Chronic Strain Low Back Pain
Introduction
Introduction to chronic strained low back pain Chronic strained low back pain, also known as chronic low back muscle strain, is one of the most common clinical conditions. Symptoms, it is completely similar to the chest and back or lumbosacral fibroin, although its occurrence is another reason, more common in wet, cold conditions, but often difficult to distinguish clinically, unless According to the characteristics of the medical history, the author thinks that it can be distinguished by distinction, because the two have different emphasis on prevention and treatment; but for those who cannot be separated, they can be collectively referred to as "lumbar muscle strain". The term "straining" refers to low back pain caused by no obvious trauma. It has been called "overwork" in the past. The strain that occurs at the waist is called the waist strain; if it occurs on the back, it is called the back strain; if both cases exist, it is called the back strain. Both often appear as a continuation, and because of its gradual formation, it is also known as chronic lumbar back strain. basic knowledge The proportion of sickness: 0.54% Susceptible people: no special people Mode of infection: non-infectious Complications: acute lumbar sprain
Cause
Causes of chronic strained low back pain
(1) Causes of the disease
Mostly caused by the sequelae of acute lumbar sprain and cumulative chronic injury.
(two) pathogenesis
The injury mechanism is mainly caused by the sequelae of acute lumbar sprain and cumulative chronic injury, but it is more likely to occur if the temperature is low and humid.
1. Acute lumbar back sprain sequelae
Acute sprains are very common. After treatment, 95% of patients can recover, but if the early treatment is wrong, the brakes and fixation are not satisfactory, because the damaged back muscles are still pulled, or because of the waist. Frequent activities of the back, which affect the normal healing of the tissue, or the operation of the heavy hand massage, so that the newly healed fibrous tissue is pulled apart, etc., can cause this adverse effect, severe back muscle laceration, even This kind of sequelae may occur in the early stage of reasonable treatment. This is mainly because the large area of scar tissue left after healing is less able to withstand the normal activity and load of the spine than the normal tissue, so that it is easy to be pulled and relaxed, and the degeneration and Ischemia can form a vicious circle. Therefore, in such cases, special care should be taken in the treatment, and the incidence is generally not more than 5% of the total number of cases of acute sprains in the lower back.
2. Cumulative chronic injury
It is not enough to cause trauma to the muscle ligament tear, or the forced position of the back muscles under high tension for a long time. It is more common in car drivers, sand blasting and tunnel operations, which can cause muscle tissue and some attachment. Excessive pulling at the point, resulting in pre-fracture state, local reactive inflammation, including local blood supply obstruction, ischemia, congestion, hypoxia and exudation, etc., gradually causing local tissue degeneration, repeated chronic Strain can make this process more and more serious, and it is easy to form a vicious circle.
3. Additional factors
Too low temperature or too much humidity can promote the development of the above pathological processes, such as endocrine disorders (female menopause is more common), serious illness and severe trauma, etc., are easy to induce this disease.
Prevention
Chronic strain and low back pain prevention
The prevention of this disease is all-round, from the living conditions to the labor posture, etc. should consider whether it will cause strain of the back muscles, and should consider the specific problems and measures to prevent chronic low back pain.
Complication
Complications of chronic strained low back pain Complications acute lumbar sprain
Complications such as acute lumbar sprains.
Symptom
Chronic strain of low back pain symptoms Common symptoms Back pain Muscle tension Pain nodules
Diffuse pain
The patient complained of diffuse pain in the lower back (sometimes including the buttocks), which is more obvious on both sides of the waist, paravertebral and sacral. It is characterized by painful drama in the morning, activity after a few minutes or half an hour, but in the evening It seems that too much pain due to activity and recurrence, and improved after rest, similar to hypertrophic spondylitis.
2. There are many predisposing factors
There are many obvious predisposing factors in patients' morbidity. Among them, physical labor, physical exercise, overwork, dampness and cold are common, and similar situations have occurred in past medical history.
3. Point tenderness and subcutaneous nodules
The patient can use his fingers to clearly indicate the pain point (one or a few points). In addition to the local pain, the nerve fiber can be transmitted along the nerve fiber tip distributed at the pain point, and the adjacent part of the pain appears to be reflected. The skin is thinner. It is still possible to reach the nodular lumps in the deep part of the pain point. The size is more than 5mm × 5mm, and sometimes it can reach the lipoma-like nodules (more accompanied by radiation pain) with a diameter of about 1cm.
4. Other
Including the general symptoms of low back pain, which is more common in the back and back stiffness, limited mobility and muscle tension.
Examine
Examination of chronic strained low back pain
Erythrocyte sedimentation rate and anti-"O" are within the normal range, which can be distinguished from rheumatic patients.
There were no positive X-ray films.
Diagnosis
Diagnosis and differential diagnosis of chronic strained low back pain
1. In addition to the history of waist and back trauma, the history of the disease has many professional features, and can be asked in detail about the long-term work and duration of the lumbosacral flexion.
2. The test erythrocyte sedimentation rate and anti-"O" are within the normal range, which can be distinguished from rheumatic patients.
3. X-ray film is not positive.
