Lower back pain, lower back pain - symptoms, causes, therapies

Lower back pain, lower back pain - symptoms, causes, therapies

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What to do if you have low back pain?

Low back pain is a widespread phenomenon in the population that can be caused by a variety of causes. Overall, joint and back pain are still one of the most common reasons for sick leave in Germany. Lower back pain is generally referred to as pain in the lower end of the spine. Although mostly older people are affected, the complaints are more and more common among young people. Postural problems, long periods of sitting, lack of movement and signs of wear and tear are common causes.

Lower back pain - a brief overview

If there is pain in the lumbar spine, this can have many causes. However, lack of exercise and incorrect strain are often the reason for the complaints. Here is a brief overview of the symptoms of low back pain:

  • definition: Painful symptoms that manifest in the area of ​​the lower back, i.e. between the last thoracic vertebra to the coccyx. The terms lumbar vertebral pain and sacrum are also used medically.
  • Symptoms: Pain in the lower back, tension, numbness, sensation, movement pain, reduced reflexes.
  • Possible causes: Incorrect strain, incorrect posture, lack of exercise, overload, tension, contusion, fracture, lumbago, herniated disc, infection, arthrosis, inflammatory diseases, Lyme disease, kidney disease, osteoporosis and psychosomatic causes.
  • therapy: Physiotherapy, manual therapy, heat treatments, medication, in some cases operations.
  • Naturopathy: Progressive muscle relaxation, yoga, autogenic training, acupuncture, active stress relief, osteopathy.
  • Prevention: Physical activity, active stress relief, avoid bed rest outside of sleep times, pay attention to good ergonomics at the workplace, avoid or overweight.

First aid for lower back pain

Since tension and poor posture trigger the painful symptoms in the lower back in many cases, there are a number of immediate measures and home remedies for back pain that can relieve the pain. Caution: If symptoms such as paralysis or urinary and bowel incontinence appear in addition to low back pain, this could be a sign of a medical emergency. This should be checked immediately in a hospital.

Otherwise, the following measures can be tried, but also applies here: If there is no improvement within a short time, a doctor should be consulted:

  • Muscle relaxation bath: Add essential thyme or rosemary oil to the bath water (approx. 10 to 15 drops) and relax in warm water for around 15 minutes.
  • Fast heat winding: Carefully pour hot but not boiling water from above into a rolled-up terry towel. Use only enough water to keep the cloth dry on the outside. Then place the wrap on your lower back for around 30 minutes.
  • walk: Even if you are in pain, you should not lie down. Instead, a walk can help with many types of back problems. Back muscles are loosened and vertebral joints are mobilized.
  • Step storage: To do this, lay your upper body flat on the floor and place your legs in an elevated position (for example, a bed, exercise ball or a couch). The angle in the hip should be around 90 degrees.
  • Ointments: Apply an oil containing camphor essential oil or a warm ointment to the painful area before sleep and massage in.

Lower back pain - an increasing problem

The "German Back Pain Study" of the Robert Koch Institute (RKI) comes to the conclusion that up to 85 percent of the population suffer from back pain at least once in their life. In a survey conducted by the RKI, around 25 percent of women and a sixth of men stated that they had suffered from chronic back pain in the past twelve months. Although lower back pain is not always to be equated with back pain, the numbers illustrate how widespread the symptoms are in the population. As the likelihood of back problems increases with age, a significant increase in the number of corresponding treatment cases can be expected in the course of demographic change.


Lower back pain is a general condition in the lower end of the spine. Colloquially, the term is often used synonymously with the more general term back pain. The lower back pain in this article should be understood as painful symptoms in the section between the last thoracic vertebra to the coccyx. In the medical community, there is often talk of lower back pain, lumbar spine pain and sacral pain.


The pain in the lower back occurs in the area of ​​the sacrum or the lumbar spine. The individual lumbar vertebrae are connected to each other via the intervertebral discs. The sacrum is connected to the pelvis via the sacrum-iliac joint (also called sacroiliac joint). The sacroiliac joints connect the sacrum to the ilium (ilium) below the lumbar spine via rigid ligaments. Together with the hip legs (Os coxae), the sacrum forms the pelvic girdle.


Lower back pain can occur on the left side, right side and in the middle. In many cases the pain radiates to other areas such as the legs or buttocks. In addition, many sufferers complain of tension and movement pain. There may also be additional symptoms such as numbness, discomfort, difficulty walking, paralysis and reduced reflexes. If there is evidence of urinary or faecal incontinence combined with back pain, it could be an emergency that needs immediate medical attention.

Possible causes

Numerous factors come into play as triggers for lower back pain, which can range from rather harmless symptoms as a result of incorrect stress, lumbago and herniated discs to rheumatic and tumorous diseases.


Older people in particular suffer from low back pain caused by signs of wear. Lack of exercise, poor posture, constant overloading, overweight and obesity can help to cause wear and tear problems earlier.

Spinal infections

Spinal infections such as bone marrow inflammation (osteomyelitis) and spondylodiscitis (inflammation of the cartilage discs) can cause pain in the lower spine.

Arthrosis and narrowing

Arthrosis of the vertebral joints (spondyloarthritis) or the sacroiliac joint (sacroiliac joint) as well as narrowing of the spinal canal, the so-called spinal stenosis, can also be the reason for the painful symptoms.

Inflammatory diseases

Inflammatory diseases such as Crohn's disease, Scheuermann's disease or Bechterew's disease must also be considered as potential triggers of the symptoms.

Lyme disease

In addition, the Lyme disease transmitted by a tick bite sometimes causes wandering back pain.

Kidneys, intestines and pancreas

Furthermore, kidney stones, inflammation of the kidneys, urinary tract infections and various diseases of the intestine and pancreas can be mentioned as possible triggers of low back pain.

Aorta sacs

So-called aortic aneurysms (sacking of the aorta) can also lead to severe stinging pain in the area of ​​the back.

Bruises and fractures

Of course, bruises and fractures due to falls or accidents can also cause pain in the lumbar spine, sacrum and coccyx.

Psychosomatic causes

Permanent negative stress (distress), often work-related, but also mental illnesses such as depression or anxiety disorders can manifest themselves through low back pain. In addition, suppressed feelings of aggression, anger or grief strain the psyche. This can also lead to low back pain.

Naturopathic approaches

The naturopathic procedure of osteopathy assumes that the back pain can also be caused by blockages, especially in the area of ​​the lumbar spine and the sacroiliac joints.

Other causes

In the case of low back pain in the lumbar spine, tension in the hip flexor muscle (Psoas muscle) is often the trigger. Furthermore, anatomical peculiarities such as a difference in length of the legs can cause low back pain. An osteoporosis disease and the associated loss of bone substance can also cause the symptoms. Because the pain in the lower back may be due to a serious illness and the careful posture can lead to an increase in symptoms, a doctor should be consulted urgently in the case of low back pain.

Risk factors for lower back pain

In general, unfavorable posture in today's office activities is a common risk factor for low back pain. Working on the computer for hours leads to muscle strain. Tension and corresponding pain are the result. Lack of exercise and inadequately trained back muscles are also often associated with the increased occurrence of low back pain. However, an excessive amount of movement or stress can also cause lower back pain, especially in the case of unfavorable movements, such as repeated bending down and lifting heavy objects.

Incorrect lifting of weights

For good reason, the experts advise not to lift weights from your back, but from your knees. Since the lower back carries a higher weight load than the rest of the spine anyway, stress symptoms often appear in this area of ​​the spine. Especially at the interface of the power transmission between the spine and legs, the sacral-iliac joint, incorrect loads are often painfully noticeable.


In order to discuss the causes of low back pain, an extensive medical history is taken at the beginning of the examination, in which the patients are asked about existing medical conditions and the situations in which the symptoms occur. In the course of the clinical examination, the first step is to check possible anatomical features (e.g. legs of different lengths). By scanning the spine, there are further indications of underlying diseases. With the help of imaging methods such as X-rays, computer tomography (CT) and magnetic resonance imaging (MRI), the diagnosis can finally be made more precise.

Treatment options for low back pain

According to the different causes of low back pain, numerous therapeutic approaches are used to treat low back pain. Basically, the therapy initially aims to alleviate the pain, rather than addressing the causes of the symptoms directly. In addition to pain relievers, alternative methods such as physiotherapy, massage or acupuncture are used here. After treating the acute pain, the causes of the discomfort should be remedied therapeutically. This is difficult depending on the cause of the complaint. In the worst case, surgery is required, for example to remove a herniated disc or a possibly existing tumor.

What drugs are used for low back pain

Medicines are often used to treat pain in the lumbar spine. The type and dosage of drug treatment is strongly related to the cause. When it comes to nonspecific low back pain, pain relievers should only be seen as occasional support and not as basic therapy. The following medications are used, among others:

  • Painkillers - as support for exercise therapy,
  • Antibiotics - for an infectious cause,
  • Cortisone - for rheumatic diseases.
  • Dietary supplements such as calcium, vitamin D or calctonin for degenerative causes.

Naturopathic therapies

Osteopathy, which is often used in nonspecific chronic low back pain, relies on manual treatment of the symptoms, whereby pressure is used to release the blockages that cause the pain. Relaxation exercises and autogenic training are often part of an alternative low back pain therapy, especially if a psychosomatic background is suspected. In addition, Jacobson's Progressive Muscle Relaxation promises to relieve the symptoms of low back pain. Muscle relaxation is also recommended in the current guideline for the treatment of non-specific low back pain (as of 05/2017).


In order to prevent the pain in the back, certain rules must be observed in everyday life alongside the treatment. Weights should not be lifted from the back, the workplace should be designed to be as gentle on the back as possible and, in case of doubt, the back should be strengthened with a few simple gymnastic exercises (back pain exercises). Regular physical activity is considered one of the most effective measures to prevent and relieve non-specific low back pain.

A good exercise for prevention and also for relieving low back pain caused by tension and blockages is the so-called "bottom slide". You sit flat on the floor with your legs extended forward and alternately push the right and left legs forward so much that you move forward piece by piece. Try to slide about two meters in this way.

Furthermore, one should refrain from curing back pain in bed. This is rather counterproductive and can aggravate the symptoms. If you are overweight, losing weight can help relieve symptoms. (fp, vb; updated on August 15, 2018)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Dipl. Geogr. Fabian Peters


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  • Nikolaus Wülker et al .: Pocket textbook on orthopedics and trauma surgery, Thieme Verlag, 3rd edition, 2015
  • Federal Chamber of Physicians (BÄK), National Association of Statutory Health Insurance Physicians (KBV), Association of Scientific Medical Societies (AWMF): National Care Guideline for Non-Specific Low Back Pain - Long Version, 2nd Edition, Version 1, 2017, (accessed August 15, 2019), AWMF
  • Peter J. Moley: Lower back pain, MSD Manual, (accessed August 15, 2019), MSD
  • Jan Hildebrandt, Michael Pfingsten: Back pain and lumbar spine, Urban & Fischer Verlag, Elsevier GmbH, 2nd edition, 2011

ICD codes for this disease: M54.5ICD codes are internationally valid encodings for medical diagnoses. You can find e.g. in doctor's letters or on disability certificates.

Video: Whats Causing Your Low Back Pain? (May 2022).