How many times has happened to be examined by a doctor who only looking at the MRI says, the symptoms are caused dall'ernia disk, or the pain is caused by 'arthritis, while the type of back pain they suffer has nothing to do with these degenerates.
This premise is necessary because back pain can have many causes, some easy to document with an instrumental test, but in most cases non-specific person's pain can not be identified by imaging (CT, X-ray etc.).
means for low back pain back pain, that is in the lower spine, it can be a sore back, but there are other causes.
is usually accompanied by muscle tension, stiffness and limitation of movement.
In most cases back pain is nonspecific, that is without diagnostic imaging examinations and tests to identify an orthopedic case.
Inflammation back is usually accused by patients of all ages.
The history and a thorough medical examination will rule out any possible source of visceral pain.
Most patients who come to the doctor and physiotherapist also suffers from neck pain, back pain or backache common.
The lumbar back pain can be acute or chronic, the difference is in the fact that acute pain disappears within thirty days, if the chronic pain continues beyond thirty days without knowing for how long.
The lumbago is an episode of acute low back pain is characterized by severe pain. The affected person is bent forward property because any movement that tries to do is extremely painful.
Since then sits or lies down sideways waiting for an improvement that will not arrive before 24 hours.
E 'strongly discouraged to try to straighten up with that pain because it may damage other structures in addition to exacerbate the pain and inflammation.
The lumbago is a type of low back pain much more painful and is characterized by a high rigidity.
What are the causes?
Many patients enter the clinic saying that they have back pain because the vertebrae and discs are crushed or consumed, but only a small percentage of cases that is true.
The causes of nonspecific low back pain can be different: a sedentary job is too heavy or too frequent lifting of objects, atrophy of the paravertebral and abdominal muscles associated with a poor fitness, poor posture or sports racing too hard.
Sometimes specialists believe that depression or poor and repetitive work can cause back pain because they have noticed that statistically it is.
often suffer from low back pain in pregnancy because the body undergoes internal change due to weight: the anteversion pelvis and increased lumbar lordosis.
The ligaments and other soft tissues become more elastic, this deterioration of the body is added to the subluxation of the sacrum in relation to the iliac bones of the pelvis, which gives the classic low-back pain of pregnant women.
Another cause of back pain can be a bad shoe, shoes hard or too low can download bad impact with the ground level of the vertebrae, while a poor foot support can overload certain muscles over others.
Low back pain can be caused by an asymmetry of the lower limbs that require a crooked posture, such as scoliosis.
There are
visceral causes for back pain such as endometriosis, such as rheumatic arthritis, ankylosing spondylitis and rheumatoid arthritis, vertebral fractures, spondylolisthesis, osteoarthritis (spondylosis), infections and malignancies.
E 'need for a medical examination to exclude all diseases attributable to non-orthopedic physician before undertaking treatment.
In adults, especially in the elderly and the spondylosis and the formation of osteophytes can lead to inflammation of the intervertebral joints, and then give pain.
In my experience you should try to treat back pain as a mechanical joint or muscle disorder, in fact almost all patients who present at the clinic, this is the case.
During the motion, if a vertebra does not flow in a straight line and adjust to each other, sliding friction and produce pain.
As a result of trauma, repetitive microtrauma, or muscle overload, it is possible that the point of greatest tension of the muscles that perform a particular movement may form bridges between the collagen bands of connective tissue of these.
These bridges of collagen are formed by trapping a nerve ending, thus causing pain during movement, and sometimes even while standing still over the loss of strength and functional limitation.
The causes of lumbago are sudden movements or efforts to collect such a heavy object on the ground (eg. a bowl) made by bending the lumbar spine.
If these bends are performed in a broken vertebrae that do not flow from one another in their tracks, but "derail" even very little, the body's reaction is an exaggerated contraction of small muscles that connect one vertebra to another .
In this case there is a rotation millimeter than the last lumbar vertebra L5 to the sacrum and the joint is misaligned.
more detail the situations that predispose to this disorder are: lift objects off the ground without bending your knees, accidents, sleep in one position too convoluted or on a mattress that s'affossa, overexertion.
A patient taking a shot of cold air does not develop back pain as often thought, though it may tighten the muscles and complicate a problem that already existed.
The lack of elasticity of the muscles is a factor that predisposes to lumbago.
The strong contraction in place by the muscles of the back is a defense mechanism, can be compared to a stiff neck, but it is bilateral.
How to get the diagnosis?
The doctor is always looking lesions, disk disease, tendon or ligament tears, scoliosis, prominent mismatch, infection, inflammation, etc.., if not nothing is what it says? In most cases requiring an anti-inflammatory or send the neurologist-psychiatrist, etc.. Even when the patient has no problems that arise in the mind.
Low back pain is simply pain in the lumbar spine, then the diagnosis is to identify the type of pain: inflammatory, mechanical, etc..
A thorough examination is the first thing to do and is irreplaceable by any instrumental test.
The doctor after seeing the painful area, carried out routine tests and the answer will determine if it is painful to the touch needed a more thorough investigation because of suspected disease confirmed by imaging.
examinations most useful in cases of back pain orthopedic appliance, are:
nuclear magnetic resonance to detect possible herniated disc
X-ray shows the bones and the space between them, showing arthrosis and fractures;
the analysis of blood and urine for the presence of any malignancy or Paget's disease or rheumatic diseases;
bone scintigraphy to search for possible metastases
electromyography (EMG) to assess the conductivity of nervous.
Scoliosis may be a cause of early osteoarthritis in one part of the column, which supports more than body weight, but is not painful in itself.
Some muscles are kept in elongation because the column is tilted and rotated to one side, then stretch the opposite side is continuous, this can cause muscle soreness.
The lumbago is immediately obvious to the location where the patient and the spinal block.
The doctor will visit the subject to determine whether the causes of the disorder is the sudden movement or if it is the consequence of other diseases.
What is the best treatment right?
Low back pain is simply pain in the lumbar spine, and then only to treat orthopedic problems.
The most important thing to do to prevent low back pain is the control of posture and the holding of a regular program of exercises and stretching target.
Many patients ask me if it's just reinforcement of the abdominal muscles to solve the problem, my advice is to avoid them completely until you suffer from back pain, can then be included in the program with others.
It 'necessary to avoid recurrence of low back pain that are often if not eliminate the cause, but only symptoms.
The patient should avoid bending your back while keeping the legs stretched out, vacuuming will keep your back straight and make the beds in the knee.
When you sit down you should keep a lumbar roll to maintain the physiological lordosis.
The best treatment for low back pain of mechanical-inflammatory therapy is a combination of instrumental (CO2 laser, Tecar) and manual therapy to put in the axis vertebrae and remove the muscle and fascial tension.
physiokinesitherapy The stretching and relaxation is also recommended as a preventive measure.
In the case of lumbago treatment is more cautious, for the first 48 hours is preferable to bed rest, then the therapy is instrumental in massage therapy and treatment for the inflammation, also gentle manual therapy and physiotherapy to eliminate the cause of the disorder.
The prognosis varies depending on the age of the subject, under the age of 35 heal in less than a week, but older people need about ten sessions.
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