10 laws for the well beeing back

1. Back pain is as a part of our every days life

Back pain can be seen as a part of our every days life since the evolution developed the idea of erect posture of man. We can easily bring up the thesis that nearly every human being experienced back pain once. Pain itself has the function to warn the body from potentially harmful objects so we can say that pain is a part of the protection mechanism of our body. In about 85% of cases pain has a harmless cause and the intensity decreases until it disappears completely after some time. A sufficient treatment can minimalize the time you have to suffer from this pain

. We can assume that a passive treatment prolong the period of time the patient suffers from pain, whilst it gets less as faster as the patient gets back into its normal life.

If you experience weight loss, paralysis, numbness or extreme sweating we have to take into account that you suffer from a specific back pain which needs further examinations.

Remember: Every chronic pain was an acute pain once which means that simple or milder symptoms need to be treated as well.

2. Do you really have to sit straight all the time?

You do not have to!

The next sitting position is always the best and a wrong sitting position does not exist.

Salesmen say the pain was caused by too much standing,
IT- specialist say the pain was caused by too much sitting
and postman say it comes from too much walking.

Maybe we chould focus more on the way how we sit, walk or stand or how much we do it every day.

The evolution optimized the human body for long periods of small bearing or movements but not for long periods of straight sitting or high- performance sport. One of the most effective ways to prevent back pain in the office is to change the sitting position as often as possible, stand up and sit down again or to take a short walk.

3. Wrong movements do not exist

Sometimes it can be more harmful to be afraid of the pain than to experience the pain. Humans who are always afraid of a wrong movement will definitely develop pain because the relaxing period between the movements are nearly as important as the alternating movements itself. If the muscles are tensed all the time without relaxing they will hurt after a certain period of time.

If certain movements cause pain than try to alter the movement until you find a movement pattern which suits you and brings the same outcome. This is also a way to train the brain and confront it with new input.

The intervertebral disks do not have their own blood supply which means that the get supplied with nutrients when you move. You can compare an intervertebral disk with a pin. If you swage the pin, twist it and bend it over the pin will break very fast. Same applies for the intervertebral disks which will get damaged if you lift a heavy case from your car with a rotary movement.

4. It is all about you.

You are not at the pains mercy. You can easily contribute to the healing process. Very important is that to belief in the fact that you can you influence the process.

The physician needs to characterize the back pain and treat it. Studies have shown that passive treatments like a massage won’t help in most of the cases. Sometimes it is hard to find the context between the back pain and its causing agent but it is well known that a good social integration and friendships have a positive effect on the healing process.

In the every days life you can contribute to the healing process by insert small phases of rest. Just take a relaxing bath or a shower, take a short walk or go to a thermal bath

5. Mobbing hurts

What is more important for the development of back pain? The physical or the psychosocial condition of the human?

Physicians all over the world go along with each other when they say that the social factors have the main impact on the development of chronical back pain. Very important is also the satisfaction factor at your workplace.

On an evolutionary point of view bulling or exclusion from the social group is as threatening as having a severe fracture. The main factor for the success of the human race is their social structure because you hunt together, you take care about each other and reproduce with each other. If you get excluded from this social structures you won’t be able to nourish yourself and to survive.

More factors which could have an impact on the chronification of back pain:

-Conviction that you cannot do anything about the pain
-Conviction that the pain is the most negative thing which could have happened

How to prevent back pain:
-design alternative at the working place
-good work climate
-acknowledgment of you work
-enough phases of rest
-good organization of your working place

A good boss should know!

6. Movement helps.

Many studies showed that movement helps against acute back pain.

If you try to spare yourself for a longer period of time this could prolong the time you have to suffer. Try to move as much as possible and if you feel insecure, feel free to ask us.

7. How shall i move?

Most often it will be the best to test as many possible ways as possible. There are only a few movements which could be harmful. You can compare an intervertebral disk with a pin. If you swage the pin, twist it and bend it over the pin will break very fast. Same applies for the intervertebral disks which will get damaged if you lift a heavy case from your car with a rotary movement. This is maybe the only movement which could be really harmful.

Rely on the knowledge which is known about the human evolution. The human body is made for long lasting but small bearing. Even streets are a very new aspect of life and we cannot expect that our body has already adapted to this new conditions. Therefore try to perform your jogging on a dirt road instead of a bituminized ground.

Try to avoid sudden movements.

8. The legend of the strong back

Even athletes can experience back pain although they have strong and distinct back muscles. The back muscles are only one of many factors which have an impact on the treatment of back pain. The main function of the muscles is not to carry our body weight but to perform movements. The body mass is carried by other structures like bones and ligaments. The muscles can be seen as the stabilizing agent which hold the bones and ligaments together.



Solche Abbildungen werden der Tatsache nicht gerecht, dass wir un in jeder Nacht etwa 50 mal umlagern.

Ein weitere Mythos ist die Matratzenfrage. In unabhängigen Tests schneiden zumeist Kaltschaummatratzen im unteren Preissegment am Besten ab. Die Matratze sollte mittelhart bis hart sein. Kaltschaum reicht nahezu immer aus.

9. Correct lifting
Heben von Spudelkasten

Heben von Spudelkasten

So nicht!

Due to the fact that the vertebral column and its disks can be seen as a mechanical element we can once more compare it to a pin.

Heavy loads should be lifted proximally otherwise there would be too much weight force acting on the frontal part of the intervertebral disks. If you try to twist the disk in addition the disk would not be able to withstand this forces which also applies for a pin.

10. Alone its not fun

Being lonely or isolation can hurt not only in psychological but also in physical way. As we explained before humans rely on the social community. Another positive aspect: Exercising together is fun. Even cocking, laghing or eating is much more fun if you do it together. That is why we are very delighted about rehabilitation.

Humans are social being no matter if we want to or not.

10 laws for the well beeing back

1. Back pain is as a part of our every days life

2. Do you really have to sit straight all the time?

3. Wrong movements do not exist.

4. It is all about you.

5. Bulling hurts!

6. Movement helps.

7. How shall i move?

8. The legend of the strong back

9. Correct lifting

10. Alone its not fun



Pain, pain, pain:

sometimes after a long time standing, walking, sitting. Or ongoing pain.

Every serious treatise on back pain begins with numbers about the horrendous effects on the economy: how many working days and money are lost through back pain.

Sometimes the suffering of the individual and the lost quality of life is forgotten.

Treating and treating back pain as the sole symptom does not do the job justice. In the pain center we know the typical causes and triggers. And even after decades of experience, we are not surprised if you have atypical symptoms and causes.


In the press it is occasionally to be read that in 85% of the cases the doctors also do not know where the back pain comes from.

Quote from the SPIEGEL 10/2011: "And what the patients do not suspect:

The number of 85% is the so-called nonspecific back pain, ie a pain for which no bad reasons can be found (inflammation, herniated disc, tumor ...).

Be certain: in most cases it is possible to find the cause of back pain and then to treat it. Even if the X-ray picture is inconspicuous.

spezifische Ursache für Rückenschmerzen

spezifische Ursache für Rückenschmerzen

Schrotschußverletzung und Kokainpacks im Darm

Depending on the discipline you choose, certain favorite diagnoses are made:

- One leg is longer -> insoles

- Whirl has wedged -> Einreken

- Mattress is to blame

- sat too much, stood, lifted, walked ... -> Repent

- bad posture, wear -> expensive construction supplements

- too little sport -> fitness sects

X-rays: osteochondrosis, spondylarthrosis

- Kaffeesatzlesen from normal x-ray image

Why does the neck hurt when stressed?

The following explanation is a good example of the connection between body and soul. The modern pain medicine no longer strictly distinguishes between physical and mental. It is considered both.

Maybe you know the problem: in stressful moments the neck hurts. The vernacular has known the connection for centuries: "....... the fear is in my neck ....... the burden is too big ...... move his head ....."

Also in Greek mythology Atlas carries the burden of the world with the neck. That's why the 1st cervical vertebra is called "Atlas".

We respond reflexively to anxiety, threat and stress with a tension of the neck muscles. This is a protective reflex learned over millennia. In the Stone Age it was vital to protect our most vulnerable point when threatened by animals or enemies: the neck. In it, a wolf bites.

(That's why men beards and bears have excess skin on their necks.)

In the Stone Age such situations were temporary, after a few minutes the situation was resolved, however.

Today, the threat situations are more complex and much longer: existential anxiety, debt, bullying.

But our reaction to it is the same as it has proven in evolution: we pull our heads in and protect our throats.

If you consider that after 5 minutes of overhead work the arms ache it is clear that the hours of tension of the neck muscles inevitably have to make complaints. The striated muscles are not made for long, static tension.

In the pain center, causes are detailed and discussed. As you may expect, patients with an anxiety disorder experience above-average levels of neck tension. But that does not apply in reverse.

Warum schmerzt der Rücken?

Warum schmerzt der Rücken?

Soul and pain

Chronic pain is like a catchy tune:

They hear a melody and they will not let go. Duly forgotten, they hear them again and she has already fixed properly. The more you focus on it, the louder it gets. (Do not try to think of a pink elephant now ..... and, did you make it?:]). You can put yourself in an MRI, have an EEG made and otherwise know what kind of examinations you can undergo. No one will find the earwig in your head ... but he is there, he is real, you hear him. He got stuck in the neural network of your brain.

The same is true of chronic pain. Triggered by an acute pain it comes to learning processes: the brain, including all intermediate stations, adjusts to the pain, which has a warning function at first, and raises the attention for it: something is wrong and the body could be damaged. The brain literally puts its "ear on the rails".

As far as these are processes that almost always expire. But already now it becomes clear that an acute pain should be treated to prevent these learning processes, also known as pain memory. For this to become a chronic pain it requires a psychosocial disposition. or a disorder in the pain-processing systems. The causes can be genetic, hormonal, psychological, social, neuropsychological or environmental.

When one considers the new insights of epigenetics, it becomes clear how 1-2 generations previously learned behave in the reading of the genetic code. In a 2014 study from Atlanta, researchers have shown how mice inherit anxiety over 2 generations (published in Nature and Spiegel). In my childhood, too, I have experienced dreams of war events that can be explained as the representative dreams of the warlord.

If there are no indications of a serious illness (specific back pain) then the exact interview and the examination are more important than X-rays.

- How long have the pain been around?

- Which body parts are affected?

- How often do they have pain, how long do they last?

- when do they occur? Running, standing, sitting, getting up, moving in bed?

- What improves the complaints?

- What have you already done about it?

- Querying typical triggers.

If you have brought X-rays we will look at them together with you.

Not infrequently patients return to the question of what leads them to us with the answer: "Look at the pictures, I have 3 herniated discs!".

3 relevant incidents are rare and such statements are made when the radiographic findings are misinterpreted.

Read the following MRI findings and you are convinced that you are really sick:

Misalignment with a raised lumbar spine
Initiale Osteochondrose Th 10-12 und L 1-L4, ausgeprägt bei L 4/5 teilweise erosiv mit Deckplattenödem Modik 1 und ventralen osteophytären Abstützreaktionen
Intraspinale Bandscheibenprotusionen L 3/4 und L 5/S1.
Bandscheibenprolaps L 4/5 medio bi-paramedian mit Pellottierung des Duralsackes und Kontakt zu den Wurzeln L5 beidseitig rechts betont.
Spondylarthose L 4/5 beidseitig und initial L 5/S1 beidseits. Deutlich verdickte Gelenke mit beginnender Einengung des Spinalkanals
Kombinierte Foramenstenosen L 4-S1 beidseits, besonders L 4/5 rechts
In der T2 Wichtung vermindertes Signal der unteren lumbalen Bandscheiben als Hinweis auf Wasserverlust mit „black disk“

The finding can be replaced by 2 words for an average 50-year-old:

Age-related findings.

The radiologist describes in the pictures everything he sees, and of course these are signs of wear.

If an appraiser assesses my car (150,000km), a multi-page report will come out. But that I still can easily drive 30.000km a year is free of this.

Wear is normal; usually that does not cause any problems.

Relevance is important in every assessment of a finding. That's why I'll discuss the x-rays with you.

If I only do enough examinations, I will always find a treatment-dependent finding. This leads to the statement that only the one who is not sufficiently diagnosed is healthy. Something cynical, but something is true.

For this I recommend the SWR broadcast by Manfred Lütz: Gesund und gleichzeitig krank.

The good news first:

...usually back pain is uncomplicated and goes back days to weeks. Therapy with over-the-counter analgesics is helpful in acute cases. Bed rest has not worked. Also, everyday life should be resumed as soon as possible. In these statements, the studies cover the subject of back pain worldwide. Behind this, there are no business bosses who, of course, want to keep the downtimes due to back pain to a minimum. It has been shown that patients are better off faster under these measures.

That's why the education is so important: According to the anamnesis and physical examination specific causes for back pain are excluded in the pain center. If it is unspecific back pain, it is important to relieve the patient of the anxiety that afflicts each person with severe pain:

- That it is "only" pain that is very annoying, but not dangerous. (Important: "only" in quotation marks!)

- That behind the pain no malignant disease hides and in a few days that is mostly forgotten.

- That if the pain does not recede on time we organize further diagnostics and not let up.

- That back pain always occurs in living beings who have decided to walk upright.

- That you can climb the Mount Everest despite the signs of wear and tear found in the X-ray image or that you can plunge into the depths on the bungee cord.

But you would not research the internet if you belong to this group of people.

When it does not get better....

You probably would not research the topic of back pain on the Internet if you are an uncomplicated case as described above.

Maybe you are, but nobody has told you yet.

Sometimes the fear makes more discomfort than the discomfort itself. Some patients have the statement of a doctor: "They will eventually end up in a wheelchair." deeply internalized. Also premature prohibitions of favorite sports rarely lead to more lightheartedness in life.

The prognosis depends on many factors, and a statement is only possible after detailed medical history, examination, pain survey if necessary individual diagnostic infiltrations.

Part of the success can be in our hands. First of all, we have to create the conditions to use your body again as nature intended:

- carefree endurance load

For this you can use all the methods offered in the pain center.

Then it's your turn. What is clear is that people who develop too little or too much pain develop. The right dosage is not hard to find, and you are not alone in finding the right dose.

The therapy will be determined together with you after a detailed anamnesis, examination, pain survey if necessary individual diagnostic infiltrations.

For this you can use all the methods offered in the pain center.

The most important therapy is the education !!

- How bad is it really?

- Do I have worse to fear?

- Where does the pain come from?

- Did I do something wrong?

- What can I do to prevent this from happening again?

Part of the success can be in our hands. We need to create the conditions to use your body again as nature intended:

- carefree endurance load

Whether physiotherapy, rehabilitation sports, medications, surgery, acupuncture, chili patches, talks, infusions, injections, nerve blocks, restrictions, stimulation current, Laserverödung .......

...... the therapy is always modular and individually put together.

The delivery of best medical care is to do as much nothing as possible.

Quotation from a study of the Bertelsmann Foundation:

• 80 to 90 percent of all back patients are symptom-free again within six to eight weeks when the back symptoms first appear. It does not matter if one - and possibly which - therapy was performed.

• Excessive diagnostics, protection, pain prevention and passive treatments obviously prolong the back pain. However, resuming everyday activities as soon as possible and getting back to work and normalcy as quickly as possible reduces back pain, days off work, relapses (relapses), and other follow-up problems.

Prevention of back pain

• Primary and secondary prevention has significant, currently underestimated importance in the prevention and treatment of back pain.

• One starting point lies in the health-promoting organization of the world of life and work, which also takes into account psychosocial factors such as room for maneuver, incentive systems and life and work satisfaction.

• In behavioral prevention of back pain, only exercise and exercise programs and measures that change attitude in the sense of dematerialization seem to be successful approaches.

Prevention of chronic back pain

• About 10 percent of patients cause 80 percent of the cost. A key goal of health care is therefore to avoid chronic back pain.

• Various psychosocial factors play a crucial role in the transition from acute to chronic back pain.

• These factors help predict the risk of chronic back pain better than physical factors.