Complaints & connections · borters.ch
Usually no damage lies behind it but an overloaded system — and movement here is medicine, not a risk.
Also known as: back pain · low back pain · lumbago
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
Back pain is one of the most common complaints — and the vast majority is “non-specific”: muscular, with no dangerous cause, even though it can hurt a lot. Good news: it usually improves within a few weeks, and staying active helps more than rest and bed rest. Only a small share comes from a disc, nerves or other causes. Important are the warning signs not to miss: pain radiating with numbness or weakness in the leg, trouble passing urine or holding stool, numbness in the saddle area, fever, unintended weight loss or pain after a fall. Without such signs, immediate imaging is rarely needed. Four further signs stand in the guideline and are easily lost in everyday life: a fall — or even coughing, sneezing or heavy lifting — with known osteoporosis or at an older age; steroid treatment over a longer period; a past cancer; and pain that is severe at night or increases when lying down instead of easing. To that comes a whole picture more often overlooked than missed: back pain lasting more than three months, beginning before the age of 45, with morning stiffness of at least half an hour, better with movement and not with rest, and buttock pain alternating from one side to the other. That is the picture of an inflammatory spinal disease — and on average it passes for ordinary back pain for years.
Mobilisation and short thrusts at joints are among the active options in the recommendations, alongside movement and exercises. Before the first session the situations in which no manipulation is done are asked about.
Onset before the age of forty, longer than three months, waking in the second half of the night and improvement with movement: these four points together describe inflammatory back pain and are the reason to look further.
The key lever: gentle movement and keeping up daily life rather than bed rest — this speeds recovery.
Warmth, movement and, if needed, short-term painkillers help through the acute phase.
Regular activity, core/back strengthening and less prolonged sitting prevent recurrences.
With the warning signs above, don’t wait — get it assessed.
Hot water bottle, cherry stone cushion or a warm bath, 20 to 30 minutes, several times a day — and move afterwards, do not stay lying down.
With back and joint pain keep moving within the pain-free range, keep everyday life going, avoid bed rest.
Every 30 to 45 minutes stand up, walk for two minutes or change position clearly.
Four in five people have an episode in their lifetime. Nine out of ten acute episodes improve markedly within four to six weeks, even without particular treatment. That is the single most important sentence, because fear of the pain lengthens the course.
Anti-inflammatory painkillers lower pain in reviews by a few points on a ten-point scale — enough to get moving again, and that is where their real value lies. Muscle relaxants act through the nervous system, cause tiredness and are meant for days. What changes the course is returning to normal movement within the first days; bed rest beyond two days measurably lengthens it. Opioids did not do better in comparisons for back pain.
Lower legs up on a chair, knees and hips at right angles, ten to twenty minutes. Takes the pull off the lower back — often and briefly, not for hours.
Pain and tissue damage are not the same thing. There are injuries without pain and pain without injury, and both are real. In lasting pain that is the most important sentence there is.
No dangerous cause despite sometimes strong pain — usually improves on its own.
Pain with tingling/weakness can come from an irritated nerve root (sciatica).
Bladder/bowel trouble, saddle numbness, leg weakness, fever, weight loss, after a fall → doctor.
No value explains the pain itself. This one looks for the rare but important exception: an inflammation or infection behind the complaints.
Raised with inflammatory back pain and with the rare serious causes. With pain at night that does not ease at rest, both values belong alongside.
Belongs alongside with unintended weight loss or a known tumour illness — then it is about the bones and not about the muscles.
Part of checking the warning signs. Normal values are to be expected in more than nine out of ten people with back pain.
Without vitamin D only a fraction of the calcium from food is taken up. It is the value that is most often too low with bone and joint complaints.
The building material itself. Better from food than from a tin: hard cheese, yoghurt, calcium-rich mineral water, almonds, broccoli and fortified plant drinks.
Activates the proteins that build calcium into bone. Green leafy vegetables and fermented foods cover it — under coumarin blood thinning the amount stays steady rather than swinging.
Bone is a third protein scaffold, and the muscles that hold it need protein too. In older people too little protein is more common than too little calcium.
Needed for building calcium in and for vitamin D to work. A lack slows both — even when calcium and vitamin D are supplied in sufficient amounts.
With persistent back pain a low level is more common. Whether it is the cause is open — measured and replaced if deficient, that is the honest frame.
Often taken for muscular tension; for back pain itself there is barely any data. 200–400 mg over 4 weeks is a cheap attempt — movement has by far the best numbers for these complaints.
500–1000 mg a day over 8 weeks has been studied for joint and back pain; the differences are small. Without piperine or a special formulation little arrives.
The decisive difference lies in the rhythm: inflammatory back pain wakes in the second half of the night and improves with movement; mechanical pain worsens with movement and eases with rest. That one question separates two worlds.
After menopause vertebrae can collapse unnoticed — sudden back pain after a harmless movement and a loss of height are the signs. Two thirds of these fractures are never noticed.
A low vitamin D level is more common in chronic back pain — whether cause or consequence of less time outdoors stays open. Measure before supplementing.
Staying in movement beats resting — that is the most important finding of recent decades in back pain.
Manual methods are much used for back pain; they do not replace the strengthening.
Warming in a massage blend, one to two per cent. What measurably helps is movement — the oil makes the way there pleasanter.
Methyl salicylate, that is aspirin through the skin. Back pain that wakes at night and eases on getting up belongs looked at rather than rubbed.
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AWMF nvl-007 · S3 · 2018-02 — expired
Nationale VersorgungsLeitlinie Nicht-spezifischer Kreuzschmerz
checked 2026-09 · last looked for a successor 2026-09-20