An image alone does not make a diagnosis.
Choose a check – an idea of possible examinations, in a few minutes, anonymously.
First know what it is – then treat it.
26.2 million people in Germany have medically documented back pain – almost one in three.¹ Back pain is also the most common single diagnosis behind sick leave: almost one in ten members of a large health insurance fund was unable to work at least once a year because of it.² Behind this single figure lie very different causes – a compressed nerve root (radiculopathy), a vertebral fracture with osteoporosis, but equally without it, an acute or chronic inflammation, a rheumatic disease, a metastasis, a vascular malformation or a mass in the spinal canal. You cannot tell from the pain which of these is behind it. That is exactly why the first step here is to name the cause, and only then to treat it. For radicular symptoms, MRI is the imaging method of first choice: it depicts intervertebral discs, nerve roots, spinal canal and bone marrow without radiation.³
Important: Sudden, severe chest pain – especially with shortness of breath, cold sweat or pain radiating into the arm, neck or upper abdomen – can be a heart attack. Please call the emergency services on 112 immediately.
Pain that gets worse at night at rest, fever, unintended weight loss, a history of cancer, known osteoporosis, a fall or prolonged cortisone treatment: such findings are considered warning signs and call for prompt assessment.⁴ The same applies to pain that keeps you from falling asleep or wakes you at night – a pattern that also occurs in rheumatic diseases. Not to cause alarm, but because this is the only way to reliably rule out fracture, inflammation and metastasis.
Pain that runs from the lower back into the leg or from the neck into the arm (radiculopathy) often comes from a compressed nerve root. Timing matters here: anyone who puts full load on a bulge too early – weightlifting at the gym, heavy carrying – can turn a manageable protrusion into a true herniation with root compression. MRI shows the level, side and extent, and thus what can be loaded at the moment and what cannot.³
Sensory disturbances and weakness are no longer ordinary back pain. For pronounced neurological deficits, the guideline recommends immediate imaging.³ The longer a nerve root remains compressed, the more likely something will remain – the aim here is to keep an irritation from becoming lasting chronic damage.
Not every back pain is wear-and-tear pain. The same symptoms may be caused by a vertebral fracture with impending narrowing of the spinal canal – with osteoporosis, but equally without it –, a fracture due to metastases or a plasmacytoma, an acute or chronic inflammation, a rheumatic disease, a vascular malformation in the spinal canal, a mass or – rarely – a haemorrhage.⁵ Clinically, these causes often cannot be distinguished from ordinary low back pain; they become visible in cross-sectional imaging. If you can hardly walk any more, please do not put it off – come and see us.
Which examination makes sense depends on your symptoms. We choose specifically and explain our choice in the consultation.
The method of first choice for radicular symptoms: intervertebral discs, nerve roots, spinal canal, facet joints and bone marrow in fine resolution, without radiation.³ Inflammation, fresh fractures and bone marrow changes are seen here earlier than with any other method. And sometimes the result is pleasingly simple – then we show you targeted exercises that help many people; sometimes a correction of posture already helps.
Pain does not simply have to be endured. In periradicular therapy, the medication is delivered with millimetre precision to the affected nerve root under computed tomography – the needle position is controlled in the image, not found by touch. The S2k guideline on the management of disc herniations with radicular symptoms covers the interventional procedures in a separate section (chapter 3.3.3) and describes transforaminal and interlaminar injections at the lumbar, thoracic and cervical spine.³ Many patients have considerably fewer symptoms afterwards; how long this lasts cannot be promised in advance.
For neck pain radiating into the shoulder, arm or hand. In addition to the disc and nerve root, the spinal cord itself is assessed – important when fine motor skills or gait become unsteady.
When the question concerns bone – fresh fractures, bony narrowing, the condition after surgery – or when an MRI is not possible. CT images the bony spine in fine slices within seconds.
Not every back pain comes from the back. The sacroiliac joint, hip, kidney and ureter can cause similar pain. Because MRI, CT and ultrasound are all under one roof with us, nobody has to go to another part of town for this.
Conveniently online or by phone – our friendly reception will give you an appointment promptly.
MRI or CT – chosen specifically, in a calm atmosphere, evaluated by experienced specialists.
You receive a detailed report and a personal consultation about the next steps – including the question of what you can do yourself.
Physicist, specialist in radiology and specialist in neuroradiology – a dual qualification that makes the difference in questions concerning nerve roots, spinal cord and spinal canal.
★★★★★ 87 × 5-star reviews on Google
Make your appointment – online in a few steps or by phone.
In Germany, back pain is not a marginal phenomenon but one of the most costly and consequential widespread diseases of all.
| Indicator | Germany |
|---|---|
| People with medically documented back pain (2021)¹ | 26,2 Mio. |
| Share of the population¹ | 31,4 % |
| Of these, chronic course¹ | 15 % |
| Health insurance members unable to work at least once a year due to back pain (2019)² | rund 10 % |
| Musculoskeletal disorders overall – i.e. including the large joints – share of all days of incapacity for work (2016)⁶ | 22,8 % |
| Loss of production due to incapacity for work, all diagnoses combined (2016)⁶ | 75 Mrd. € |
The expensive part is chronification – the 15 % in whom the symptoms persist. The German National Disease Management Guideline describes avoidance behaviour, fear of movement and the resulting deconditioning as central mechanisms of this transition from acute to chronic low back pain.⁴ Both can be influenced – but only if you know what the trigger was.
| MRI findings in people who have no symptoms (yet)⁷ | at age 20 | at age 80 |
|---|---|---|
| Disc degeneration | 37 % | 96 % |
| Disc bulge (bulging) | 30 % | 84 % |
| Protrusion | 29 % | 43 % |
Two things can be read from this second table. First: a conspicuous imaging finding is not in itself an explanation for pain – it must be read together with symptoms, examination findings and medical history. Second, and this is rarely said: disc degeneration is already found in a good third of 20-year-olds.⁷ That wear begins so early is not a law of nature but an indication of load patterns – sitting, posture, training errors – that can be changed. We advise on this too.
Our work is guided by medical problems, not by business considerations. Our interest is that you do not have to come back.