Psychological factor
Back pain can creep in over the years, and subconsciously place an increasing burden on the patient. What started with a slight pulling in the cervical spine develops over the years into a chronic pain in the cervical region, and then spreads to the thoracic spine (BWS). Once the pain has manifested itself, it is very difficult to get rid of it.
In such situations, however, it is always important to clarify psychological factors. Thus the psyche can certainly “hit you on the back”, as they say. A depressive mood or manifest depression can manifest itself in many ways.
Some patients then suffer from stomach aches and digestive disorders, others from constant headaches. But psychological effects on the back are also very common. Unfortunately, no “booster injection” or operation helps against psychological problems.
Especially when patients have been plagued by back pain for years, it is important to put together a multidisciplinary competence team consisting of an orthopaedist, psychologist and psychotherapist. Especially when imaging procedures do not show any degenerative changes in the intervertebral disc and yet there is still severe pain, a psychological process should also be considered. However, psychological and psychosomatic problems such as depression are far less tangible than a herniated disc.
Often there is a lack of understanding for this among relatives or friends. This attitude unfortunately persists over the years and is probably due to the fact that the patient appears to be outwardly healthy. The psyche cannot be judged so quickly from the outside.
However, this attitude is subject to a strong change since several years, so that health insurances and doctors increasingly consider also psychological events. If psychological problems strike the body, one speaks of a psychosomatic process. A psychological problem becomes a physical one.
This is not a matter of sensations, but of biological and physical processes that take place in the brain and nervous system. Depression, stress, and dissatisfaction can manifest themselves successively in the back and impress like a herniated disc. For the treatment of psychological problems, therefore, not only the orthopaedist, but also a psychologist and a physiotherapist are required.
Psychosomatic complaints can usually only be eliminated by long-term long-term therapy and represent a serious illness. Herniated discs show a statistical accumulation in the lumbar region (lumbar spine), and in the cervical region (cervical spine). The distribution between lumbar, cervical and thoracic spine (BWS) is 100 to 10 to 1. i.e. for a herniated disc in the thoracic spine, statistically 100 occur in the lumbar spine.
The high accumulation in the lumbar spine is primarily explained by the fact that the lumbar spine bears the most weight. No other vertebral body segment is exposed to such high forces as the lumbar spine. The weight of the entire upper extremity, as well as the trunk and head, rests on it.
For this reason, the vertebral bodies of the lumbar spine have a particularly solid structure. For illustration, while a vertebral body of the lumbar spine is almost the size of a fist, the vertebral bodies of the cervical spine are the size of a toy car. This is already another problem of the spinal column: The fragile vertebral bodies of the cervical spine are not particularly stable and must be constructed as filigree as possible so that our range of movement in the neck/neck area is retained. If you consider that the human skull including brain weighs about 3-5 kilos, but the intervertebral discs in this area are not larger than a €2 piece, you understand why the cervical spine is also frequently affected by herniated discs.
