Body region
Back and spine
A longer drive, bending down in the garden or walking to the shops becomes tiring because your back no longer copes as it used to. Perhaps the pain stays in one place. Perhaps it travels into your buttock or leg. Do you already have a report, for example from an X-ray or MRI scan? We explain whether the findings match your symptoms.
Open individual sections or all the details on this page.
Seek help promptly if these changes occur
New difficulty controlling your bladder or bowel, numbness between your legs (the saddle area) or increasing paralysis in a leg requires immediate medical assessment. Do not wait for a routine appointment with us. In an acute, serious situation, call 112 or go straight to an emergency department.
Pain after an accident, back pain with fever or a marked deterioration in someone with known risk factors should also be assessed promptly by a doctor. Pain intensity alone does not reliably indicate how urgently the cause needs attention.
Understanding
A closer look
This page provides an introduction to the back and spine. You can learn which distinctions matter for assessment and where to read more about your concern.
What back symptoms mean for you
“Back pain” can describe very different experiences. Some people have had lower back pain for only a few days; others feel it with almost every physical activity. Others can walk a certain distance and then have to stop because of back or leg symptoms.
To assess your problem, we want to know how it has developed. The timeline and the situations in which symptoms occur provide clues that an image alone cannot give. We also want to know what you avoid or can no longer manage. Your goal might be a working day with fewer interruptions or feeling more confident on a walk again.
How the spine enables movement
The spine supports the upper body while allowing movement. Discs lie between the vertebral bodies, and small spinal joints help guide movement. Muscles and ligaments support this interaction. Nerves run through the spinal canal and its exit points.
Symptoms can therefore arise in different ways. Muscular strain, changes to joints or discs and nerve irritation are assessed differently. Even after careful examination, it is often not possible to attribute the pain reliably to one structure. Useful treatment steps may still be possible.
Further information
When pain travels into your leg
Radiating pain deserves a more precise description. Does it travel only into your buttock, or all the way to your foot? Is there also tingling, numbness or a feeling of weakness? These distinctions help us assess whether nerve irritation could be involved.
A slipped disc is one possible explanation, but not all radiating pain means a slipped disc. Narrowing of the spinal canal may also play a part. This condition, known as spinal stenosis, can cause symptoms when walking and standing. The overall findings from the examination determine which cause is actually present.
If you want to understand a finding
Terms such as “degenerative changes”, “protrusion” or “stenosis” can sound alarming in a medical letter. Initially, they describe changes whose significance needs to be assessed. A protrusion, for example, is a bulging disc. The word alone does not tell us whether it is responsible for your pain.
We therefore consider whether the location and extent of a finding match your symptoms and physical examination. An existing image may support a treatment decision, put a suspected cause into perspective or raise another question. Please bring existing images and reports if possible; a new examination is not automatically the next step.
Back symptoms and bone health
With new back pain, the strength of the vertebral bodies can also matter. This is particularly relevant if you have known osteoporosis, have already had fractures, or the pain began after relatively little strain. A vertebral fracture needs to be assessed differently from muscular symptoms.
Our dedicated “Bone health and osteoporosis” section explores this question. It may also be helpful if you originally came to the website because of your back. A bone density scan does not replace an examination of new, acute pain.
Reduced bone strength can also increase the likelihood of fractures at the wrist, the upper arm near the shoulder or the hip, for example at the femoral neck. We therefore consider a possible osteoporotic vertebral fracture alongside your risk of further fractures.
Finding the right information in more detail
If you would first like to understand what may be behind back pain and when it should be assessed, read the “Back pain” page. It also explains the role of movement and carefully selected imaging.
The specialist focus page “Back pain treatment” describes the care we offer. There, we explain how conservative treatment, medication and, where appropriate, image-guided procedures fit together. For PRT or an infiltration already recommended to you, you will find a dedicated explanation under “Treatments”.
What to expect and next steps
Preparing for your assessment together
You may find it helpful to note when your back symptoms began and which movements or activities limit you. If your walking distance has changed, an everyday example is useful.
Please bring any existing X-rays, MRI or CT scans, ideally with the written report and corresponding images, for example through image access with a QR code or on CD. An up-to-date list of diagnoses and medication helps us take other conditions and treatments into account. You do not need to arrange new imaging yourself for the initial assessment.
Your main contacts for non-surgical back care at OrthoCoast are Priv. Doz. Dr. med. habil. Richard Kasch, Dr. med. Christoph Jährling and Björn Weidemann. We will agree with you how best to direct your enquiry.
Our doctors in this specialty
Priv. Doz. Dr. med. habil.Richard Kasch
Specialist in orthopaedics and trauma surgery
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Dr. med.Christoph Jährling
Specialist in orthopaedics and trauma surgery
DVO-certified osteologist
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Björn Weidemann
Specialist in orthopaedics and trauma surgery
DVO-certified osteologist
View profileMeet our doctors who assess orthopaedic symptoms. We discuss the symptoms that concern you and what matters in your everyday life.
Frequently asked questions
Is all back pain caused by a spinal condition?
No. Pain can arise from the interaction of different structures; occasionally, its cause lies outside the musculoskeletal system. Assessment therefore includes questions about accompanying symptoms and pre-existing conditions as well as the examination.
Does a disc finding mean that I need surgery?
Imaging findings alone do not determine whether surgery is needed. Symptoms, examination, the course of the problem and any loss of nerve function are decisive. Many situations can be treated without surgery; certain neurological deficits may require prompt further assessment.
What belongs on the Back pain page and what on the Back pain treatment page?
The symptoms page helps you understand symptoms and their assessment. The specialist focus page explains the treatment options at OrthoCoast and the questions that guide our choice of them.
Can I remain active despite an abnormal finding?
That depends on the condition and your symptoms. An abnormal image does not automatically mean you must avoid physical activity. A recent fracture or neurological deficits call for different precautions from non-specific back pain. Ask for an explanation of what makes sense in your situation.
Your next step
