“A true all-rounder for basic therapy”

Be it as a first measure during ongoing diagnostics or as a long-term follow-up treatment after spine surgery – Dr. med. Philip Lübke, orthopedist from Kiel, Germany, uses the LumboTrain supports for all sorts of indications. As a gentle exterior support, they are very popular with patients suffering from back pain and can stabilize situations that tend to be unstable – this provides more freedom during pain therapy.

Back pain is the second most frequent diagnosis on certificates of incapacity to work. Around two in three Germans are affected every year, one in five reports having chronic pain that lasts at least three months and occurs almost daily1. In times of the pandemic, another manifestation has appeared – telework-associated back pain, a vicious circle of sitting incorrectly and increasing pain caused by unergonomic work stations and a lack of activity. The condition is not that new, but the age of those affected, with many in their 20s, and the severity of the symptoms are surprising nonetheless, says Dr. Philip Lübke from Mare Med in Kiel.

A desire for external stabilization

Back pain associated with working from home has also arrived at Kieler Förde, where sailing and handball are generally very popular. Caring for a predominantly sporty client-base, Mare Med is situated there, right by the water, now seeing a noticeably high number of students suffering from low back pain. Dr. Lübke points at the model of a spine on his desk. “In many patients, the muscles have become weak and shortened,” explains the orthopedist and sports physician, who also supports the medical team of the handball record champion and Champions League winner THW Kiel. He is also the team physician and consulting healthcare professional for other teams and athletes. “At home, they sit in their arm chair more than is good for them. The symptoms are most often felt in the spine, yet the root cause lies in muscular imbalances. They increase pressure on the lumbar vertebrae and sacroiliac joints. This reduces internal stability. Patients mention the typical feeling of breaking apart – and a desire for external stabilization.”

Stabilizing an unstable situation 

This is when Dr. Lübke suggests elastic back supports with a pad. For the spine expert, they are part of multi-modal pain therapy and act as an external stabilizer – for functional as well as structural problems, such as vertebral displacement or herniated discs. “In my treatment concepts, lumbar supports, such as the LumboTrain, play the role of an all-rounder,” says Dr. Lübke, describing his game plan for back pain. “At the beginning of treatment, I can use them in a relatively non-specific manner to stabilize a situation that tends to be unstable. They are perfect for basic treatment.” This usually provides him with more time for his differential diagnosis and the introduction of other measures, he reports. In his experience, treatment with lumbar supports is generally quick, and patients readily accept them. It is important that the product is pleasantly flat in the abdominal area to ensure it easily fits under clothing and does not exert uncomfortable pressure on the inner organs. According to Dr. Lübke, this supports the all-important early mobilization and ensures the muscles are guided into a better position for working. “LumboTrain supports remind the patient to straighten up. This ‘help to help oneself’ is crucial for the mind, not only for the back.” Patients have to understand where their problem lies and how they can deal with it. Otherwise, the pain can never be treated successfully.  

At Mare, back treatment is team work

“As the physician, I’m the diagnostician who examines, tests and asks questions. Additionally, I check with the physical therapists involved whose feedback holds essential information, and I ask for findings from radiologists. I’m also in touch with medical retailers who are responsible for providing supports and braces,” Dr. Lübke explains. However, he particularly emphasizes one other “player”: the patient. “The patient is the most important element of this team. He sets the course and the speed.” When communicating with patients, the orthotist relies on close monitoring and a constant exchange of information by e-mail. “That’s how I can find out immediately how individual measures are working during the different treatment phases. I can respond and adjust, if necessary.” In this type of communication, he sees the key for improved treatment flexibility that helps to achieve the best for the specific patient. Patient education also benefits from this in his opinion: those affected will learn how to categorize their pain perception more effectively and become more aware of which measures help them when and why.

Influencing factors in pain therapy

By adjusting many therapy factors, the physician can achieve the best possible pain reduction. Pain therapy, physiotherapy, manual therapy and electrotherapy (TENS) can be used in addition to supports. “The important thing is to work out a realistic goal together. This is not something that has to be decided right at the beginning. We must have the option of trying out different treatment paths and reacting to what is happening. The same rule applies here: the best way is to personalize treatment.”

For example in the case of blockages: “That’s usually a stiffness to protect from pain,” he explains. “If I can loosen this stiffness by mobilizing the patient, I will create mobility in an area that, in turn, can cause pain. That is something I need to treat as well, and explain my methods to the patient.” This is the only way of breaking the pain cycle. For the orthopedist, the LumboTrain perfectly suits this role: “The support gives me the opportunity of creating time slots with only a little pain during which I can do certain things or refrain from doing them. That provides me with a lot of flexibility.” An external support will also allow patients act flexibly. They can take it off for a little while and get it back out when the pain returns or they are subjected to excessive strain to protect themselves from risks.

Non-surgical approach creates freedom 

For 15 years, the orthopedist certified by DWG (German Spinal Society) worked at the Lubinus Hospital in Kiel, one of the most prominent German centers for spine surgery, including several years as an attending. After that, he started delving into the wide range of non-surgical options and integrating them into his treatment regimes. “They allow me to approach the problem step-by-step and escalate treatment in a controlled way to see what is actually beneficial and necessary. We often don’t need surgery, and external stabilization is sufficient. The conservative treatment path is exciting and incredibly effective if you can adjust the right elements.” Dr. Lübke’s patients are just as convinced by the effectiveness of the LumboTrain as their treating physician, as confirmed by Thore Jöhnck and Sabine Jakob.

“At some stage, my father asked me if I was being bullied at training. I was so quiet afterwards. I was 14, and I played handball in Flensburg as the goalie. The reason was this incredible pain I felt. When I was subjected to strain and, most of all, when making a hollow back, I had huge problems. The diagnosis: vertebral displacement. When I was 15, Dr. Lübke inserted four screws into my vertebral bodies. After that, I had to wear a rigid corset for a long time. It wasn’t the best time of my life. It took a year until I could return to exercise. A rigid back support helped me in those days. Today, I’m back in the goal in the third division. Like many of my fellow players, I wear the LumboTrain for safety, for when I feel a twinge or contact the ground awkwardly. This product is a great help for immediate support. I get it out of the drawer, and it provides me with warming stabilization for my muscles. It’s really pleasant, especially if I do feel a bit of pain. Ultimately, it’s also in the mind. I never again want to experience the pain that I had.”

“As a surgical nurse, I stand at the operating table every day. Three years ago, when moving a patient, it happened: I got up, turned the patient – and that was the end. A herniated disc in the lower lumbar spine. I was off work for eight weeks. Pain therapy and exercise followed. I did aqua jogging and back exercises. After that, I was able to work again. When the pain reduces, you forget to do your exercises regularly. This year, the pain returned. It felt like a gigantic boulder in my back. But I didn’t want to take any pills. Dr. Lübke suggested the LumboTrain Lady until the cause was found and he could pursue a targeted plan of action. I’ve been wearing the waisted support for a week. On the first day, it felt strange but nice. My posture changed immediately. And it hurt less, even though my work is physically very demanding. Patients’ legs can be heavy when you have to support them for quite some time when they’re being washed for surgery. Supported by the LumboTrain Lady, I was able to tie my shoes at the end of the day, despite the excessive strain.”

1 Kuntz B, Hoebel J, Fuchs J et al. (2017) Soziale Ungleichheit und chronische Rückenschmerzen bei Erwachsenen in Deutschland. Bundesgesundheitsblatt 60(7):783–791.

Images: Pat Scheidemann, Bauerfeind