Further measures

As a further passive support in physiotherapy/physical gymnastics to get rid of the pain in a lumbar spine syndrome, various complementary measures and therapies are recommended:

Massages
Trigger point therapy
Fango
Sling table
Manual traction
Medication, tablets, syringes

For physiotherapy in the case of a lumbar spine syndrome, massages are often used to relieve the tension in the back muscles caused by the spinal column problem. Massages are usually very pleasant for the patient and quickly relieve the patient’s symptoms. However, massages should not be used as a routine and especially not as the sole treatment strategy for lumbar spine syndrome.Massages are a purely symptomatic therapy and can eliminate the cause of tension in most cases and certainly not in the case of chronic back problems.

A massage should never take up the full treatment time, unless the patient has experienced acute muscle tension due to acute overloading or incorrect strain. Before or after mobilizing techniques or a strengthening program, a massage can be used in therapy as a complementary treatment. Even if massages provide quick relief for the patient and are pleasant, there is a risk of “dependence on the therapist” due to the passive treatment technique.

The patient should always be made aware of his or her own role and responsibility for the success of the therapy. Trigger point therapy is also a passive treatment technique frequently used in lumbar spine syndromes. Specific pain points in the muscles are pressed and held until the metabolism in the tissue changes, the tone of the muscles and the pain subsides.

Trigger point treatments often have a longer-term success than massages, but are also rarely seen as a causal therapy method. Trigger points are created by overloading the muscles. In a therapy session, a lot of time can be spent on the treatment of trigger points, but not every session should only be used for trigger point therapy.

It makes sense to release the pain points in order to bring the musculature back into a physiological position. However, a further focus should be on the treatment of the causes of the underlying overloading in order to improve the pain points in the muscles and the entire symptomatology in the long term in the case of lumbar spine syndrome. Fango therapy is a form of heat therapy.

The patient lies down on a warming mud mass (often also warming pads, no longer filled with real mud) and lets the warmth penetrate into the depth of the musculature for some time (at least 10 max 20-30 min), where it causes relaxation and detonation. Due to the special composition of the fango, a relatively high heat can be applied gently and penetrate deep into the tissue. This requires a certain amount of time until the heat reaches the deep muscle layers.

For acute pain relief and relaxation, but also before the mobilizing therapy, a fango application can be very useful. It is often perceived by the patient as very pleasant and symptom-improving. However, the patient should be advised that although heat therapy is an effective symptom-improving form of therapy, it does not bring about a long-term improvement, as it is not a treatment of the underlying causes of lumbar spine syndrome.

In the treatment of lumbar spine syndrome, the sling table serves to relieve the spine and its structures (vertebral joints, intervertebral discs). The patient experiences a pleasant relief through the targeted suspension of body parts and their own weight in the slings of the sling table. The reduction of the patient’s own weight can also help the therapist to perform certain techniques to relieve the spinal column, such as the traction technique (pulling on the spinal column creates more space between the structures, thus relaxing the tissues).

A sling table treatment may well take a longer time of a therapy session, especially if the therapist uses accompanying techniques. However, under no circumstances should every therapy session for the treatment of a lumbar spine syndrome be reduced to the sling table, as this form of therapy is not a real treatment of the cause, but rather a purely symptomatic form of therapy. Manual traction can be used in different ways in the therapy of lumbar spine syndrome.

The therapist can bring individual joints into traction in a targeted manner, or relieve entire sections with more global grips. The traction treatment can also be carried out with the aid of the sling table. Traction means that the joint surfaces are minimally released from each other by pulling.

The supply of the tissue improves, capsule structures can be stretched and the cartilage is relieved. The technique can be applied continuously over a certain period of time (with less than 10 minutes) or can be actively varied by the therapist. Oscillating traction is an alternation of pulling and releasing the tension and is particularly effective in improving cartilage nutrition.

Traction therapy for lumbar spine syndrome is often perceived as pleasant.It can have a relatively high significance within a therapy session, but should not be the sole component of the therapy, as it is not a causal treatment method. In electrotherapy, different forms of current are used to achieve certain effects in the tissue. The therapy aims to increase blood circulation, reduce pain and relax the muscles.

As long as there are no contraindications for the use of current, such as implants, acute inflammation, fever or pacemakers, electrotherapy can be used to treat the lumbar spine syndrome. A therapy session can last 10-20 minutes. If a pure electrotherapy prescription has been issued for the treatment of lumbar spine syndrome, then each therapy session can be filled by electrotherapy.

In the case of physiotherapy prescriptions, electrotherapy can be used as a supplement, but other strategies such as soft tissue treatment, traction and, above all, active exercises should also be chosen. Electrotherapy is a symptomatic but not a causal form of therapy. Patients suffering from acute pain in the context of a lumbar spine syndrome often resort to pain and inflammation-relieving medication.

Aspirin (ASA), ibuprofen, diclofenac or paracetamol are frequently used. These are drugs that are freely available in small doses but should still be taken with caution. Used deliberately and in a controlled manner, these drugs can be used well.

If you are taking them over a long period of time, you should urgently consult a doctor. Injections that are sometimes used in pain therapy should be used with caution. Medications containing cortisone can be used permanently and can damage cartilage and connective tissue, even if they achieve a good improvement in symptoms.

Muscle relaxants can provide relief in acute severe pain and can be injected directly into the muscles. However, they can impair the ability to react and the patient’s fitness to drive and further behavior should be discussed with the doctor. If necessary, muscle relaxants can also be taken orally.

Here, too, fitness to drive and limitations in the ability to pay attention and react must be urgently clarified.

Aspirin is a relatively weak painkiller in relation to back pain, when using it, stomach problems and the influence on the coagulation system of the patient must be considered. By taking aspirin, one bleeds longer in case of injuries.
Ibuprofen and diclofenac belong to the so-called non-steroidal anti-inflammatory drugs (NSAIDs) and also have a particular effect on the stomach (heartburn, inflammation of the mucous membranes). However, they can also damage the kidneys and also have a lesser effect on the coagulation system.
Paracetamol has a different mechanism of action and can damage the liver in high doses.