Acute simple traumatic low back pain
Introduction
Introduction to acute simple traumatic low back pain Acute simple traumatic low back pain is mainly caused by ligaments and bones of the spine, and muscle involvement is rare. A relatively minor vertebral compression fracture or a facet fracture is often neglected because of minor trauma or inconspicuous symptoms, followed by chronic low back pain. More than 90% of acute simple traumatic spinal disease, low back and leg pain, occurs in the ankle joint of the lumbosacral spine. The lesion sometimes occurs in one place, sometimes in two places. Therefore, simple traumatic spinal disease, waist and leg pain can be divided into lumbosacral joint injury; ankle joint injury; and lumbosacral and ankle joint injury and other three kinds of low back pain. The disease is mainly symptomatic treatment, such as sprain is heavier, when the small fractures such as articular processes are found during the examination, the fracture should be treated. If it is only a tear of the tendon or ligament, it is necessary to rest in bed for 3 to 6 weeks. Due to the repair of ligaments and other soft tissues, the hematoma dissipates or absorbs, and the recovery of muscle ligament function takes 3 to 6 weeks. Therefore, it is not advisable to perform intense massage massage during this time, but appropriate physical therapy may be used to help recovery. basic knowledge The proportion of the disease: the incidence of the disease caused by trauma is about 0.1%-0.3% Susceptible people: no specific population Mode of infection: non-infectious Complications: scoliosis
Cause
Acute simple traumatic leg and leg pain
From the perspective of traditional Chinese medicine, traumatic low back pain refers to the pain of the waist caused by different reasons, that is, the waist is affected by external forces such as falling servants, falling squats, flashing, weight bearing, etc., or injury, or damage. Bone, due to venous damage, blood stasis, stagnation, low back pain, severe pain, tingling or pain, pain has a fixed position, do not dare to prone to the side, the movement is painful, pain is unbearable and to one side or double Lateral lower extremity is radiated to the lower leg or the bottom of the foot. If the treatment is not timely or incomplete, it will not heal for a long time.
The activities of the lumbosacral joints are mainly flexion, posterior extension and lateral curvature, and there is less rotational activity. The direction of the fifth lumbar subarachnoid and the first atlantoaxial articular process are different, and some are parallel to the sagittal plane of the human body. Therefore, the flexion, extension, lateral bending, and rotation of the spine are more flexible, and some are parallel to the frontal plane of the human body. Therefore, the lateral bending and rotation of the spine are limited, and some people have bilateral joint asymmetry. Therefore, the direction and range of motion on both sides are uncoordinated, which is one of the reasons for the easy sprain of the lumbosacral joint.
Prevention
Acute simple traumatic low back pain prevention
The disease is caused by traumatic factors, so pay attention to production and life safety, avoid trauma is the key to prevention and treatment of this disease, in addition to pay attention to functional exercise, functional exercise plays an important role in the prevention and treatment of low back pain, Chinese medicine believes that for acute attacks Type, functional exercise should be based on bed and limb function exercise, through the functional exercise of the limbs, increase the body's blood circulation, at the same time, the relative static of the injury site, also created conditions for tissue repair, for the chronic extension type, mainly let The patient adopts active exercise mode, and the action is active. The active functional exercise can make the blood and blood fill, support the whole body, smooth the meridian, strengthen the muscle ligament, improve the disease resistance, reconstruct the stability of the waist, improve and consolidate the curative effect, and exercise functionally. According to the age, physical condition and other factors should be considered comprehensively, choose the appropriate exercise method.
Complication
Acute simple traumatic complications of low back pain Complications scoliosis
The main cause of this disease is complicated scoliosis.
More than half of the patients have scoliosis, varying degrees, and the direction of the scoliosis is related to sprains, tears, and nerve stimulation and compression of the ligaments. The scoliosis is to relieve sprain or tear the pain of the ligament, and to reduce nerve stimulation or The symptoms of compression, the presence or absence of scoliosis, the direction and extent, can be determined by the pathological changes of the nerves and ligaments.
Symptom
Acute simple traumatic low back pain symptoms Common symptoms Edema local tenderness neuralgia thigh pain lumbar muscle spasm sciatica tender leg sore sprain motor dysfunction
The disease mainly has the following symptoms:
(1) Patients with spontaneous low back pain suddenly feel low back pain when they have a sprain, severe acute pain, and obvious limitations. They can clearly indicate the pain area, which is easy to diagnose, and sometimes feels a simple sound or tear after a sprain. Immediately after the pain is relieved, or the sprain is not obvious, the back pain is aggravated after the rest or the next day. The waist is issued, the movement is difficult, the back muscles are weak, and even the back of the thigh causes the leg pain.
(B) local tenderness sprain early in most patients have limited tender points, can help diagnose, and sometimes because the piriformis tendon squeezes the sciatic nerve trunk, the tender point in the large ischial sciatic nerve exit.
(3) Radioactive or involved neuropathic radioactive or involved neuropathic pain, mostly in the buttocks, the back of the thigh, the anterior medial thigh, etc., the posterior cutaneous nerve and the sciatic nerve distribution area. There are three reasons for this nerve pain:
1. The ligaments around the lumbosacral and ankle joints, muscles and other soft tissues, which are dominated by the 4,5 lumbar nerves and the posterior tibial nerves, and the anterior femoral sciatic nerve and the femoral cutaneous nerve, so reflex neuralgia often occurs.
2. The sciatic nerve and the posterior cutaneous nerve bundle, close to the anterior side of the ankle joint and the piriformis. When the ligament is hemorrhagic due to a sprain, the edema directly stimulates the nerve, causing radiation neuralgia, such as piriformis. He also oppresses the sciatic nerve trunk, causing radiation-induced neuralgia and localized tenderness at the sciatic notch.
3. If the soft tissue around the intervertebral foramen is swollen after the sprain, the sciatic nerve root is directly squeezed in the intervertebral foramen, causing radioactive sciatica.
(4) Extensor or gluteus maximus. In many patients, one or both sides of the dorsal extensor or gluteus maximus tendon appear after a sprain. The patient is particularly prominent when standing upright or bent down. It can be relieved after prone, and the tendon is examined when the tender point is examined. Restore immediately, this point is helpful for diagnosis.
Examine
Acute simple traumatic low back pain check
The disease is mainly performed on the X-ray to check the spine: the ankle joint surface is ear-shaped, uneven, consisting of 1, 2, 3 sacral vertebrae and tibia. The bone vertebra is large and small, and the front is wide and narrow, making it Can not shift backwards and backwards, but there is a tendency to move forward, rotate or laterally. It is stabilized by strong patellar ligaments, tendon ligaments, and sacrospinous ligaments to prevent the sacral vertebrae from moving into the pelvis. Position, these ligaments have different directions, varying lengths, complicated interlacing, and the uneven surface of the ankle joint is uneven. The slight displacement causes the incompatibility of the ankle surface, and some ligaments are sprained or torn, causing obvious waist. Pain in the legs.
Diagnosis
Diagnosis and diagnosis of acute simple traumatic low back pain
diagnosis
Diagnosis can be based on medical history, clinical symptoms, and laboratory tests.
Differential diagnosis
The disease mainly needs to be differentiated from congenital and neoplastic low back pain, but this disease has a history of trauma. The examination should be detailed in the medical history. X-ray examination can determine whether there is any tumor. The above examination methods are beneficial to this disease. Identification of the disease.
