Back pain

Definition

What is back pain?

Back pain refers to all pain conditions that occur in different areas of the back. Back pain is a common health problem that affects people of all ages and is one of the most widespread conditions in the world. It occurs when muscles, fascia, ligaments, intervertebral discs, nerves or vertebrae in the spine are affected. Back pain is assessed according to various criteria.

Position

• Lower back pain in the area of the lumbar spine (lumbar spine)
• Middle back pain in the thoracic spine (thoracic spine)
• Back pain in the upper back in the area of the cervical spine (cervical spine)

Duration

• Acute back pain: The back pain lasts for a maximum of 6 weeks.
• Subacute back pain: The back pain persists for 6-12 weeks.
• Chronic back pain: The back pain lasts longer than 12 weeks.

Frequency

• One-off acute back pain
• Recurring back pain
• Persistent back pain

Intensity

• Back pain is hardly noticeable
• Intermittent severe back pain
• Moderate back pain
• Unbearable back pain

Causes

• Non-specific cause: No exact cause can be identified.
• Specific cause: Here, exact causes of back pain can be identified, such as muscle tension in the lower back, vertebral blockage, SI joint syndrome, slipped disc, osteoporosis, etc.

Causes of back pain

Back pain is one of the most common complaints in our modern society and can increasingly be attributed to changes in environmental conditions caused by the widespread sedentary lifestyle and lack of exercise in everyday life. These factors interact on several levels and have a negative impact on the health of the spine and the surrounding muscles, fascia, ligaments and intervertebral discs.

Today's working and living environment is fundamentally different from that of previous generations and our ancestors, who were hunter-gatherers. Technological advances have greatly reduced physically strenuous work, but have also restricted the natural variety of movement. The use of computers, smartphones and automation means that many activities are performed in static and often unphysiological positions. In addition, environmental factors such as noise, stress and time pressure make it difficult to consciously care for the musculoskeletal system, which has a negative impact on the back in the long term. Furthermore, the hard, flat floors and the wearing of shoes with a stiff sole have also changed the gait pattern and the strain on the musculoskeletal system, which has a negative effect on the back. The effects of this on the development of back pain are described below.

Most people spend a large part of their day sitting down - whether in the office, on the way to work or in their leisure time. This prolonged static posture puts strain on the spine and often leads to muscular imbalances. While the trunk and back muscles are strengthened by movement, they become slack when sitting for hours on end, which can lead to pain (e.g. back muscle pain). An unergonomic sitting posture is particularly problematic, as it not only causes back pain (e.g. low back pain or lumbar spine pain), but also long-term damage such as slipped discs. The effects of this on the development of back pain are described below.

Lack of exercise and a sedentary lifestyle

The modern way of life, which is characterised by a lack of exercise and a sedentary lifestyle, places incorrect strain on the musculoskeletal system. The lack of exercise and sedentary lifestyle lead to physical adaptations that can cause severe back pain. The following changes play a significant role and are therefore the causes of unpleasant back pain.

• Weakened muscles and muscular imbalances

  Regular exercise is essential to strengthen the core and back muscles and thus stabilize the spine. However, a lack of exercise weakens the muscles. The deep stabilizers in particular, such as the deep abdominal and back muscles, lose strength. At the same time, muscular imbalances can develop. Certain muscle groups, such as the chest muscles, are shortened by the sitting posture, while others, such as the back muscles, are overstretched and weakened. These imbalances increase the strain on the spine and cause back problems such as low back pain, neck tension or a twinge in the back.
  

• Poor posture and overloading of the spine

  When sitting for long periods, especially in an unergonomic position, the natural S-shape of the spine is often not maintained. A curved posture (hunched back) or leaning on one side puts one-sided strain on the intervertebral discs and vertebral joints. The lack of movement exacerbates this effect, as the spine is hardly dynamically relieved. Persistent poor posture leads to chronic back pain and can result in long-term structural damage, such as herniated discs or vertebral arthrosis. For this reason, the cause of back pain should be rectified as quickly as possible to prevent chronic back pain from developing.
  

• Foot malpositions

  The connection between the feet and the back may not be obvious at first glance, but it is crucial for the entire body statics. Foot misalignments such as flat feet, fallen arches and hollow feet have a negative impact on body statics and can cause or exacerbate back pain. They lead to uneven weight distribution, which can cause the pelvis to tilt and the spine to lose its natural shape. This results in poor posture, which places particular strain on the lumbar spine. Foot misalignments cause muscular imbalances, as some muscles are overloaded and others weakened, which affects the stability of the spine and the intervertebral discs. Furthermore, an intact arch of the foot acts as a shock absorber. This function is lost if the foot is misaligned, which means that the shocks are transmitted directly to the joints and spine with every single heel strike. In the long term, this promotes wear and tear and pain. In addition, an altered gait pattern leads to asymmetrical movements, which can cause tension and chronic back pain.
  

• Restricted blood circulation and intervertebral disc supply

  The intervertebral discs, which act as shock absorbers between the vertebrae, are dependent on a good supply of nutrients. This mainly occurs through diffusion, which is stimulated by movement. A lack of movement disrupts this process, causing the intervertebral discs to dry out and lose elasticity. This can not only cause pain in the back (e.g. back pain in the lumbar vertebrae), but also increase the likelihood of herniated discs.
  

• Shortened and tense structures

  The lack of physical activity can cause certain muscle groups to shorten, particularly the hip flexors and the muscles at the back of the thighs. These muscles influence the pelvic position, which directly affects the load on the spine and can therefore trigger or worsen back pain. Additionally, prolonged sitting often results in tension in the neck and shoulder muscles, which can lead to back pain in the thoracic and cervical spine as well as headaches.
  

• Fascia dysfunction

  Fasciae change their original structure and can become brittle if they are subjected to irregular and unphysiological strain. Tension, adhesions and blockages in the fasciae are the result. This increases the tension on the spine and surrounding structures, making them susceptible to inflammation and injury.
  

• Joint stiffness

  Due to a lack of exercise and a sedentary lifestyle, the joints are not moved to the maximum possible range of motion. This results in a natural stiffening of the joints and can lead to back pain when bending over, among other things. Immobile joints increase the force exerted on the spine and surrounding structures, which puts additional strain on them. Joint stiffness can therefore also be a cause of back pain.

Hard, flat floors and stiff, restrictive footwear

Flat, hard floors and inflexible, supportive shoes have a major impact on the musculoskeletal system and can trigger or aggravate back pain. The following factors are key contributors to the occurrence of back pain.

• Reduced shock absorption and increased force effect

  Due to the firmness of hard floors such as concrete or tiles and the stiffness of conventional shoe soles, the impact forces are reflected instead of absorbed with every step. The lack of shock absorption increases the impact force and the strain on the joints and spine. Furthermore, the increased and early application of force shortens the possible reaction time of the responsible muscles. If the muscles cannot tense up in time, the joint in question is insufficiently stabilized, which also leads to incorrect and excessive strain. The muscles around the back and the underlying structures help to protect the spine. In the long term, the lack of cushioning and the resulting increased force can cause wear and tear in the spine and painful overloading.

• Limited foot function and muscle weakness

  Shoes with rigid soles or enhanced supports restrict the feet from utilizing their natural flexibility. This leads to reduced activation of the foot muscles, resulting in a weakening of the foot arch and stabilizers. A weak foot arch negatively influences the entire body posture and can promote poor posture, causing back pain. Moreover, a weakened foot arch alters the load distribution in the legs and spine.
  
  Additionally, altered body posture often leads to compensatory movement patterns. For instance, a pronated foot position can cause the pelvis to tilt and the spine to curve unnaturally. This increases the strain on certain vertebral segments and muscles, which can promote back pain in the long run (e.g., lower back pain or lumbar spine pain). Poor foot function also affects the deep muscles and postural control of the entire body. Since the feet form the basis of posture, imbalances in the foot area can significantly impair the body's ability to maintain spinal stability.
  

• Changed gait and rolling movement

  Inflexible shoes and hard, flat floors affect the natural rolling behavior of the feet. If the feet cannot roll actively and physiologically, the natural sequence of movements is interrupted. Due to the lack of rolling movement, the forces that occur cannot be absorbed properly, which increases the strain on the overlying structures. Furthermore, the muscles responsible cannot stabilize sufficiently when the heel strikes without cushioning, as the force exerted increases rapidly. This causes the foot to drop uncontrollably. The so-called "hinged foot" increases the strain on the entire musculoskeletal system. Instead of a dynamic movement, the step when walking on hard, flat floors and in immobile, supportive shoes often becomes stiff and unnatural, which leads to incorrect load distribution. This incorrect load distribution can extend into the knees, hips and spine, resulting in a variety of back pain (e.g. low back pain, mid-back pain in the thoracic vertebrae, pain in the upper spine in the cervical vertebrae).

Symptoms of back pain

As the causes of back pain can be very individual and there are numerous dysfunctions and symptoms, back pain symptoms can vary greatly. Back pain symptoms can, for example, cause a stabbing sensation in the back, trigger a dull ache or even lead to symptoms of paralysis. Back pain can often also radiate to adjacent regions. The symptoms of back pain often depend on various factors such as pain sensation, cause of the injury, degree of injury, physical constitution, etc. In order to obtain a clear diagnosis, a doctor should be consulted. The symptoms of the most common types of back pain are described below:

Muscle tension
Possible throughout the back. Often in the lumbar region (muscle tension in the lower back) as well as the shoulder and neck area.

• Dull pain
• Pressure pain
• Restriction of mobility

Lumbago
Pain in the lumbar vertebrae (i.e. lower back pain).

• Severe and sudden back pain in the lower back
• Mobility very severely restricted
• Pain eases when lying down with legs elevated

Slipped disc/disc hernia
Often in the lumbar spine with pain in the lower back (i.e. lumbar spine pain or low back pain). Also possible in the cervical spine with pain in the neck.

• Severe back pain
• Pain extending into the buttock or leg, or arm or hand
• Tingling in the leg or hand (pins and needles)
• Symptoms of paralysis
• Feeling of coldness in the buttocks or leg or arm or hand

ISG syndrome
Noticeable in the area of the sacroiliac joint and in the hip area.

• A sudden pain when flexing or rotating the torso
• Blockage in the SI joint area and in the hip
• Pain similar to that of a herniated disc
• Lower right back pain, lower left back pain or even pain on both sides

Help with back pain - conventional therapies

There are several approaches to treating acute and chronic back pain. Some back pain therapies are listed below. The list of back pain therapies is not exhaustive. Various measures can also be combined to treat back pain. A medical consultation is recommended to determine the appropriate therapy for back pain.

• Exercise therapy: Regular physical activity and special exercises to strengthen the back muscles and improve mobility.
  
• Physiotherapy: Professional treatment by physiotherapists who use techniques such as massage, manual therapy and targeted exercises to relieve pain and improve function.
  
• Drug therapy: Use of painkillers for back pain for short-term relief of acute pain. In some cases, muscle relaxants or anti-inflammatory drugs may also be prescribed.
  
• Heat and cold therapy: application of heat (e.g. heat packs, heating pads) or cold (e.g. ice packs) to relax the muscles and reduce inflammation.
  
• Acupuncture: Traditional Chinese method in which fine needles are placed at specific points on the body to relieve pain and promote healing.
  
• Chiropractic: Manual therapy in which chiropractors use targeted hand movements to correct misalignments of the spine and thus relieve pain.
  
• Back school: Special training programs that teach patients techniques for correct posture, movement and back protection.
  
• Occupational therapy: support in adapting everyday life and the working environment to prevent acute and chronic back pain and improve quality of life.
  
• Surgery: In severe cases, such as herniated discs or spinal stenosis, surgical intervention may be necessary. This solution should always be at the end of a series of conservative treatments if these have not led to any improvement.

Unfortunately, these measures often do not lead to a long-term reduction in back pain, as the causes of back pain are not eliminated. The aim of any treatment should therefore be to eliminate the causes of back pain. As described above, the lack of exercise, sedentary lifestyle, hard, flat floors and immobile, supportive shoes should be addressed. The kybun mode of action proves to be a suitable therapy for back pain, which can eliminate the aforementioned causes of back pain.

Help with back pain - how kybun works

The kybun range of products aim to eliminate the harmful effects of hard, flat floors and immobile, supportive shoes and actively tackle the lack of exercise and sedentary lifestyle. The elastic, springy properties of kybun products relieve the musculoskeletal system on the one hand and activate it on the other. The relief ensures that back pain is reduced as a first step. Activation is intended to tackle the causes of current and chronic back pain so that the complaints become a thing of the past in the long term. This makes kybun shoes ideal for back pain, as they help to treat back pain through the following modes of action:

• Promoting physical activity and reducing sedentary behavior

  It is a well-known fact that exercise positively impacts back pain, while inactivity usually worsens the condition. Moderate activity with the elastically-springy kybun products encourages the enjoyment of movement, as walking and standing on the unique material eases the back and surrounding soft tissues. The following outlines the numerous benefits associated with promoting movement. Using kybun products can also reduce the time spent in sedentary activities, preventing harmful shortening and blockages of myofascial structures, which can lead to acute and chronic back pain. Increased walking and standing stretch and lengthen the often shortened hip flexor muscles and the posterior chain with calf and thigh muscles, which can positively influence the angular position of individual vertebrae and the tension and pressure on the surrounding soft tissues.
  

• Activates and strengthens the muscles thanks to its elastic and springy properties

  When standing and walking on elastic, springy material, the entire body has to work on the unique surface so that both the muscles around the feet and the deep muscles of the entire musculoskeletal system are activated and strengthened. This can improve muscle function, which has a positive effect on the stabilization and guidance of the spine and surrounding soft tissue.

Equilibrium and EMG

The ability to maintain balance was measured with a force plate by moving the body's center of gravity from front to back (ant-post) and sideways (med-lat) when standing. At the same time, muscular activity was recorded using electromyography (EMG).

By activating and strengthening the foot muscles, foot misalignments such as splayfoot, flat foot or fallen arches, which are often caused by muscular deficits, can be counteracted. As an intact longitudinal arch reduces the forces generated during heel strike, the individual vertebrae and soft tissue are also relieved. As the foot is also prevented from bending inwards or outwards, the leg axis remains in its physiological position and the back and adjacent structures are protected from additional incorrect and excessive strain. The slow and controlled sinking of the heel into the elastic, springy material creates myofascial pretension in the muscles involved. This pretension and the improved muscular activity allow the spine to be stabilised and guided at an early stage, which also reduces the force exerted on the back and the surrounding soft tissue.

• Reduction of the force exerted by hard, flat floors due to damping effect

  When the heel strikes the ground in kybun shoes, the elastic, springy material is compressed. This rebound effect of the sole means that some of the forces generated can be absorbed and released again for the rolling phase. The force absorption capacity of the kybun sole leads to cushioning and thus protects the back and surrounding structures from excessive force. The reduced impact of force reduces strain and reduces the risk of back pain. Furthermore, the slow sinking of the heel into the elastic, springy material gives the body more time to tense the relevant muscle groups. The improved basic tension of the muscles stabilizes the individual joints and thus reduces the force exerted on the spine and surrounding structures.

Furthermore, as the heel slowly sinks into the elastic, springy material, the body has more time to tense the relevant muscle groups. The improved basic tension in the muscles stabilises the individual joints and thus reduces the force exerted on the spine and surrounding structures.

• Natural foot roll thanks to muscle activation and roll-off function

  When the heel hits the ground in kybun shoes, the elastic, springy material is compressed. This slower sinking into the kybun sole delays the point at which maximum force is applied. This additional time gain helps the muscles to tense up in time to put the foot down in a controlled manner after heel strike. This prevents the damaging collapse of the foot and allows the foot to roll naturally. On the one hand, active rolling over the forefoot transfers the force exerted into the forward movement. On the other hand, the active rolling motion increases the range of motion of the overlying joints, which ultimately leads to rotation of the upper body. The rotation can, for example, relieve back pain in the lower back, muscular tension and blockages. Furthermore, by using the full range of motion of the feet and the joints above them, an active gait is induced, which brings the thigh-hip-back mechanics back into a physiological position. The cooperation of all joints results in an improved distribution of force over the entire body, which ultimately also relieves the back and adjacent structures.

• Care and protection of the facia

  Fasciae practically surround the entire body and are interconnected. They hold our body together and give it its shape. Fasciae are responsible for the transmission of force and the degree of stretch in all movements. They keep the muscle fibers lubricated. If the fasciae are tense, sticky or matted, they can no longer or only partially fulfill their function. A lack of exercise and unnatural movements on hard, flat floors and in immobile, supportive shoes can lead to a change in the fascia structure and thus affect the way it functions. Tense fascia around the back can increase the tension on sensitive soft tissue (muscles, nerves, intervertebral discs, etc.) and thus lead to pain. Tense fascia can also reduce the natural range of motion of the vertebral bodies and surrounding soft tissue. This limitation results in increased use of the remaining possible range of movement. For example, changes in the fascia structure mean that certain muscle groups cannot work to their full range of movement. Similarly, the adhesions of the various fasciae can also involve muscle groups that should not be active for a specific movement. In both cases, this results in incorrect and excessive strain on the individual vertebrae and the surrounding soft tissue. The elastic, springy material promotes movement and ensures natural and physiological strain. This cares for the fascia and protects it from structural changes.
  

• Improved circulation through increased movement activity

  The injured structures in and around the back require numerous nutrients to heal. These nutrients are transported to the relevant tissue by the blood and synovial fluid. In addition, anti-inflammatory substances are transported to the back and the surrounding soft tissue via the blood, while harmful and inflammation-promoting messenger substances are transported away. This constant exchange of fluids thus supplies the corresponding structures. The elastic, springy kybun materials promote movement and thus activate the muscles around the spine. This increases blood circulation, which in turn promotes the benefits mentioned above.
  

• Optimized pressure distribution

  The entire sole of the foot is surrounded by this unique elastic, springy material. This leads to optimized pressure distribution in the feet. As a result, the punctual load on the back (e.g. intervertebral discs) and the surrounding soft tissue can be reduced. In addition, the constant slight movement on the kybun products increases the load-bearing surface, which can also reduce individual pressure points. This can protect the back from overloading and injuries.

Advice on wearing shoes for back pain relief

Before you wear kybun shoes for the first time, you should consider a few tips on how to use them. Correct use can help to relieve back pain. Current and chronic back pain can also be treated with targeted back pain therapy, which is explained in the next section.

• At the beginning, only wear the kybun shoes for as long as your body allows. Take breaks if the back problems (e.g. low back pain) become more severe or if your musculoskeletal system becomes tired. Back pain treatment takes time. The activating properties of kybun products train the muscles, which can lead to so-called initial reactions, especially at the beginning.
  
• If you suffer from back pain, you should mainly walk and stand less. It is not uncommon for people suffering from back pain to complain of back pain when lying down and back pain from lying down, back pain in the morning, back pain when sitting, back pain after sleeping, etc.. All of these static positions usually increase back pain, as the constant and continuous pressure on the intervertebral discs increases back problems.
  
• Try to roll as actively as possible over the forefoot. Increasing the range of motion of the feet also generates more movement in the back, which is particularly helpful for myofascial tension and blockages.
  
• Change speeds when walking. Trotting faster for short periods of time increases the rotation of the spine, which often has a positive effect on back pain. The vibrations of the elastic, springy sole can relieve muscle tension in the back. Tension in the lower back in particular benefits from the trampoline-like movement.
  
• Try the following exercises to boost the effectiveness of kybun shoes and increase the likelihood of recovery. These are intended as a complementary therapy for back pain and should form part of the treatment for back pain.

Exercises that help with back pain

To enhance the effectiveness of kybun shoes and increase the likelihood of recovery from back pain, we recommend performing the following exercises to combat acute and chronic back pain. The exercises also address the causes of back pain. The selection of exercises is not exhaustive and can be supplemented with other back pain exercises. The basic rule for all exercises is that the back problems must not get worse. If one of the exercises increases the pain, it must be discontinued. Soothing and relieving "pain" is desirable. The exercises are generally for back problems (acute and chronic back pain) and not specific to a particular clinical picture. It should also be mentioned that due to the myofascial connection throughout the body, the location of the back pain symptoms does not automatically have to be the location of the causes of back pain. For example, shortening of the hip flexor due to a sedentary lifestyle can lead to low back pain. Treatment therefore focuses on releasing the hip flexor to eliminate the low back pain.

The back pain exercises are divided into the following areas: "Correct walking in kybun shoes", "Muscle length training", "Fascia rolling" and "Strengthening". Ideally, the different areas should be used as complementary therapy for back pain.

Walking the right way in kybun shoes

The quality of each individual step is crucial in the treatment of back pain in order to reduce pain and eliminate incorrect and excessive strain. The kybun shoes therefore offer ideal therapy for back pain.

Active heel strike

• Press your heel deep into the elastic, springy material to feel the cushioning properties of the kybun sole.
• Controlled foot position so that the foot does not tilt inwards or outwards.
• Lower the midfoot and forefoot in a controlled manner to reduce the force exerted on the body.

Active foot rolling

• Actively roll over the forefoot and utilise the maximum range of motion.
• It is important to utilise the maximum range of motion so that there is a physiological connection between the pelvis and the back.

Muscle length training

Muscle length training is of crucial importance in the treatment of back pain, as the pain is often caused by shortening, tension and blockages in the posterior chain (including the sole of the foot, calf and posterior thigh muscles). Targeted stretching exercises can actively tackle the shortening, tension and blockages and are therefore an ideal therapy for back pain.

Child's Pose

• Begin in an all-fours position.
• Move your body backwards by placing your buttocks on your heels and your upper body on your thighs.
• Actively stretch your arms forwards.
• Hold the position for 3 x 30 seconds.
• Perform 1-2 times daily.

Gluteal muscles crosswise

• Start lying on your back.
• Stretch both arms out to the side at a 90-degree angle and place your left leg bent on your right side.
• Press the bent knee down with your right hand.
• Make sure that both shoulder blades remain on the floor.
• 3 x 30 seconds per side.
• 1-2 times a day.

Fascia roller

Fascia training with the fascia roller is important in the treatment of back pain, as this is often caused by shortening, tension and blockages in the posterior chain (including the sole of the foot, calf and posterior thigh muscles). By regularly rolling out the shortened and tense myofascial chain, the fascia roll is suitable as an active therapy for back pain.

Back Muscle Extender

• Start position: On your back with knees bent.
• Place the fascia roll under your back.
• Roll out slowly and in a controlled manner above the buttocks to below the shoulder blade.
• Adapt the pressure to your personal feelings, but go to the tolerable pain threshold.

Gluteal muscles

• Bend both legs and roll out the corresponding half of the buttock with the fascia ball. Increase the pressure by placing the leg on one side. If pain occurs in the wrist, the exercise can also be performed on the forearms.
• Perform the exercise slowly and in a controlled manner
• Adjust pressure to personal feeling, but go up to the tolerable pain threshold.
• Roll out any localised adhesions or hold the position at this point.
• 3 minutes each side.
• Perform 1-2 times daily.

Strengthening

Targeted strength training helps to stabilise the torso and thus relieve the spine. Strengthened muscles can better absorb the forces acting on the back with every movement. Furthermore, the muscles stabilise the individual joints and thus protect them from incorrect and excessive strain. Strengthening exercises are an effective therapy for back problems and help to alleviate pain in the long term.

On all fours

• Begin in an all-fours position.
• Place your hands shoulder-width apart below your shoulders and your knees hip-width apart under your pelvis.
• Extend your right leg backwards and your left arm forwards.
• Straight and stable back.
• Then bring your right leg and left arm together and stretch them out again.
• 3 sets of 8 - 12 repetitions.
• Perform 2 - 3 × weekly.

Planks

• Starting position in forearm support.
• Position forearms shoulder-width apart, legs hip-width apart.
• Straight line of the body from head to toe, without the buttocks moving up or down.
• 3 sets of 30 seconds to 2 minutes each. Adjust the duration according to your physical fitness level.
• Perform 2 - 3 × weekly.