to resolve these, which are intended to activate the body’s self-healing powers.

Heat or cold treatment

Heat treatment can help to relax the muscles, especially in the case of acute back pain. This stimulates blood circulation and improves metabolism. However, heat is not always the best treatment of choice, as it can actually worsen the condition if there is irritation or inflammation. In this case, cooling pads should be used to alleviate the body’s pain signals.

Alternative forms of treatment for back pain

If the possibilities of non-medicinal forms of treatment have been exhausted or the condition does not allow them, other methods of pain treatment should be used.

Anti-inflammatory agents in particular, such as ibuprofen, diclofenac or naproxen, are used more frequently if the back pain is acute. However, patients suffering from severe heart or kidney problems should only take these with caution and prior medical clarification. In general, the advice of a specialist should be sought before taking medication for back pain to ensure that the treatment is effective.

The last resort is surgery. This is only absolutely necessary in a few cases. If there are indications of a bladder and bowel dysfunction, action must be taken as soon as possible. Even if the pain affects the feeling in the leg or causes muscle weakness, an operation is certainly conceivable. Operations for back pain are usually due to herniated discs. However, here too, surgery is not always the best alternative. If surgery is not absolutely necessary, all other alternatives should be considered in advance and a second opinion obtained if necessary.

After the operation, the primary focus should be on rebuilding the muscles. A feeling for the body and its balance as well as full mobility should be regained. Subsequent rehabilitation measures or manual therapy are particularly suitable for this.

Even if back pain can occur sooner than expected, you have a few options for recognising it early and taking prompt action. Typical warning signs are muscle tension, fatigue or stiffness in the joints and back immediately after standing up. If you are already experiencing these early symptoms, try to identify their triggers and take various measures to prevent them.

Firstly, try to distribute loads evenly, for example when carrying shopping by using two bags. Bend down actively, i.e. let your legs do the main work by squatting down and trying to keep your back straight. It is best to pick up heavy objects with your back straight and hold them close to your body while you exhale. When sitting, you can try to place your feet flat on the floor and regularly change your sitting position with a straight back.

If you stand a lot, it can help to ensure that your weight is evenly distributed to relieve the strain on your back. Regular exercise and targeted back training are also well suited to strengthening the muscles and providing support for the spine. Sports such as swimming, walking or yoga also promote back health. You should also make sure you follow a balanced diet to avoid being overweight and thus relieve the strain on your back. Last but not least, your mental health also plays an important role. If you suffer from a high level of stress, various relaxation techniques, such as meditation, can also help to prevent back pain.