For patients · Reading time 8 minutes · Version 1.2 · Translation of the German page, medically reviewed on 5 October 2026 · the German version is authoritative · Diese Seite auf Deutsch

Back pain: it is not always the disc

Almost everyone has back pain at some point. Mostly it comes from muscles, joints and ligaments, is unpleasant but harmless, and goes away by itself. Here you can find out when you need help, which pain pattern fits you and what you can do yourself.

The essentials in three sentences

  1. Without warning signs, back pain is almost never dangerous, even when it hurts a lot.
  2. Movement is the treatment. Bed rest and taking it easy prolong the pain.
  3. A finding on an MRI scan often does not explain the pain: most people without complaints have one too.

1

Is it dangerous? The signpost

These signs are rare. If one applies, you should not start with exercises but get examined.

Tick whatever applies. If nothing applies, leave everything blank.

No warning sign: you can start yourself

The vast majority of back pain without warning signs is unpleasant but harmless, and improves clearly in the first weeks. If it is not better after two to three weeks, come to the practice.

Your ticks are neither stored nor sent anywhere. The list does not replace an examination: if you are unsure or feel very ill, call.

2

Which pain pattern fits me?

Five common patterns. For each: how to recognise it, what helps, and where to find good exercises to join in.

Lumbago, the sudden "crick in the back"

Medical term: acute low back pain

Where: Lower back, without radiating into the leg

How to recognise it

  • Shoots in suddenly, often when bending, lifting or twisting
  • The back is rigid, you stand crooked or can hardly straighten up
  • Better at rest, a stab with certain movements

What helps

  • Warmth: hot-water bottle, grain cushion or a warm bath
  • Lying on your back with the lower legs on a chair, for short breaks
  • Walk again as soon as possible. Walking is the best first exercise
  • No bed rest. It prolongs the pain

Come to the practice: If it is not clearly better after two to three weeks, or a warning sign appears.

Exercises to join in

These videos and pages are in German. The exercises in the videos can be followed by watching; English-language sources may be added later.

The pictures are patterns to recognise, not a diagnosis. Exercises may pull, but must not stab. If the pain gets stronger while exercising or runs further into the leg, stop that exercise.

The videos play directly on YouTube, without a detour through a page with a cookie prompt. They come from physiotherapists, clinics and German health insurers; YouTube may show advertising before each video. We have no influence on its content and receive nothing for it. The text pages come from the Austrian health ministry and German statutory health insurers.

3

“But the MRI says something”

Many people are alarmed by their scan report. Yet the same changes are found in people who have never had back pain. Set your age.

Out of 100 people of this age who have no back pain at all, the MRI shows this in so many:

80 Disc degeneration

60 Bulge of a disc

36 Disc herniation

A finding on the scan therefore often does not explain the pain. It may have been there for years. Without warning signs an MRI does not help in the first six weeks, but it can frighten.

Source: Brinjikji and colleagues 2015, 33 studies with 3110 people without complaints.

4

What can I do myself?

Ordered by how well it is supported by studies.

Keep moving

Well established

The most important sentence on this page. Go about your daily life as well as you can. Pain with movement does not mean something is breaking.

Exercise regularly

Well established

For pain lasting more than three months, exercise programmes reduce pain by an average of 15 out of 100 points. Which exercises matters less than sticking with them.

Warmth

Some studies, small effect

Eases the first days and makes moving easier.

Sleep and stress

Some studies, small effect

Anyone who sleeps badly and is under pressure feels pain more strongly. That is not imagination but how the nervous system works.

Painkillers for a few days

Some studies, small effect

They heal nothing. Their purpose is to let you move again. One option is ibuprofen 400 mg, up to three times a day with food, as in the package leaflet for at most four days without medical advice. If you need it longer or this dose is not enough, come to the practice. Please ask first if you have a stomach ulcer, kidney or heart weakness, take blood thinners, or are pregnant.

Bed rest and taking it easy

More likely to harm

Anyone who lies down and waits has pain for longer and loses strength. Short breaks yes, days in bed no.

5

So that the pain does not stay

Whether back pain becomes chronic is rarely decided at the spine. It is decided by thoughts, habits and strains. That is the good news: you have influence over these.

Which sentences do you know from yourself? Be honest, nobody is reading along.

Five steps that are in your own hands

  1. 1Understand

    Pain does not measure damage. After weeks and months the nervous system has often become more sensitive than necessary. That can be unlearned.

  2. 2Pace yourself

    Ten minutes every day rather than two hours once a week. Stop before it gets too much, not after.

  3. 3Choose a goal

    Not "being pain-free", but something you want to do again: walk to the baker, work in the garden, lift your grandchild.

  4. 4Plan for setbacks

    Bad days are part of it and do not mean it was all for nothing. The next day you carry on with half the amount.

  5. 5Accept help

    Physiotherapy, rehabilitation sport, pain management in a group: ask us what suits you.

6

From other healing traditions

Further reading, not a recommendation. Each item says how well it is supported by the standards of Western studies.

Yoga

India

Some studies, small effect

For back pain lasting more than three months, yoga slightly improves pain and mobility in studies. It works much like other exercise programmes. A gentle form without ambition matters.

Tai chi and qigong

China

Some studies, small effect

Slow, flowing movement. Good for people who hardly move any more for fear of pain: the start is very gentle.

Acupuncture

China

Some studies, small effect

For chronic pain of the lumbar spine, German statutory health insurance pays for acupuncture. In the large German studies it helped better than usual treatment. It helped just as well, though, when the needles were not placed at the traditional points.

Manipulation and osteopathy

Europe, USA

Some studies, small effect

Can relieve in the short term and works about as well as exercises in studies. The difference: exercises you can do yourself every day. Jerky manipulations of the neck should be avoided.

Cupping

China, Middle East, Europe

Few, small studies

Small studies show brief relief. The bruises are harmless. Not with blood thinners.

Devil's claw and willow bark

Southern Africa, Europe

Few, small studies

Herbal remedies that worked slightly better than a placebo in the short term in a few studies. Herbal remedies also have side effects and interactions: please tell us what you take.

Ayurvedic oil massage

India

Not supported by Western studies

Soothing and relaxing; a lasting effect on back pain has not been shown. Harmless as an addition.

7

Quick check: what will you take away?

Five questions for anyone who likes. No marks.

1. You have lumbago without warning signs. What is best?

2. The MRI of a 50-year-old without any back pain says "disc bulge". How common is that?

3. You suddenly feel numbness between the legs and cannot hold your urine. What do you do?

4. What best protects against back pain becoming chronic?

5. The pain sits on one side above the buttock and stabs when turning in bed. What is most likely?

No marks, no time pressure. Your progress is kept on this device only.

What this page cannot do

It makes no diagnosis and does not replace an examination. The note on the painkiller is a general recommendation: if you have pre-existing conditions or take other medicines, ask at the practice or pharmacy first. The pain patterns are patterns to recognise. If your pain fits none of them, is unusually severe or you are worried, come to the practice. This page is a translation of the German original, which is the medically reviewed version; where the two differ, the German text applies.

Version 1.2 · Translation of the German page, medically reviewed on 5 October 2026 · the German version is authoritative

Reviewed by Stefan Höhne, Facharzt für Allgemeinmedizin. Numbers, doses and emergency numbers are identical to the German version and checked automatically. If anything is unclear, the German text applies.

Sources: German National Disease Management Guideline on non-specific low back pain (2017); Brinjikji and colleagues 2015 (findings in people without complaints); Hayden and colleagues, Cochrane 2021 (exercise for chronic low back pain). Medically responsible: Stefan Höhne, specialist in general practice (Facharzt für Allgemeinmedizin). This page is independent: no sponsor, no advertising, no brand names. All patient information (German)