[Low back pain: diagnostic and therapeutic concepts]

During the last couple of years the lumbar back pain has gained importance like no other complaints in rheumatology and orthopaedics. This is mainly due to the chronic futile course and a general increase in relation to socio-economic factors. This is also where new therapeutic concepts have been created, which not only emphasise the pure somatic proceeding but also include the bio-psycho-social concept of treatment that on the one hand takes a lot of time and trouble, yet on the other hand is the treatment most likely to be a therapeutic success. However, in diagnosis one always has to start out from the somatic possibility and construct a working hypothesis within the framework of clear diagnostic steps, which then can be used as a basis for further therapeutic proceeding. Backache of young people differs greatly from backache of adults. New examinations even question the general belief that there is only a pure somatic reason that leads to backache of young people. The ergonomic way of thinking absolutely has to start being used for therapeutic reflections. Moreover, not only the analysis of the place of work and the adaption, yet also the strain in the spare time has to be structured usefully and sensibly.