What is the treatment for back pain

Diagnosing and treating back pain

However, a medical examination makes sense - especially if, in addition to the pain, there are sensory disturbances, numbness or symptoms of paralysis. Your GP or orthopedic surgeon will examine your back pain with the aim of ruling out serious conditions such as osteoporosis (bone loss) or infection. To do this, he asks you in detail about your symptoms (anamnesis) and examines you physically. Further examinations, such as x-rays or blood tests, only follow if there are indications of acute causes that require treatment.

Basic diagnostics: medical history and physical examinations

When taking the anamnesis, your doctor asks specific questions about your medical history or back history, for example: Where and with which movements does the pain occur? Do they radiate into arms or legs? And which movements do they reinforce? He often asks about your current professional and private burdens.

During the physical examination, he looks at the shape and posture of your back and checks the back muscles and the mobility of your spine. To rule out any nerves being compromised, he will also perform neurological tests if necessary.

Image and laboratory examination only in the case of warnings

Imaging methods such as x-rays, computed tomography (CT) and magnetic resonance tomography (MRT) are usually only used if specific suspicions arise during the basic diagnosis. The reason for this is that these methods often do not provide any additional benefit. Blood and urine tests are also not necessary in most cases.

Actively address back pain

Back pain that has no specific underlying cause usually improves on its own. Your doctor will talk to you about measures such as exercise and back training so that your symptoms disappear quickly and, above all, in the long term. Because you can do a lot for your back yourself if you take action!

You can do that:

  • Keep your normal activities and sporting activities - taking it easy can even make the symptoms worse
  • Make your everyday life more active and take the stairs instead of the elevator, for example
  • Exercise your back muscles, for example with swimming or cycling
  • Make sure you are doing the right amount of activity and do not overwhelm your back
  • Relieve your back and change your position more often when you sit for a long time
  • Take emotional problems seriously and discuss them with your doctor


Anyone who is in pain quickly takes a relieving position. However, this often leads to further tension and even more pain. Therefore, if you have back pain, it sometimes makes sense to take a pain reliever for a certain period of time and thus break the vicious circle.

But: Painkillers are not a permanent solution and have side effects, especially when used for a long time. The following therefore applies to drug treatment:

  • The dose should be as low as possible - but also as high as necessary
  • Tolerance, effect and dose should be checked in the course of the doctor
  • Regular intake makes more sense than waiting each time until the pain becomes unbearable
  • Discuss signs of side effects immediately with the attending physician

Medication for non-specific back pain

Doctors are most likely to recommend non-steroidal anti-inflammatory drugs (NSAIDs) such as diclofenac, ibuprofen and naproxen. If the NSAIDs are not tolerated or they do not relieve the pain, experts recommend other active ingredients such as metamizole. If this pain medication does not work sufficiently either, the doctor can prescribe more effective drugs from the group of opioids. The right pain therapy always depends on the individual situation and is determined by the attending physician.
Experts generally no longer recommend other medications, such as muscle relaxants.


Acupuncture is a treatment method in traditional Chinese medicine (TCM) in which fine needles are inserted into the skin. The stimulus to certain energy points is supposed to relieve pain and activate self-healing. Despite contradicting studies, almost 90 percent of patients report that they feel better with the treatment.

More: Acupuncture therapy with needles

Exercise therapy

Movement therapy includes physiotherapy, physiotherapy, but also guided yoga courses and the Alexander technique. The procedures can help to move around in a back-friendly manner and improve overall physical performance.

However, studies show that normal everyday activities can relieve acute back pain just as effectively as exercise therapy. Experts therefore recommend them especially for long-lasting pain.

Relaxation procedure

With procedures such as progressive muscle relaxation according to Jacobson or autogenic training, you learn to relax muscularly and mentally. If there is a risk of lower back pain becoming chronic, you can actively counteract this by relaxing regularly.

Occupational therapy

Sometimes mobility is so limited by chronic low back pain that those affected can no longer carry out everyday movements and activities such as showering or cooking. In occupational therapy, chronic pain patients learn these movement sequences and skills anew. Occupational therapy measures are often integrated into so-called multimodal (diverse) treatment programs.


During chirotherapeutic manipulation or mobilization, the doctor works with his hands on individual vertebrae or parts of the spine. This releases blockages in the vertebral joints or muscles. In many cases, the pain will then subside.

More: Chiropractic for the back


Massages are particularly suitable for treating long-standing or chronic back pain - especially when combined with physical exercise. For acute low back pain, experts advise against massages and rather recommend active movement training.

More: Massages - Handles for Health

Psychotherapy and behavioral therapy

Back pain and emotional stress are often related. Because stress and emotional overload lead to muscle tension, which can manifest itself as back pain. If psychotherapy improves mental well-being, back pain often also subsides. In behavior therapy, patients learn to change habits and attitudes that lead to tension. In addition, pain management skills are taught.

More: Cognitive Behavioral Therapy

Back school

In a back school course, you will learn practical exercises to strengthen the back muscles. The course instructor also teaches back-friendly behavior in everyday life. The technician also offers special back programs.

More: back school

Heat and cold applications (thermotherapy)

Warmth, for example in the form of hot water bottles, poultices and warming patches, can relax muscles and relieve pain. People with back pain also often find cooling, for example with gel pillows or cold sprays, to be pleasant.

As long as the application is doing you good, there is nothing wrong with placing a grain pillow or a cold compress on the painful area. However, activity and movement are more important for a sustainable treatment of back pain.

More: thermotherapy