What is the spinal canal?

The spinal canal is a bony canal that runs through the entire spinal column and protects the spinal cord and the nerves that emerge from it. It is formed by the vertebral bodies, the vertebral arches and the intervertebral discs between them. The spinal cord (up to about the first or second lumbar vertebra) and the nerve roots, which transmit signals between the brain and body, run within the spinal canal. Among other things, these nerves control movements and sensations in the arms and legs.

What is spinal canal stenosis?

Spinal canal stenosis is a narrowing of the spinal canal that can exert pressure on the spinal cord or the nerves running through it. This narrowing is usually caused by signs of wear and tear in the spine, such as bony growths (spondylosis), herniated discs or thickening of the ligaments in the back. Spinal canal stenosis occurs most frequently in the lumbar spine, as this section of the spine is subject to heavy strain.

Spinal canal stenosis and leg pain: how are they connected?

With spinal canal stenosis, the space in the spinal canal is reduced. This constricts the nerves, which can lead to impaired transmission of stimuli. If the stenosis affects the lumbar spine, the nerve roots that control the legs and feet are affected.

Typical complaints associated with this are

• Pain that increases when walking or standing
• Relief of pain by sitting or leaning forward
• Tingling, numbness or weakness in the legs
• Problems with prolonged walking or climbing stairs

The symptoms can vary depending on the severity of the narrowing.

Diagnosis of spinal canal stenosis with leg pain

Leg pain can have many causes, including circulatory disorders, herniated discs or nerve disorders. If the problems last longer, get worse or are accompanied by numbness, muscle weakness or unsteady gait, it is important to seek medical clarification. An early diagnosis can help to treat symptoms in a targeted manner and avoid long-term restrictions.

At our private practice for orthopaedics and traumatology in Frankfurt, we diagnose spinal canal stenosis in several steps. This allows us to ensure that the leg pain is actually caused by a narrowing of the spinal canal.

• Medical consultation (medical history)
  First, we ask you specifically about your symptoms:
  • Does the pain occur when walking or standing and does it subside when you sit down or bend forward?
  • Is there any additional tingling, numbness or muscle weakness in your legs?
  • How long have the symptoms persisted?
  • Are there any pre-existing conditions such as osteoarthritis or disc problems?
• Physical examination
  The next step is to examine your musculoskeletal system.
  • We check the mobility of your spine.Can you bend forward?
  • Does the pain subside in this case?
  • We then carry out nerve tests. How are your reflexes, how is the muscle strength and sensitivity of your legs?
  • If necessary, we can follow up with walking tests. How well can you walk?
• Imaging procedures
  To confirm the diagnosis, we can follow up with various other examination methods:
  • X-ray
    The X-ray examination can provide indications of signs of wear and tear, but does not show any nerves or soft tissue.
  • MRI
    Magnetic resonance imaging shows the narrowing of the spinal canal and whether nerves are trapped.
  • CT scan
    Computed tomography allows a detailed representation of bony changes in the spine.

In some cases, we also perform a diagnostic nerve block. This involves injecting an anesthetic into the affected area. If the pain disappears temporarily, this indicates spinal canal stenosis.

Treatment of leg pain caused by spinal canal stenosis

Treatment for spinal canal stenosis aims to reduce the pressure on the affected nerves and thus alleviate leg pain, numbness or muscle weakness. Depending on the severity, conservative or surgical treatment may be considered.

Conservative treatment at our orthopaedic practice in Frankfurt

We use the following methods as part of spinal therapy, especially for mild to moderate symptoms:

Medication

First of all, we can prescribe non-steroidal anti-inflammatory drugs (NSAIDs) to relieve pain and inflammation. In addition, muscle relaxants can help to relieve tension that may be associated with the stenosis. For more severe nerve pain, nerve medications such as pregabalin or gabapentin are useful.

Injections and minimally invasive procedures

We use so-called spinal infiltrations to inject anti-inflammatory and pain-relieving substances near the affected nerve roots and vertebral joints. This can help to reduce inflammation and relieve pain caused by the narrowing of the spinal canal.

Traction treatments have also proven effective. Using gentle longitudinal traction and the simultaneous application of heat, we relieve pressure on your spine and the surrounding structures. This method can help to reduce the pressure on the nerves and thus alleviate the symptoms of spinal canal stenosis. We can correct misalignments or blockages of the vertebral joints using special chiropractic techniques. This can improve mobility and reduce pressure on the nerves.

Acupuncture can also provide valuable support for leg pain caused by spinal canal stenosis. Although it cannot correct the narrowing of the spinal canal, it relieves pain, relaxes the muscles and promotes blood circulation. The targeted stimulation of certain points releases the body’s own painkillers and reduces inflammatory processes. The procedure can also stabilize nerve function.

Kinesio taping, which we also offer at our practice in Frankfurt, can also have a supportive effect. Taping can support the muscles, relieve tension and promote blood circulation. The elastic tapes reduce pressure on nerves, which can relieve pain and improve mobility.

CT- and MRI-guided infiltrations (periradicular therapy, PRT)

Under imaging control (CT or MRI), we inject an anti-inflammatory medication directly into the irritated nerve roots. This precise method aims to relieve the pressure on the nerves and thus reduce the pain radiating into the leg.

Physiotherapy and physical measures

Targeted exercises to strengthen and stretch the muscles support the stability and flexibility of the spine. Physical therapies such as heat or cold applications can also relieve pain and reduce inflammation.

If conservative therapy is not enough: surgical treatment

If the symptoms increase despite conservative therapy, neurological deficits occur or the walking distance is severely restricted, surgery may be necessary. Possible options here are

Decompression surgery (pressure relief)

Excess tissue or bony growths are removed to relieve pressure on the nerves.

Stiffening surgery (fusion surgery)

If the spine is unstable, spondylodesis (fusion using screws and rods) may also be necessary.

Dynamic stabilization

In some patients, a motion-preserving implant (e.g. interspinous spreader) can be used instead of fusion to keep the spinal canal open.

Leg pain due to spinal canal stenosis: diagnosis and treatment in our practice in Frankfurt

Leg pain caused by spinal canal stenosis can significantly reduce your quality of life. At our practice in Frankfurt, we offer precise diagnostics and individually tailored treatment concepts to specifically alleviate your symptoms. Using modern examination methods, we determine the cause of the pain and develop a customized treatment plan. Our aim is to maintain your mobility and reduce the pressure on the nerves.

Let our experienced team advise you and help you find the best way to improve your mobility and quality of life. Simply contact us to arrange an appointment!

236262208 © Syda Productions | 433581203 © dbayan | stock.adobe.com

What are vertebrae?

Vertebrae are the bony building blocks of the spinal column, which together form a flexible and stable axis in the human body. Each vertebra consists of several components:

Vertebral body
The vertebral body is the front part of a vertebra and forms the largest part of the mass. It is round in shape and bears the weight of the vertebrae above it and the torso.

Vertebral arch
The vertebral arch extends backwards from the vertebral body and surrounds the spinal canal in which the spinal cord is located. It consists of two vertebral arch roots and a spinous process.

Transverse processes
Each vertebra has two transverse processes. They protrude laterally from the vertebral arch. Muscles and ligaments attach to them, which are important for stabilizing the spine.

Spinous process
The spinous process is an extension that projects backwards and to which muscles and ligaments also attach. It also serves as a lever arm for the back muscles.

Articular processes (facet joints)
These processes are located on the sides of the vertebral arches and form joints with neighboring vertebrae. They enable movements of the spine such as bending and turning.

Intervertebral foramen
The intervertebral foramen are located laterally between the vertebrae, through which nerve roots emerge from the spinal cord and lead to the various regions of the body.

Intervertebral discs
The intervertebral discs are soft but resilient structures made of cartilage tissue that are located between the vertebrae. They act as shock absorbers and allow the spine a certain degree of flexibility.

Together, these components form each individual vertebra, which differs in shape and size depending on its position in the spine (cervical, thoracic, lumbar vertebrae, etc.). The vertebrae are not only important for the mechanical support of the body, but also for the protection of the spinal cord and the transmission of forces and movements within the spine.

What is a vertebral blockage?

A blockage causes a vertebra to lose its normal mobility. Sometimes several vertebrae are affected at the same time. A blockage can be triggered by various causes, e.g:

Muscle tension
Vertebral blockages are often caused by muscle tension due to overloading, incorrect posture, stress or sudden movements. The surrounding tense muscles can consequently pull the vertebrae into a position in which they can no longer move freely.

Changes in the facet joints
The facet joints are the small joints between the vertebrae that ensure the mobility of the spine. If there is a blockage, these joints can get stuck. This results in limited mobility.

Intervertebral disc problems
Sometimes an intervertebral disc near a vertebra can also swell or become displaced, which can lead to a blockage – especially if it presses on or irritates nerve structures.

Possible symptoms of a vertebral blockage

Local pain
Pain in the area of the blocked vertebrae can be acute or chronic. Patients describe the pain as dull, stabbing or pulling. It can intensify with movement or persist at rest.

Restricted movement
The blocked vertebrae often lead to restricted mobility of the spine in certain directions. Turning or bending the back can be painful or only possible to a limited extent.

Muscle tension
The muscles around the blocked vertebrae can tense up because they want to stabilize the affected region. This tension can cause additional pain and further restrict mobility.

Radiating pain
Sometimes the pain radiates from the blocked area. You may then feel it in neighboring regions such as the shoulders, arms, buttocks or legs. This depends on the position of the affected vertebrae and the affected nerve roots.

Muscle and sensory disorders
In more severe cases, the blockage can also cause muscle weakness or numbness in the affected areas. This may indicate irritation or compression of the nerve roots.

Stiffness and a feeling of tension
Those affected often report a feeling of stiffness and tension in the affected area of the spine, especially after prolonged sitting or lying down.

Not all symptoms occur immediately and are present with the same intensity. The symptoms can also vary from person to person.

Diagnosis of a vertebral blockage

A vertebral blockage is diagnosed through a careful clinical examination in our private practice for orthopaedics and traumatology in Frankfurt. First, we will ask you about your symptoms, the onset of your complaints and any injuries or previous treatments. This is followed by a physical examination. We look for signs of muscle tension, swelling or asymmetries. Using targeted pressure points and movement tests, we identify the area of the spine that is affected by the blockage.

This is followed by certain tests: we ask you to perform various movements (e.g. bending, twisting and flexing the spine). We will check whether and where movement restrictions or pain occur. Neurological tests may also be used to clarify whether there is evidence of nerve irritation or compression.

In most cases, a vertebral blockage is a clinical diagnosis based on symptoms and physical examination. Sometimes we use X-rays – for example, to rule out other possible causes for the symptoms or to determine whether there are additional disc problems or structural changes.

Vertebral blockage, bulging disc, herniated disc – differential diagnosis necessary

There are various findings that can trigger similar symptoms. However, they have completely different causes and therefore different treatment approaches. In order to plan the right treatment, it is therefore important for us to find out what your underlying situation is.

Vertebral blockage

• Cause
  A vertebral blockage is caused by a temporary restriction in the mobility of one or more vertebrae in the spine. This can be caused by muscle tension, incorrect posture, overloading or sudden movements.
• Symptoms
  Local pain in the area of the blockage, restricted movement, tension in the surrounding muscles and possible radiation of the pain to neighboring regions are characteristic.

Protrusion of the intervertebral disc

• Cause
  In a bulging disc, the outer fibrous ring of an intervertebral disc is weakened due to strain or wear. This causes the inner, gel-like core of the intervertebral disc to push outwards or bulge. However, it does not break through the fibrous ring.
• Symptoms
  The disc protrusion can lead to back pain, which is often localized. Depending on the location of the protrusion, the pain may also radiate. Numbness or weakness in the affected areas is also possible.

You can find out more about this finding here: Treating a bulging disc: What you need to know

Herniated disc

• Cause
  In a slipped disc, the inner, gel-like core of an intervertebral disc leaks through a tear or a weak point in the outer fibrous ring. This can happen due to sudden strain, wear and tear or degenerative changes.
• Symptoms
  A herniated disc is accompanied by pain, which is often severe and can radiate to neighboring regions such as the arms or legs. Depending on the location of the prolapse and the affected nerve roots, neurological symptoms such as numbness, tingling or muscle weakness may also occur.

You can find more information here: Slipped disc treatment: these options are available

Relieving vertebral blockages in Frankfurt

If we have diagnosed you with a vertebral blockage, treatment can take place directly in our practice in Frankfurt. The therapy aims to restore the normal mobility of the blocked vertebrae, relieve the pain and avoid further complications.

The treatment of choice is chirotherapy. We use special manual techniques to mobilize and manipulate the blocked vertebrae. In this context, many people refer to this as “realignment”. There is a cracking, popping sound when the vertebra returns to its normal position and the normal mobility of the spine is restored. Traction treatments, which have a similar approach, are also suitable for treating a vertebral blockage.

Depending on the individual case, painkillers such as non-steroidal anti-inflammatory drugs (NSAIDs) can also be used for short-term relief of pain and inflammation. We may also prescribe muscle relaxants to reduce the muscle tension often associated with a vertebral blockage.

In some cases, we can administer injections directly to the blocked area or around the nerve roots to reduce pain and inflammation. Simply contact us to make an appointment! After a thorough examination, we will address your findings.

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What is the thoracic spine?

The thoracic spine is the middle section of the spine. It extends from the lower neck to the lower back. The thoracic spine consists of 12 vertebrae, which are referred to as T1 to T12. These vertebrae are larger and more stable than those of the cervical spine, but smaller than those of the lumbar spine.

The thoracic spine forms the connection between the upper body and the trunk. It supports the ribs and the sternum, which makes it crucial for breathing. It also enables movements such as bending, twisting and stretching the upper body.

Overview: Common complaints of the thoracic spine

Discomfort in the thoracic spine can cause a variety of symptoms that can interfere with daily life. Common complaints that can be associated with problems in the thoracic spine include:

Back pain
This is one of the most common symptoms. The pain can be localized or spread to other areas of the back.

Stiffness
People with thoracic spine problems often notice stiffness in the upper back. This can restrict movements such as bending and twisting.

Shoulder and neck pain
Pain in the shoulders and neck can also originate from the thoracic spine. These areas are interconnected and can affect each other.

Numbness and tingling sensations
Compression, for example, can irritate nerves that emerge from the thoracic spine. This can result in numbness, tingling or weakness in the arms and hands.

Headaches
Muscle tension in the upper back and neck area and problems with the thoracic spine often cause (tension) headaches.

Important for you to know: The symptoms can always vary. Not everyone affected by problems in the thoracic spine experiences all of these symptoms – nor do they experience them with the same intensity. Other factors can also trigger the symptoms.

What is chiropractic?

Chiropractic is a form of manual medicine that aims to diagnose and treat functional disorders of the musculoskeletal system. It includes techniques such as manual mobilization, manipulation, muscle stretching and strengthening as well as soft tissue techniques. The aim is to relieve pain, improve mobility and optimize the body’s ability to function. At our private practice for orthopaedics and traumatology in Frankfurt, we often use chiropractic for back, neck and joint complaints.

A colloquial term for a well-known chiropractic technique is “adjusting” (in technical jargon: manipulation). This is a quick, controlled movement. It aims to bring a restricted or blocked joint back into its normal position or to restore normal mobility. During the adjustment, we apply targeted pressure to the affected joint and mobilize it with a short, precise impulse. A characteristic “cracking” sound can often be heard. This is caused by gas bubbles escaping from the joint fluid.

Chiropractic treatment of the thoracic spine: how manual techniques can help you

Chiropractic treatment of the thoracic spine can be useful for various complaints. These include pain, restricted movement, poor posture, muscle tension or rehabilitation measures following injuries or operations. We also often use it to treat chronic complaints. Whether we use chiropractic treatment depends on various factors – e.g. the type and cause of your complaints, your medical history and your general state of health.

If you are eligible for this type of treatment, chiropractic therapy for the thoracic spine can have various positive effects:

Relief from pain
Through targeted manipulation and mobilization techniques, we can reduce pain in the thoracic spine. We do this by restoring the normal mobility of the vertebral joints and releasing muscular tension.

Improving mobility
Chiropractic techniques can help to improve the mobility of your spine. This can have a positive effect on your posture and ability to move freely.

Correction of misalignments
In the case of vertebral blockages or misalignments in the thoracic spine, chiropractic therapy can help to correct these through targeted manipulation and bring the spine into optimal alignment.

How does chiropractic treatment of the thoracic spine work?

The procedure for chiropractic treatment of the thoracic spine varies depending on your individual complaints. As a rule, we begin the session with a thorough medical history and examination in our private practice for orthopaedics and traumatology in Frankfurt. Here we analyze your symptoms and identify possible causes for the complaints. We then ensure that the treatment is appropriate for you and meets your needs.

Based on this diagnosis, we develop an individual treatment plan, which may include various manual techniques. These include, for example, manipulations, mobilizations, stretching exercises and muscular strengthening exercises.

Chiropractic thoracic spine Frankfurt

Dr. Tabrizi is your experienced orthopaedist and chiropractic doctor in Frankfurt. He offers you a variety of chirotherapeutic techniques to improve your health and well-being – e.g. for complaints of the thoracic spine. His focus is on a thorough diagnosis and individual treatment planning.

Simply contact us to make an appointment! Together we will address your back problems.

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What are intervertebral discs?

Intervertebral discs are structured, cartilaginous “cushions” between the individual vertebrae in the spine. They are designed to support pressure and weight while allowing the spine to be flexible.

When you move, they are compressed and then stretched apart again, allowing you to move in different ways. The intervertebral discs also act as shock absorbers to absorb shocks and stresses placed on the spine.

Intervertebral discs are structured as follows:

Outer fibrous ring (annulus fibrosus)
The outer ring of the intervertebral disc consists of strong, fibrous tissue and surrounds the inner core. This ring serves to support the inner, softer substance and keep the disc stable.

Inner gel nucleus (nucleus pulposus)
The inner part of the intervertebral disc consists of a gel-like substance containing water and proteins. This nucleus is elastic and enables the intervertebral disc to deform and absorb loads when the spine moves.

What is a disc protrusion?

In a disc protrusion, part of the disc between the vertebrae in the spine pushes outwards. This occurs when the outer fibrous ring of the intervertebral disc is weakened or cracked and the inner gel core partially protrudes into the outer area of the intervertebral disc – but without breaking through the outer shell.

A bulging disc can cause pain and discomfort as the protruding part of the disc can press on nearby nerve roots or other anatomical structures. Symptoms can vary from person to person and can cause pain, numbness, tingling or weakness in the affected areas of the body.

What are the causes of a disc protrusion?

A protrusion of the intervertebral disc can be caused by various factors and risk factors. Such a finding is often not attributable to a single cause. In many cases, there is also a combination of different factors.

Typical causes and risk factors include

Age
Over the years, the intervertebral discs undergo a natural process. They lose elasticity and become more susceptible to degeneration, which increases the risk of protrusion.

Stress and overload
Repetitive strain and overloading of the spine, particularly in occupations or activities that require heavy lifting, severe bending or twisting of the spine, can stress the discs.

Injuries
Acute injuries or trauma, such as falls, accidents or sports injuries, can damage the discs and trigger a protrusion.

Poor posture and body mechanics
Poor posture and inadequate body mechanics, e.g. when lifting, can also increase the strain on the intervertebral discs.

Being overweight
Obesity increases the strain on the spine and can also lead to a bulging disc.

Genetic predisposition
There is evidence that genetic factors may play a role in susceptibility to intervertebral disc disease. If you have a family history of disc problems, you may have an increased risk of developing the condition.

Smoking
This can reduce blood flow to the intervertebral discs and impair the supply of nutrients. This can result in disc problems.

Bulging and herniated discs: what’s the difference?

Bulging and herniated discs are two different conditions related to the discs in the spine. They differ mainly in terms of the severity and type of disc problem.

Bulging disc (disc protrusion)
In a disc protrusion, part of the disc pushes outwards, but without breaking through the outer sheath (the outer fibrous ring). A disc protrusion is often considered less severe than a herniated disc. Therefore, the symptoms are usually less pronounced.

Herniated disc (prolapsed disc)
In the case of a herniated disc, the inner gel nucleus of the disc breaks through the outer fibrous ring and enters the space outside the disc. There it presses on nearby nerve roots or the spinal cord. A herniated disc can cause more severe symptoms than a bulging disc. It can cause more severe pain, numbness, muscle weakness and in some cases even neurological impairment. You can find more information on prolapse in our separate blog post “Slipped disc treatment: these options are available”

A disc protrusion can also be a kind of precursor or forerunner of a herniated disc. If the strain on the disc continues or worsens, the outer fibrous ring can weaken further. As a result, there is a risk that the inner gel nucleus will eventually break through the outer sheath and enter the space outside the disc.

However, not every protrusion necessarily leads to a prolapse. Many people have a disc protrusion without ever developing a herniated disc.

How is a bulging disc diagnosed?

A bulging disc is usually diagnosed through a combination of medical history, physical and imaging examinations. Here are the steps we usually take in our practice in Frankfurt when diagnosing a bulging disc:

Medical history
First, we will ask you about your symptoms and medical history. It is important that you tell us about any pain, numbness, tingling or other complaints relating to your back or extremities.

Clinical examination
The next step is to carry out a physical examination to check the mobility of your spine, muscle strength, reflexes and sensitivity. This will allow us to determine if there are any signs of nerve compression.

Imaging examinations
X-rays of the spine help us to identify changes in the spine, such as osteoarthritis or vertebral fractures. Bulging discs themselves are not normally easy to see on X-rays, as they consist mainly of soft tissue. We therefore use additional radiological procedures in this case. MRI is the most commonly used imaging technique for diagnosing bulging discs. It allows a detailed visualization of the discs and their surroundings. A CT scan can be used to provide additional information about the discs and their effects on the surrounding structures. This is particularly useful when an MRI is not possible or additional information is required.

How can a bulging disc be treated?

The treatment of a bulging disc depends on the severity of your symptoms, the degree of the bulge and your individual needs. In most cases, treatment begins conservatively with the following measures:

Pain management
We will prescribe painkillers and/or muscle relaxants. These medications can help with muscle tension and spasms caused by the bulging disc.

Injections
Depending on your individual findings, we can also administer epidural steroid injections into the area around your affected disc. Bulging discs can lead to inflammation in the area of the affected disc. Inflammation can cause pain and press on nearby nerve structures. The injected steroids are anti-inflammatory drugs that can reduce the inflammatory reaction in the area of the spine. This can also reduce the intensity of the pain. Less pain and inflammation can increase the mobility of the spine and allow you to perform everyday activities better.

Physiotherapy
Targeted physiotherapy can be helpful in strengthening the back muscles, stabilizing the spine and promoting correct posture. Physiotherapists can show you techniques to relieve pain and improve mobility.

Heat or cold applications
You can also use heat or cold applications to combat the symptoms. Some people prefer heat, while others benefit from cold. It is important to choose the method that is best suited to the individual’s discomfort.

Ergonomic adjustments
Changing workplace conditions (such as your desk chair and monitor height), for example, can also help to promote better posture and avoid unnecessary strain.

Weight management
If obesity is a contributing factor to bulging discs, weight loss is recommended. This will reduce the strain on your spine.

Treating a bulging disc: Further supportive therapy options in our practice in Frankfurt

Kinesio taping
This is a technique in which we apply special medical and elastic tapes to your skin. We use taping to treat various muscle and joint problems or to support their therapy. Kinesio taping can – in addition to conservative treatment – help to relieve pain and improve the stability of the surrounding muscles. The tapes lift your skin and promote blood circulation. They can relieve the muscles and spine and reduce the pressure on the diseased disc. This in turn can help the spine to improve functionality.

Acupuncture
In this alternative treatment method from Traditional Chinese Medicine (TCM), we place thin needles at specific points on your skin to relieve pain and promote overall health. Acupuncture can release endorphins. These are your body’s own pain-relieving substances. These help to reduce pain associated with bulging discs. The treatment also helps to relieve muscle tension. This can be beneficial for disc protrusions, which are often accompanied by tense muscles. The stimulation of acupuncture points can promote blood circulation and improve the supply of nutrients to the intervertebral disc.

Treating a bulging disc in Frankfurt

As you can see: There are various ways to treat a bulging disc. Usually, this does not require surgery. The combination of treatment options depends on your individual situation and your symptoms.

Our top priority is to develop an optimal conservative therapy strategy to minimize the pain and impairment caused by the disc protrusion as much as possible. Do not hesitate to contact us – we are your experts for spinal therapy in Frankfurt!

Image sources: 377073510 © utah51 | 433581203 © dbayan | stock.adobe.com

Lower back pain: Possible orthopaedic causes

Sacroiliac joint syndrome (SIJ syndrome)
Pain in the lower back is often caused by sacroiliac joint syndrome. The sacroiliac joint connects the spine to the pelvis and is also known as the sacroiliac-iliac joint. Compared to other joints, the SIJ has limited mobility as it is held taut by strong ligaments. A blockage of the SIJ, which can be caused by prolonged incorrect posture, overloading or accidents, for example, can result in pain and restricted movement. In this case, the joint surfaces of the SIJ shift against each other and also become blocked due to increased muscle tension.

Slipped disc
A slipped disc, medically known as a prolapse, can also affect the lumbar spine (lumbar disc herniation). The gelatinous core of an intervertebral disc breaks through its fibrous ring and presses on the nerves, which typically causes pain that can radiate into the legs and feet. Sensory disturbances such as tingling or numbness in the leg also occur frequently. The pain intensifies when coughing, sneezing and during movement. Poor posture and incorrect movements are the main causes of a herniated lumbar disc.

Wear and tear on the spine
Over the years, the joints of the spine wear out. In some cases, pronounced age-related joint wear occurs, which can be accompanied by unpleasant pain in the lower back. In such situations, osteoarthritis may also be behind the symptoms.

Spinal canal stenosis
The spinal canal runs through the spine and houses the spinal cord. It carries nerve signals back and forth between the brain and the body. In the case of spinal canal stenosis, the canal is narrowed at certain points and exerts pressure on the spinal cord and nerve roots. This can cause pain in the sacrum area.

Curvature of the spine
In scoliosis, the natural alignment of the spine is disturbed. In this clinical picture, the spine sometimes leans visibly to the left or right. This lateral curvature can also cause pain in the lower back. Tension and a tilted pelvis are also often associated with scoliosis.

Spondylolisthesis
If the vertebrae are unstable, they can shift more easily. While some sufferers may have no or only minor symptoms, others may experience back pain when straining or making certain movements. In some cases, sensory disturbances and paralysis can also occur if a displaced vertebra presses on a nerve root.

Muskelverspannungen
Manchmal sind es auch verspannte Muskeln, die Schmerzen im unteren Rücken verursachen. Sie resultieren oft aus Fehlhaltungen oder Bewegungsmangel.

Muscle tension
Sometimes it is also tense muscles that cause pain in the lower back. It often results from poor posture or lack of exercise.

Treating lower back pain: how we can help you at our practice in Frankfurt

Depending on your findings, we can help you with various therapies at our private practice for orthopaedics and traumatology in Frankfurt. We can treat your lower back pain with the following methods:

Neural therapy
In neural therapy, we inject local anaesthetics and anti-inflammatory substances near nerves or hardened muscles. Neural therapy can help with lower back pain by reducing inflammation and muscle tension.

Segmental therapy
Segmental therapy is a form of manual therapy that focuses on the targeted treatment of specific spinal segments and their effects on the body. Through targeted exercises and mobilisation, we can use segment therapy to strengthen your back muscles and realign the spine. In this way, we can relieve pain and improve the function of the lower back.

Infiltrations close to the spine
In this specialised treatment, we inject special therapeutic substances into the area near your spine. There are different types of spinal infiltrations, including epidural injections (into the epidural space around the spinal cord), facet joint infiltrations (into the small joints between the vertebrae) and sacroiliac joint infiltrations (into the joints between the sacrum and the pelvic bones). We can use these procedures for various back problems such as herniated discs, osteoarthritis or inflammation to relieve your pain and improve your symptoms.

Chiropractic therapy
This is based on manual techniques in which we use our hands to apply targeted movements, pressure or manipulation to the affected tissue. This enables us to improve the function and mobility of the affected structures. Chiropractic can help with lower back pain by correcting misalignments of the vertebrae or joints that may be the cause of the pain. We can also use it to release muscle tension and blockages that can trigger lower back pain. Manual therapy can also be used to increase the mobility of your spine and joints, which can relieve pain and improve function. We can also promote blood circulation and metabolism in the affected area to support healing.

Traction treatments
Traction therapy uses traction forces on the spine or other parts of the body to treat certain orthopaedic problems. For lower back pain, traction treatments can reduce pressure on the discs and create space for the nerve roots. We stretch your muscles and ligaments to relieve tension and improve flexibility. Traction treatments can also increase blood flow to the affected area, which promotes healing and reduces inflammation.

Kinesio taping
Kinesio taping is a therapy method in which we apply elastic, self-adhesive tapes to your skin in a specific system to treat various muscular and orthopaedic problems. These tapes are specially designed to lift the skin and apply gentle tension to the underlying muscles and tissues without restricting your freedom of movement. We can use taping to relieve your lower back pain. The tapes provide gentle support and reduce tension in the affected muscles. They can also help to increase the stability of your spine, especially in the case of minor injuries or muscle tension in the lower back. The procedure can also activate circulation in the affected area to help heal tissue damage. We can apply the kinesio tapes to help you adopt a more correct posture and avoid the misalignments that can cause your back pain.

Acupuncture
We like to use this traditional Chinese healing method in orthopaedics to relieve pain and treat musculoskeletal problems. For the treatment, we place fine needles at specific points on your skin, the so-called acupuncture points. These are located along the energy pathways in the body, known as meridians. The treatment is also indicated for lower back pain. The needles can stimulate the release of the body’s own pain-relieving substances, such as endorphins, and thus reduce acute or chronic pain. They can also relieve muscle tension in the lower back, which leads to improved blood circulation and loosening of your affected muscles. In Traditional Chinese Medicine (TCM), acupuncture is also believed to harmonise the flow of energy (Qi) in the body. Blockages or stagnation of Qi can cause pain and the needles can release these blockages. Acupuncture can also reduce inflammatory processes in the body that can cause pain and discomfort in the lower back.

Lower back pain treatment: We are here for you at our practice in Frankfurt!

As you can see: There are many different causes of lower back pain – and just as many treatment options! At our orthopaedic practice in Frankfurt, we will examine you in detail and check where your pain is coming from. After a thorough diagnosis, we will determine which treatments are best suited to your individual symptoms and draw up a personalised treatment plan. Feel free to contact us to tackle your pain!

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What are intervertebral discs and what is their function?

The intervertebral discs act as a kind of shock absorber and allow the spine to move in almost all directions due to their flexible shape. Each disc is located between two vertebrae of the spine, with the exception of those between the first and second cervical vertebrae and between the occipital bone (part of the skull) and the first cervical vertebra.

Each intervertebral disc consists of an outer fibrous ring, also known as the annulus fibrosus, and an inner gelatinous nucleus, known as the nucleus pulposus. The outer fibrous ring is made up of individual cartilage cells (fibrocartilage) and resembles tight connective tissue. These cells are surrounded by cartilage ground substance and lie between bundles of collagen fibres, which gives them a high tensile strength. The inner gelatinous nucleus is soft and flexible, which enables it to move towards the stretched side when the spine bends.

The intervertebral discs are attached to the end surfaces of the overlying and underlying vertebral bodies by a layer of cartilage. Their wedge-shaped form adapts to the natural curvature of the spine.

Slipped disc: When the soft core of an intervertebral disc protrudes from its normal position

A slipped disc occurs when the soft gelatinous nucleus protrudes from the disc due to damage to the fibrous ring or its instability. In some cases, the nucleus may even protrude through the fibrous ring. If the nucleus leaves the disc, there is a risk that it will compress the spinal cord and the spinal nerves emerging from the vertebrae. This can lead to pain and impairment of the spinal cord as well as neurological problems. A slipped disc can cause burning pain, tingling or a feeling of running ants in the arms and legs, numbness or even paralysis of the extremities. However, there are also cases in which patients have a slipped disc without noticing any obvious symptoms.

How does a slipped disc occur?

A slipped disc usually occurs due to degeneration or damage to the intervertebral disc. Common causes are

Age-related wear and tear
The natural ageing process can cause intervertebral discs to lose elasticity and become drier. This makes them more susceptible to tears and leaks of the gelatinous nucleus.

Traumatic injuries
A fall or accident, for example, can damage the outer fibrous ring and cause a herniated disc.

Excessive strain
Heavy lifting, poor posture and repetitive movements that strain the spine can put excessive strain on the discs and lead to wear and damage.

Smoking and poor diet
Smoking and an unhealthy diet can reduce blood flow to the intervertebral discs and affect their health.

Genetic predisposition
Some people are naturally more susceptible to disc degeneration. A corresponding genetic predisposition can increase the risk of slipped discs.

Slipped disc and bulging disc: what is the difference?

It is crucial to differentiate between a slipped disc (prolapse) and a bulging disc (disc protrusion). In a disc protrusion, the inner disc tissue moves outwards without the fibrous ring rupturing. This can cause symptoms similar to a slipped disc. A classic example is lumbago, which is accompanied by sudden, severe pain in the lumbar vertebrae.

How is a prolapse diagnosed?

The diagnosis of a slipped disc usually involves several steps and examinations to accurately confirm the condition and assess its severity:

Medical history
We begin with a detailed interview to gather information about your symptoms, the duration of your symptoms, any injuries or previous illnesses and your family medical history.

Physical examination
This is followed by a physical examination. We check your muscle strength, reflexes, sensitivity and mobility of your extremities and back.

Imaging procedures
X-rays can provide information about the general structure of the spine. Magnetic resonance imaging is better suited for diagnosing a slipped disc. An MRI scan provides detailed images of the spine and the intervertebral discs. This allows us to precisely determine the location and severity of the slipped disc. In some cases, a computed tomography (CT) scan can complement the diagnosis to provide additional information about the disc and its effects on the surrounding structures.

How can a slipped disc be treated?

The combination of medical history, physical examination and imaging allows us to precisely locate the slipped disc, assess its severity and create an individual treatment plan for you. We use the results of the diagnosis to determine whether conservative treatments are sufficient or whether surgical intervention is required. Common treatment options at our orthopaedic practice in Frankfurt include

Conservative treatment
This involves pain management. We can prescribe painkillers, anti-inflammatories and/or muscle relaxants to alleviate your symptoms. Targeted exercises as part of physiotherapy and/or osteopathy have also proven effective. These can strengthen your muscles, improve mobility and reduce pain. Heat and cold applications can also help.

Injection therapy (epidural steroid injection)
To reduce inflammation and relieve pain, we can inject anti-inflammatory medication into the epidural space. This is the space between the outer covering of the spinal cord (dura mater) and the inner part of the spinal column, where the nerve roots and blood vessels are located. Steroids have anti-inflammatory properties. When we inject them into your epidural space, the active ingredients can reduce inflammation that can be associated with herniated discs. This inflammation is often a major cause of pain associated with spinal problems. By reducing the inflammation, the pain in the affected area is usually also reduced.

Surgical options
If conservative measures or injection therapy are not sufficiently effective or if there are severe neurological symptoms (e.g. paralysis), surgery may be considered. During disc surgery, the affected part of the disc is removed. This can be performed in various ways, including minimally invasive procedures.

Treat a slipped disc: Further supportive treatment options in our practice in Frankfurt

Kinesio taping
Kinesio taping is an alternative medical technique in which we apply special elastic tapes to your skin. In this way, we can treat various muscular and joint-related problems. In some cases of slipped discs, kinesio taping can help to relieve pain and improve mobility in addition to conservative treatment. This is due to the fact that the tapes lift the skin and promote blood circulation. They can also support the affected muscles, relieve pressure on the spine and reduce pressure on the affected disc.

Acupuncture
Acupuncture can also be useful as part of comprehensive pain treatment for a slipped disc. The insertion of special needles can help to relieve pain associated with a slipped disc by releasing endorphins and influencing pain conduction. Acupuncture can also help to relieve muscle tension, which often occurs with slipped discs, and thus also improve mobility. The stimulation of certain acupuncture points can also promote blood circulation in the affected area. This can also support healing.

Slipped disc treatment in Frankfurt

As you can see: The choice of treatment measures depends on your individual situation and your symptoms. We work closely with you to treat your slipped disc. We develop the best possible conservative treatment strategy and do everything we can to minimise the pain and limitations caused by the prolapse. Feel free to contact us – we are your experts in Frankfurt for spinal therapy!

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Neural therapy according to Huneke: What is it?

Neural therapy is a modern regulatory therapy in which we act on the autonomic nervous system by briefly anesthetizing a specific part of the body. With this procedure, we can stimulate your blood flow and interrupt persistent nerve signals. These signals are mainly sent by overstimulated nerves and can cause pain, for example.

Normally, the body is able to relieve the pain stimulus by repairing the damage or allowing the inflammation to subside. However, if this does not succeed, the persistent stimulus can cause the body to store it in pain memory. As a result, the pain becomes chronic.

By interrupting the stimulus with Huneke’s therapy, the organism can restore its self-regulation and balance the nervous system. For this purpose we use the local anesthetic procaine, which has anti-inflammatory and analgesic effects. It can also reduce local tissue stress. It inhibits the transmission of stimuli to the nerves, thus blocking the perception of pain at the site.

In what cases is neural therapy useful?

Therapeutic local anesthesia can help with a variety of conditions, such as acute and chronic pain, especially of the musculoskeletal system (back pain, neck pain, joint pain, or headaches). It can also help with neuralgia, nerve inflammation or postoperative pain.

Forms of neural therapy

Local therapy
Here, we inject the active ingredient into the exact spot where you have pain. The therapeutic local anesthesia interrupts the pain stimulus. As a rule, rapid relief occurs. Typical sites for local therapy are tendon insertions, periosteum, joints and areas where your muscles are severely hardened.

Segmental therapy
In segmental therapy, we inject the local anesthetic not only into the area to be numbed itself, but also into the segment associated with it. Segments represent specific organ systems that may be connected to superficial regions of the body via nerve connections. When the anesthetic is injected under the skin, it also acts on these nerve pathways leading to the internal organs, thus promoting the healing process.

Neural therapy Frankfurt

For example, as part of spine treatment, we offer neural therapy as a treatment option in our practice in Frankfurt. Dr. Nader Tabrizi and Dr. Chwalek are your experienced contacts. Please feel free to contact us to make an appointment!

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