Breakthrough feeling - instability of the spine: causes and treatment

Breakthrough feeling on the spine

Back complaints in the area of ​​the spine are described by many affected as a real "breakthrough feeling". Less the pain than the feeling of instability in the area between the sacrum and lumbar spine or between the thoracic and cervical spine convey the feeling that the back can break through.


The feeling of breakthrough describes a noticeable instability of the spine.

Causes of breakthrough feeling

Usually, increased mobility of individual segments of the spine is directly responsible for the feeling of breaking through. The associated clinical picture is described in the medical literature as spondylolisthesis (sliding vertebrae). Parts of the spine shift in position.

The disease can either be congenital or due to wear, injury, illness, or spinal surgery. If the vertebrae completely lose contact with one another in the course of the disease, this is referred to as spondyloptosis. For those affected, the increased severity of the disease is associated with an increased feeling of breakthrough in the spine. According to Meyerding, spondylolisthesis is divided into four stages; the fifth stage would be spondyloptosis.

Symptoms of breakthrough feeling

Under load, such as standing for long periods, walking or heavy lifting, there is a feeling of instability in the lumbar region. This can be accompanied by back pain, buttock pain or lower back pain, but can also be completely painless.

A similar feeling of instability arises in the area between the cervical and thoracic spine, for example after sitting for a long time or when the head is put back for a long time. For example, those affected feel extremely uncomfortable washing their hair at the hairdresser. Jerky turning of the head can also trigger the symptoms. The feeling of breakthrough can certainly indicate serious complaints in the spinal area, which is why a medical examination should urgently be carried out.


The localization of the symptoms and their intensity allows doctors and physiotherapists to give an initial assessment of the causes of the disease. A palpation of the spine can provide further information on the diagnosis. The ability of the individual spine sections to bend also allows conclusions to be drawn about possible underlying diseases.

Furthermore, the neurological examination, including checking the reflexes, can be used to make the diagnosis. Ultimately, a sliding vertebra can be diagnosed relatively clearly using imaging methods such as X-rays or computer tomography (CT).

Treatment for spinal instability

The first step is to relieve and support the spine as part of the therapy. In spondylolisthesis, this is often done using a trunk orthosis, but a plaster may be required.

In order to avoid the symptoms in the long term, the patients receive physiotherapy. The training of the back and abdominal muscles should stabilize the spine and counteract the feeling of breakthrough. In the context of physiotherapy, attempts are also made to compensate for other bad postures that, for example, impair equilibrium regulation. Accompanying massages are often used to relieve the patient's complaints.

Naturopathic treatment approaches for corresponding back complaints are available, for example, in the field of Rolfing and osteopathy. Acupuncture is also successfully used against the various diseases of the back.

However, it may not be possible to alleviate the symptoms with the non-invasive treatment methods. Chronic nerve damage and permanent postural damage are at risk. In such cases, only an operation can help, in which the incorrectly positioned spinal segments are straightened again. (fp)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Dipl. Geogr. Fabian Peters


  • Jan Hildebrandt, Michael Pfingsten: Back pain and lumbar spine, Urban & Fischer Verlag, Elsevier GmbH, 2nd edition, 2011
  • Alfred J. Cianflocco: Spondylolisthesis, MSD Manual, (accessed 02.09.2019), MSD
  • S. Kroppenstedt, A. Halder: Specific low back pain, German Society for Orthopedics and Orthopedic Surgery (DGOOC), (accessed 02.09.2019), AWMF

Video: Vision problems from vagus nerve injury and cervical instability (January 2022).