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The back - a playground for the soul

Selcuk Bas
Photo: djd

Expert Interview

The WUNDERWEIB expert for chronic back pain: Selcuk Bas

Selcuk Bas is a doctor of the Medical Care Center "SZ Schmerzzentrum Berlin". There he works with doctors, medical assistants, nurses and nurses to look after chronic pain patients.

His specialties are chronic back pain, migraine, pain pump therapy and Mipas training.

In the large WUNDERWEIB interview, the expert talks about the common illness of back pain and gives helpful tips on prevention and treatment and therapy options.

Back pain is a common disease - but who is actually the most affected?

Selcuk Bas : Back pain is one of the most common complaints in Germany. According to a representative survey, nearly two thirds of all Germans suffer from back pain.

Often they occur in the form of a lumbago or neck tension. In 90 percent of cases, the symptoms resolve themselves after a few weeks. A study shows that 65 percent of women and 57 percent of men are affected by occasional back pain.

Chronic back pain is more common in women: every fifth has ongoing pain. Men suffer about 15 percent of chronic complaints. Most affected are middle-aged people between 30 and 50 years, as well as overweight people.

Is the number of patients increasing? If yes why?

Selcuk Bas : Although the exact causes are not known, but it turns out that the number of those affected under 30 is particularly strong.

In 65 percent of adolescents under the age of 18, postural defects of varying severity were already noted. Overall, spine and back diseases cause 3.7 million sick leave per annum, totaling 75.5 million days off work.

When are back problems considered chronic?

Selcuk Bas : For a pain that lasts more than 3 months, one must assume a chronification. The pain then loses its warning function and becomes itself an independent disease.

Lumbago, sciatica, herniated disc - can one feel the differences?

Selcuk Bas : No, you can usually feel no difference. Patients often go to the doctor because of severe pain (lumbago): If the pain is intense and the circumstances require it, an imaging examination is initiated that often finds a herniated disc.

Unfortunately, we doctors can not tell when it's there and if it's related to the acute pain. For even about 40 percent of the pain-free, without knowing it, already had a herniated disc.

How can you specifically prevent back problems?

Selcuk Bas : Patients can do a great deal to prevent themselves: by redesigning their workplace, back-friendly behavior and regular exercises to strengthen the back muscles, effective prevention can be achieved.

But it's not as easy as it sounds. First of all, there is no proof that regular exercise is an effective preventive measure. And then the question arises: What exactly is back-friendly behavior?

Did not we hear somewhere else that it was just wrong to spare the back? There is no clear answer and always depends on the individual case.

Can the spiral of pain, restraint and other cramps be interrupted without tablets?

Selcuk Bas : Some sufferers get their pain under control with relaxation exercises, yoga and meditation. Everyone has to find their personal help program here.

When should you resort to medication, tablets, ointments, heat pots?

Selcuk Bas : There are various recommendations of the medical societies, according to which an individually tailored therapy is to be built up gradually. In practice, however, this usually looks like the doctor tried different drugs sequentially, so as to find out the most effective substances. However, one should not forget physiotherapeutic aspects and take measures to improve the psychological situation of the person concerned. After all, one does not say in vain: "The back is a playground for the soul."

Again and again you hear of serious side effects that bring painkillers - are NSAIDs really as bad as their reputation?

Selcuk Bas : The so-called NSAIDs, ie active ingredients such as ibuprofen or diclofenac, have been on the market for so long that they are extremely inexpensive. Based on so-called meta-analyzes, that is, summaries of existing data from previous studies, it has been found that prolonged use of high doses of these NSAIDs may increase the risk of heart attack or stroke. In addition, stomach problems can occur.

How do muscle relaxants work?

Selcuk Bas : The nerves are highly activated in pain and lead to increased muscle tension. One can also reduce this excitability by medication, so that it comes to a significant relaxation - for example, with the active ingredient flupirtine in Trancolong.

It acts on pain-processing nerve fibers, so to speak "sealing" and reduces their excitability. These drugs have been increasingly prescribed in recent years.

What are the benefits of alternative treatments such as acupuncture?

Selcuk Bas : Acupuncture has shown superiority over current guidelines in a large study. However, the study included only patients who were extremely open-minded about the method. Basically, the acupuncture effect over a placebo effect certainly does not go beyond.

To what extent are back problems also a sign of mental overload?

Selcuk Bas : The exact connections are unknown but they persist. My personal theory is that as biological beings we develop an escape reflex in situations we do not like, such as a bad job or an unhappy relationship. This is associated with increased muscle tone - the muscle is, so to speak, switched to "warm-up". But then nothing comes, because the social character prohibits us, so to speak, the escape. A vicious circle arises.

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