Dolor de espalda

Back pain frequently has physical (organic) and/or psychosomatic causes along with malpositions and inappropriate biomechanical stresses. Possible causes include:

• Injuries such as the fracture of a vertebral body, a vertebral body displacement or the tearing of a nerve root

• Inflammation and

• degeneration. Diagnoses include arthrosis, osteoporosis, ankylosing spondylitis (Bechterew’s disease), herniated discs, instability of the spine, muscle imbalances or a leg length difference that disrupts the statics.
  No specific cause is found for 90 per cent of all cases of back pain. X-rays or magnetic resonance tomography are used to make a diagnosis.

Back pain is classified as radicular pain, in which a nerve root is irritated by a herniated disc, for instance, or as pseudoradicular pain. With the latter, back pain is caused by changes in the small joints of the spine.
Other possible distinguishing features include:

• Lumbago: back pain that occurs suddenly

• Chronic back pain: ongoing back pain for more than three months

• Lower back pain and radiating pain in the legs

• Loss of control over leg functions

• Bladder dysfunction

Entre el 60 y el 70 % de las mujeres de entre 30 y 60 años sufre dolor de espalda; en el caso de los hombres, las cifras alcanzan el 65 al 80 %. Más del 75 % de los dolores de espalda se producen en la zona lumbar. Los dolores de espalda suponen el segundo motivo más frecuente de las hospitalizaciones. Son el principal motivo de la aprobación de tratamientos médicos estacionarios por parte de los seguros y también el principal motivo de las incapacidades laborales. Cerca del 50 % de la solicitudes de jubilación anticipada se deben a este motivo.
Cada año se tratan en Alemania 31 millones de casos de dolor de espalda. En el 87,5 % de los casos se trata de dolores agudos, y en el 12,5 % de dolores crónicos. Se estima que, en Alemania, el dolor de espalda origina unos gastos de cerca de 49 000 millones de euros. De ahí que el tratamiento y la rehabilitación de las personas afectadas no se consideren solo una tarea sanitaria, sino también económica.

Treatment depends on the cause of the symptoms and often begins with conservative approaches – that is, without an operation. Surgery is only carried out in rare cases. The prognosis is good for most people with back pain. In more than half the cases, the pain goes away within one week. After two weeks, about 80 per cent of all cases have largely recovered due to appropriate treatment with pain therapy, orthopaedic technology devices such as back orthoses/supports and physiotherapy. The guidelines of the orthopaedic professional associations and the Drug Commission of the German Medical Association emphasise that only those measures that incorporate the patient’s active involvement (for example, active physiotherapy, the use of functional orthoses, back-friendly behaviour at work, and so on) are beneficial over the long term.