Press release: Method against back pain (DE/EN)

Press release (DE) – brief overview

Hamburg, Dorotheenstrasse 48 – Back pain is one of the most common reasons for visits to the doctor and absence from work. The orthopedic practice in Hamburg presents a structured, conservatively oriented method that combines diagnostics, information, exercise therapy and - if appropriate - complementary, non-surgical procedures. The goal: reduce pain, improve functionality and prevent relapses. The method does not replace an individual diagnosis, but it does offer a clear treatment plan based on international guidelines.

• Conservative first: activity, training, education as a basis
• Structured diagnostics including red flag screening, functional analysis and – if appropriate – 4D back measurement
• Optional modules: focused shock wave (ESWT), acupuncture, neuromodulative procedures (e.g. Axomera) and IHHT as supplementary measures
• Evidence assessment transparent: benefits and limitations are clearly stated
• Offer in Hamburg, support possible in DE/EN

Back pain: background and need for care

Non-specific back pain is widespread and affects people of all ages. In many cases they are an expression of functional disorders, muscular imbalances, stress or insufficient exercise. Not every complaint requires imaging or invasive measures. What is crucial is a careful clinical assessment, the recognition of warning signs (red flags) and a therapy that is adapted to the individual's everyday life.

• Acute, subacute or chronic: course and duration control the intensity of therapy
• Red flags (e.g. fever, paralysis, bladder/rectal disorders, trauma) require immediate clarification
• Movement and self-management are central adjustment screws
• Psychosocial factors (stress, fear of movement) can increase pain and should be addressed

The method: conservative first, individually combined

The approach is modular. The initial focus is on anamnesis, physical examination and joint definition of goals. This is followed by a tailored plan that prioritizes the most effective conservative measures. Supplementary procedures are only used if there is a clear indication and are explained transparently.

1. Diagnostics and planning: Detailed anamnesis, red flag screening, neurological examination and movement quality testing. For functional questions, a 4D back and posture analysis (e.g. DIERS) can be used for objectification.
2. Basic therapy: education (understanding pain), everyday exercise, ergonomic advice, sleep and stress management. Early activation instead of protection.
3. Physiotherapy and active training: strength, endurance, mobility and coordination - tailored to the course (acute/chronic).
4. ESWT module (focused shock wave): For myofascial trigger points or tendon insertion problems, ESWT can alleviate symptoms and support function when conservative basic measures are not sufficient.
5. Module Acupuncture (TCM): Can help as a complementary method to reduce symptoms, especially in chronic lower back pain.
6. Neuromodulation module (e.g. Axomera): In selected cases with chronic or neuropathic pain, neuromodulatory treatment can be considered.
7. Module IHHT (Interval Hypoxia-Hyperoxia Training): As a supplementary metabolism and regeneration training in individual cases, such as exhaustion or training build-up, if there are no contraindications.
8. Evaluation: Regular follow-up and adjustment. If red flags develop or conservative therapy does not work, further diagnosis and – if necessary – referral are made.

Important: No measure works equally well for everyone. The modules are only used after information and a joint assessment of the benefits and risks.

Evidence in brief – benefits and limitations

• Movement therapy, activity building and education: widely recommended internationally, good evidence for better function and fewer pain episodes.
• Focused Shock Wave (ESWT): ESWT can be helpful for myofascial pain and certain tendon insertion problems; Data on nonspecific low back pain are heterogeneous.
• Acupuncture: Studies show some moderate effects for chronic non-specific back pain; individual reaction varies.
• Neuromodulation (e.g. Axomera): Potential in selected pain syndromes; Limited clinical data to date, careful indication necessary.
• IHHT: In orthopedics, a complementary approach with still limited evidence; not intended as a sole measure.
• 4D back analysis: diagnostic tool for functional assessment; supports therapy planning, but does not replace clinical examination.

Practice places value on transparent information: where evidence is robust, it is used; Where data is limited, this is communicated openly. Individual goals and safety have priority.

Suitable for whom? Indications and limitations

• Suitable: Non-specific acute, subacute or chronic back pain without red flags.
• Suitable: Myofascial trigger points, muscular imbalances, stress-related complaints.
• With caution/decide on a case-by-case basis: Pre-existing neurological diseases, osteoporosis, heart/lung diseases (especially before IHHT), pregnancy - only after individual clarification.
• Not suitable without further clarification: Red flags (e.g. paralysis, fever, trauma, suspected tumor, bladder/rectal disorders), infections, recent fractures.

Even though most back pain can be treated without surgery, warning signs require further diagnostics as quickly as possible. The method is seen as a structured, conservative treatment concept - not a replacement for necessary emergency or surgical indications.

Procedure in the Hamburg practice

1. Initial appointment (Dorotheenstrasse 48, 22301 Hamburg): anamnesis, examination, red flag screening, functional check; 4D analysis if necessary.
2. Therapy plan: shared goals, start of basic therapy, information about additional options.
3. Therapy phase (4–8 weeks): Physiotherapy/training, if necessary ESWT/acupuncture/neuromodulation/IHHT as indicated.
4. Re-evaluation: adaptation, progress measurement, relapse prevention.
5. If there is no response or new warning signs: repeat diagnostics and, if necessary, referral.

Support is possible in German and English. Appointments can be requested via Doctolib or by email.

Voices from practice

• “For us, conservative first means: exercise, education and a realistic plan – supplemented by procedures that can offer added value if indicated.”
• "We don't promise miracles. Our aim is clear, evidence-based treatment with regular reviews and honest communication."

Press contact & service (DE)

Location: Dorotheenstraße 48, 22301 Hamburg. Interviews possible in German/English. Images and original sounds on request. For press inquiries, please use the email address or arrange a meeting via Doctolib.

Press release (EN) – Summary

Hamburg, Dorotheenstraße 48 – Back pain is among the leading reasons for medical consultations. Our orthopedic practice presents a structured, conservative-first approach that combines clinical assessment, education, exercise-based care, and—where appropriate—adjunct non-operative options. The aim is to reduce pain, improve function, and prevent recurrence. This approach does not replace individual diagnosis; it provides a clear, evidence-informed pathway aligned with international recommendations.

• Conservative-first: education, activity, and exercise as core
• Structured assessment including red-flag screening and, when helpful, 4D spine analysis
• Optional adjuncts: focused shockwave (ESWT), acupuncture, neuromodulation (e.g., Axomera), and IHHT in selected cases
• Transparent evidence appraisal: benefits and limits clearly stated
• Services available in Hamburg; consultations in German/English

The method: conservative-first, evidence-informed

1. Assessment and planning: thorough history, red-flag screening, neuro exam, functional analysis; optional 4D assessment to support planning.
2. Core therapy: education, graded activity, ergonomic advice, sleep and stress management.
3. Physiotherapy and active rehabilitation: strength, mobility, coordination tailored to pain stage.
4. Module ESWT: for myofascial trigger points or enthesopathies when core measures are insufficient.
5. Module Acupuncture: adjunct option for symptom relief in chronic low back pain.
6. Module Neuromodulation (e.g., Axomera): selected chronic or neuropathic-like pain cases after careful indication.
7. Module IHHT: metabolic support in selected patients without contraindications.
8. Follow-up: regular review, adapt or escalate if red flags appear or response remains insufficient.

No single modality suits everyone. Adjuncts are offered only after informed discussion of potential benefits and risks.

Who may benefit, and limits

• Potential candidates: non-specific acute, subacute, or chronic back pain without red flags.
• Caution/individual decision: neurological comorbidities, osteoporosis, cardiopulmonary disease (esp. for IHHT), pregnancy.
• Not suitable without further work-up: red flags (e.g., new weakness, fever, bladder/bowel dysfunction), infection, fresh fracture.

Most back pain can be managed without surgery, but urgent assessment is essential when warning signs occur.

Media contact (EN)

Location: Dorotheenstraße 48, 22301 Hamburg, Germany. Interviews in DE/EN available. Media assets upon request. Please reach out via email or arrange appointments via Doctolib.

Important information for patients

• No therapy guarantees freedom from symptoms. Goals are set realistically and collaboratively.
• If you experience red flags (e.g. paralysis, fever, severe nighttime pain, bladder/rectal disorders), please seek immediate medical attention.
• Imaging (e.g. MRI) is only useful if the question is suitable. The clinical examination is crucial.
• Nutrition, sleep, stress reduction and regular activity support the treatment in the long term.

Further information and related content

In-depth contributions to individual modules and diagnostics: Storz Medical ESWT - focused shock wave (DE/EN), Diers measuring systems - 4D analysis for back & gait (DE/EN), Axomera - neuromodulation for pain (DE/EN), IHHT - interval hypoxia-hyperoxia training (DE/EN), TCM acupuncture in orthopedics (DE/EN). Also: Prof. Citak Videos – Orthopedics understandable (DE/EN) and orientation: Orthopedist Hamburg Altona – The 5 most important selection criteria.

The 5 tips at a glance

1. Conservative first: activity, training, education as a basis
2. Structured diagnostics including red flag screening, functional analysis and – if appropriate – 4D back measurement
3. Optional modules: focused shock wave (ESWT), acupuncture, neuromodulative procedures (e.g. Axomera) and IHHT as supplementary measures
4. Evidence assessment transparent: benefits and limitations are clearly stated
5. Offer in Hamburg, support possible in DE/EN

Information does not replace an individual examination. If there are any warning signs, please seek medical advice.