When Baastrup syndrome is a chronic back pain the lower lumbar spine, which often is associated with hard work and can also occur in older age. This results in complaints such as severe pain in the lower back, restricted mobility and poor posture, which can severely limit the quality of life of those affected. The treatment of Baastrup syndrome is initially conservative with medication, exercise and heat therapy. Surgical intervention can only be considered after all conservative methods have been exhausted.
What is Baastrup Syndrome?
The Baastrup syndrome is one of the chronic pain syndromes of the lumbar spine (lumbar spine), the cause of which is usually the contacting spinous processes (spinous processes). The unphysiological contact of the bone processes causes moderate to severe pain, which can occur depending on movement and is only slightly improved by rest.
An association with degenerative diseases of the spine, such as a decrease in the height of the vertebrae with age, can often be established. In addition, people who have to lift heavily at work are more often affected, as there is also greater stress on the spine.
Causes
There are various causes that can lead to the development of Baastrup syndrome. The most common cause is oversized spinous processes. These are unpaired bony protrusions that arise from the vertebral arch of a vertebra and point towards the back. Each vertebral arch therefore has only one spinous process.
Taken as a whole, all spinous processes are an important holding element of the deep back muscles as well as of fascia, ligaments and tendons. They contribute to the stability of the entire spine and to an upright gait. A Hyperlordosis the lumbar spine, the emergence of a Baastrup syndrome favor.
Hyperlordosis is an excessively convex forward curvature of the spine, which leads to an approximation of the neighboring spinous processes and, in the long term, can result in poor posture of the whole body.
In old age, degenerative changes in the intervertebral discs are responsible for a reduction in the height of the vertebrae in relation to one another. This is also connected with the development of Baastrup syndrome. In most cases, hard workers and the elderly are affected by the disease.
Symptoms, ailments & signs
The symptoms of Baastrup syndrome are relatively unspecific, especially at the beginning, and can only be distinguished from other lumbar spine problems with difficulty. Those affected frequently complain of increasingly severe pain in the lower lumbar spine area, which is only slightly improved by rest. An aggravation of pain occurs especially when a hollow back is formed and when stretching.
This can mean that everyday movements can be severely restricted. For this reason, those affected often take a gentle posture, which can worsen the symptoms in the long term. The physical examination reveals tenderness and tenderness in the lower lumbar spine. In addition, the pain can be aggravated by shaking the hip.
Diagnosis & course
The first indications of the existence of Baastrup syndrome can already be obtained after a consultation with a doctor and a detailed physical examination. Many patients express pain in certain situations such as when cycling (jolting pain) or when stretching in the morning. Imaging usually confirms the diagnosis.
Either an X-ray or a CT is made, as these imaging processes enable the best possible representation of the bony structures of the spine. The mutual contact of the superposed spinous processes (“kissing spines”) can be made directly visible, especially in the CT. Often there are bony attachments (osteophytes) on the adjacent bones of the vertebral arches.
The deep back muscles can show calcifications in the affected regions.
Occasionally, local anesthesia is performed for diagnostic purposes. An anesthetic is injected into the affected area with a syringe. An improvement in pain speaks strongly in favor of Baastrup syndrome.
Complications
Baastrup syndrome can have many serious complications. In most cases, patients complain of severe back pain. As a result, the patient’s movement is only possible to a limited extent. Those affected are often dependent on walking aids in order not to lose their mobility completely. The quality of life is severely restricted by the Baastrup syndrome.
In many cases, patients take a relieving posture when the pain occurs. Although this relieves the symptoms and pain for a short time, it is very unhealthy in the long term and usually leads to the worsening of Baastrup’s syndrome. However, the pain caused by Baastrup syndrome does not have to be permanent.
For some people, they only occur in certain situations or when doing heavy physical work. The hip is also affected by this pain. In severe cases, surgery is possible. However, operations on the spine are very risky and often lead to complications and consequential damage.
Furthermore, therapeutic treatments are possible, but they cannot completely combat the cause of the pain. However, you can limit the pain so that you can go about your everyday life. Further complications and worsening can occur if the patient does heavy physical work despite the Baastrup syndrome.
When should you go to the doctor?
Since the Baastrup syndrome is associated with relatively severe restrictions in everyday life and in the life of the person affected, a doctor should definitely be consulted if the patient experiences pain in the back and restricted mobility. Especially in the case of poor posture or relieving posture, a doctor should definitely be consulted who will correct this posture in order to avoid further damage to the body.
Above all in the area of the spine there are permanent complaints that can also lead to a hollow back. As a rule, severe pain with light exertion or when pressure is applied to the back is a sign of Baastrup syndrome, which must definitely be investigated. Treatment by a doctor is also necessary in the event of discomfort or pain in the hip.
In most cases, a family doctor can be consulted. Baastrup syndrome can be diagnosed relatively easily. The actual treatment then takes place in the form of massages or physiotherapy, which can significantly alleviate and reduce the symptoms.
Treatment & Therapy
The treatment of Baastrup syndrome is mainly conservative. It is important to strengthen the deep back muscles in the lumbar spine area through physiotherapy. The aim is to widen the distance between the individual spinous processes, which leads to relief from pain.
The same goal is pursued by treatment with trunk orthoses, which also contribute to better posture. Heat and pain therapy are used as a support in order to avoid relieving postures and to be able to implement physiotherapy successfully. Drug pain therapy also contributes to an increased quality of life and can maintain the ability to work, which is a prognostically favorable factor.
Only in rare cases is conservative therapy insufficient for treatment. Then surgical treatment methods can be considered. A spinous process is removed under general anesthesia in order to remove the contact with one another and thus the cause of the pain. It should be noted that operations on the spine are always associated with a particular risk.
Outlook & forecast
The Baastrup syndrome has a good prognosis and a good prospect of recovery provided the patient is actively involved. In some cases, the sufferer can achieve relief and cure for the condition without seeking medical treatment and care.
Building up the muscles in the back is necessary for the healing process. This can be done independently with a very good chance of success. People who feel insecure about good and healthy muscle building can get the help and support they need from a doctor. In a targeted treatment plan, he refers the patient to a physiotherapist and, in parallel, checks the results achieved.
The cooperation of all parties usually leads to relief of the symptoms after a few months and then to freedom from pain for the patient. The exercises learned should also be carried out outside of therapy. This supports the healing process to a considerable extent. In addition, the patient can pursue various sporting activities that optimally promote the development of his muscles.
Movement sequences should also be controlled and optimized. It is also necessary to achieve restructuring, especially when the body is exposed to everyday occupational stress.
The vision of healing diminishes as soon as the patient suffers from other diseases of the skeletal system. If there are already movement restrictions, this makes it more difficult to build up muscles.
Prevention
A lot can be done to prevent Baastrup syndrome from developing. The most important thing is the consistent strengthening of the back muscles through endurance sports such as running or swimming. Through strength training, the deep back muscles, which are supposed to serve as spacers between the individual vertebrae, can be trained in a targeted manner.
It is also important to make the workplace back-friendly. A change from sitting, standing and walking activities makes sense here. Activities in the office should be carried out alternately at the desk and the standing desk. Lifting that is too heavy should be avoided.
When lifting moderately difficult, it is important not to bend at your hips but to get up from your knees and keep your back straight at all times. Targeted physiotherapy and back training can be useful for people with an existing back problem.
Aftercare
After healing, the typical symptoms can recur. The patient is obliged to take preventive measures. These aim to strengthen the back muscles. Regular visits to a fitness studio are advisable. If there is sufficient reason, a doctor may order physical therapy.
There the patient learns exercises that he can use in his spare time. There are also opportunities for optimization in the workplace. Lifting heavy loads should always be done in the correct posture. Anyone who sits at a desk for a long time should value an ergonomic office chair.
The most important indicators of Baastrup syndrome are back pain and restricted mobility. Imaging procedures such as an X-ray and computed tomography provide information about the structure of the back. A doctor orders these examinations in the event of acute complaints or documents the progress of the disease.
Baastrup syndrome can be present for a long time. This applies when conservative treatment methods are initially given preference, even in the case of severe illness. Given the abundance of options, it is important to find the right mix of therapies. Pain cannot always be ruled out. At his request, the patient can receive medication in order to experience a tolerable everyday life.
You can do that yourself
The most important contribution to self-help that those affected can make is to strengthen the lower back muscles in the lumbar spine area. In this way, a widening of the distance between the spinous processes (bone processes on the vertebrae) can be achieved, which leads to a reduction in pain.
At a very early stage and for prevention, it is usually sufficient for those affected to do endurance sports on a regular basis. Sports such as running, walking or swimming are particularly suitable. In addition, the muscles can be strengthened through targeted strength training. In every good fitness studio there is special equipment and professionally trained staff who put together a suitable training plan for those affected.
In more severe cases, especially if the movement has already been restricted, physiotherapeutic therapy should definitely be started. This not only aims to strengthen the relevant muscle groups, but also to correct malpositions, which counteracts further degeneration.
It is important for heavy workers to maintain correct posture while doing their work. So should never be bent from the hips, but rather lifted from the knees. If the employer does not offer appropriate training, those affected can receive training from a physiotherapist or request information from their health insurance company. Anyone who works sitting down and is affected by Baastrup syndrome should ensure an ergonomically oriented workplace and, if possible, alternate between sitting and standing.
