Muscle tension, postural damage and wear disorders. Over 20 million people in Germany complain of some chronic back pain.
Causes of back pain
Congenital malformations of the spine, a pelvic deformity
standing, an unrecognized leg shortening, hollow back, sagging feet or developmental disorders in childhood and adolescence can be causes of back pain. The result is:
- Muscle tension,
- Posture damage and
- Signs of wear on the vertebral bones and intervertebral discs.
In a herniated disc, the fibrous ring of the disc becomes brittle and parts of the nucleus nucleus emerge.
A herniated disc can occur anywhere in the spine, but most commonly in the heavily loaded lumbar region.
Area. There is an increased risk of congenital weakness of the intervertebral disc and connective tissue as well as spinal curvature.
A too narrow spinal canal, a so-called spinal canal stenosis, can lead to chronic pain. This also applies to scoliosis, a permanent (innate or acquired) curvature of the spine. The latter, such as spondylarthritis (Bechterew's disease), is often treated by spinal fusion (surgical spinal fusion).
Back pain from osteoarthritis
Arthrosis is the most common joint disease. They are based on disorders of the hyaline articular cartilage matrix. After initially increased cartilage metabolism, cell content and thickness of the articular cartilage decrease. It eventually leads to sclerosis (bone compaction), cyst formation and the edge of the joint to marginal ridges.
Although the articular cartilage itself is not innervated, possible sources of pain include the subchondral bone below the cartilage, the bone marrow (increased pressure), and capsular distension in joint instability. As with other joint diseases, inflammatory reactions lead to the activation of pain receptors (nociceptors), leading to central neuronal hyper excitability and dilation of the painful areas.
Frequently affected are the hip (coxarthrosis), the knee (gonarthrosis) and the spine with involvement of vertebral bodies, intervertebral discs (spondylosis) and small vertebral joints (spondylarthrosis).
Wear and tear and their consequences
It is estimated that around 12 million people in Germany suffer from rheumatic complaints. Most are signs of wear on the spine and joints, which lead to pain and limitations of mobility and can ultimately lead to a pronounced joint arthrosis. Changes to muscles, tendons and tendon sheaths as well as to connective tissue and bursals can cause severe discomfort.
Both children and adults are affected by inflammatory articular rheumatism, chronic polyarthritis or rheumatoid arthritis. The onset of this sporadic disease is insidious. After the first pain and swelling of the joints, the skin that lines the joint (synovia) thickens and releases messenger substances that promote inflammation. The joint continues to swell; chronic inflammation first destroys the articular cartilage and later also the bone.
The result is pain, restricted mobility and joint deformity. Rheumatoid nodules often form on the extensor sides of the joints. The disease is one of the autoimmune diseases, ie the body forms antibodies against the body's own substances. This leads to joint inflammation, but also explains the partial involvement of the skin and internal organs.
Osteoporosis - loss of bone mass
Osteoporosis, also known as bone loss, is the most common bone disease in Germany with about 6 million people affected. About 18 percent of all women and 8 percent of men over the age of 40 suffer from osteoporosis. Every third woman over the age of 60 is affected. Osteoporosis refers to a continuous loss of bone mass, because the normal balance of bone formation and degradation no longer exists and the degradation predominates.
Signs of osteoporosis are severe back pain during exercise and at rest, even at rest. With pronounced reduction of the bone substance it can come to bone fractures. The most common (80 - 90 percent) are the so-called "primary" forms of osteoporosis (without other underlying disease), while the "secondary" forms occur as part of or as a result of another disease (eg diabetes mellitus, hormonal imbalances) or after cortisone use,
Health in words and pictures: back pain, word and picture publishing house, Munich, 1995
F. Becher, E. Keck, RHEUMA: Recognize. Treat, Herder-Verlag, Freiburg, 1993
HW Minne, Th. Von Holst (ed.), German Green Cross and Federal Self-Help Association for Osteoporosis eV (BfO), Osteoporosis - Questions and Answers, Verlag im Kilian, 2000