Chronic pain is one of the most common diseases worldwide. In Germany, more
than a third of the population suffers from back pain or headaches. About 70 %
have back pain at least once a year and thus account for 15 % of all working
days.
The cause of back pain can be divided into structural and functional disorders.
Structural disorders include degenerative changes such as arthrosis. Functional
disorders are accompanied by malpositions and limited mobility. 90 % of patients suffer from functional disorders such as unspecific back pain. Statistical
studies show that less than 2 % of patients who attend primary care appointments
do not have experience serious structural changes.
A functional disorder is indicated by pain symptoms of less than two weeks,
back pain independent of exercise, no pain radiation distally of the knee and a
functional induced difference in leg length.
Evidence-based guidelines show that manipulation and mobilization in combination with exercise therapy show the best results in acute and chronic functional
back pain.
However, research on chronic back pain is still far behind manual clinical
knowledge. Therefore, I am particularly pleased that my friend of many years,
Rainer Thiele, has dealt with this topic in his doctoral thesis.