Back pain
General medical information on the cause, diagnosis and treatment of back pain is available under Back pain.
Introduction
Back pain developed to the national illness NR. 1 and to a substantial cost causer for the health service and the economy in Germany. The total costs for the supply of chronic back pain amount to approx.
20 billion euro/year, whereby the main part of the costs is caused by sick notes. The costs per patient are on average 1200 euro, of which 54% are allotted to the direct (medical) costs, the indirect costs (caused by sick notes and losses of production) account for 46% of the total sum. Back pain causes about 15% of all sick leave per year and is the reason for 18% of all early retirements.
About 60% of all adult men and women report back pain (regardless of severity and duration) within the last 12 months, chronic back pain (back pain that lasts at least 3 months or longer and occurs almost daily) within one year is reported by about 20% of all adults, based on the entire life time, this is about 30% of all adults. Women are generally more affected in terms of frequency and intensity. While back pain used to be a problem of older people, today those affected are getting younger and younger and the need to have therapeutic options at hand to prevent recurrence (reoccurrence of symptoms) and chronification is increasing.
The main goal in the treatment of back pain is therefore not exclusively the temporary improvement of symptoms, but due to the tendency to relapse and chronification, the long-term therapeutic success and the prevention of recurrence. There are many different causes for the development of back pain, and despite the most modern diagnostic possibilities, it is not always possible to determine a clear cause. For the development of back pain and the tendency to chronicity, besides the physical factors, many concomitant circumstances such as workload, social class, cognitive evaluation of pain and depressive mood are important.
In the following topic I would like to discuss spinal instability caused by a weakness of the local (deep) muscle system as a possible cause of high recurrence rates. The stabilizing system of the spinal column consists of three parts, which can only guarantee optimal movement control of the spinal column in posture and movement when it is fully functional and in cooperation with each other. 1st and 2nd part: active movement system = musculature, consisting of the global and local muscle system Complicated control and management systems of our nervous system ensure that the two muscle systems are activated at the right time and in the right order during posture and movement.
Thus, our body is able to maintain stability while executing movements in an optimal way. Movement execution can be planned in advance and adjusted after the movement has been completed for further perfection. Complicated control and management systems of our nervous system ensure that both muscle systems are activated at the right time and in the right order during posture and movement.
Thus our body is able to maintain stability while executing movements in an optimal way. The execution of movements can be planned in advance and after the movement has been completed it can be adjusted for further perfection.
- The global muscle system consists of long, more superficial muscles that have a primary moving function.
They are able to perform movements of the spine and extremity joints quickly and with great strength and are jointly responsible for controlling balance. The muscle fibers of the global musculature are dependent on intensive blood circulation for their work and therefore tire quickly during prolonged holding work.
- The local muscle system consists of small muscles located deep and close to the joints of the spine, which predominantly have a stabilizing function. They are responsible for our upright posture and work with little effort, as they are in constant use all day long.The local muscles ensure that the small vertebral joints always remain in a certain position, even during intensive movement, falls or impacts. In this way, they prevent functional disorders (painful movement restrictions, “blockages”) of the spine and relieve the passive support system of the back.
- Part: passive support system, consisting of the bony components of the spinal column, capsule and ligamentous apparatus, the intervertebral discs, and the central (the part of the nervous system located in the skull and spinal canal) and peripheral (consisting of the cranial nerves and spinal cord nerves) nervous systems.
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