diffuse low back pain
Introduction
Introduction Diffuse low back pain is one of the symptoms of plasma cells. Plasmacytoma is a primary and systemic malignant tumor originating from the bone marrow. It is derived from B lymphocytes and has the property of differentiating into plasma cells. Isolated solitary cell tumors are rare and can be cured. Among them, multiple plasmacytoma is the most common, characterized by osteolytic lesions and plasma cell infiltration of bone marrow. In addition, often associated with anemia, hyperglobulinemia, hypercalcemia, impaired renal function and predisposition to infection. Clinically, patients with over 40 years of age may have skeletal or diffuse low back pain, fatigue, paleness, and mild weight loss. The possibility of myeloma should be suspected.
Cause
Cause
There are many causes of low back pain, about dozens, more common are kidney deficiency, lumbar bone hyperplasia, bone spur, disc herniation, lumbar hypertrophy, spinal stenosis, lumbar fracture, spinal canal tumor, lumbar acute or chronic trauma or strain , lumbar muscle strain, ankylosing spondylitis, etc. The lower back is the most powerful part of the human body. It provides support for the human body and protects the spine. For those who have been sitting in the office for a long time without lack of exercise, or those who need to stand for a long time, they maintain a position or posture for a long time. It is easy to cause pain in the lower back and cause chronic osteofascial compartment syndrome in the lumbosacral region, and some accumulate disease after repetitive injury. Many patients with chronic low back pain are associated with chronic osteofascial compartment syndrome. The reason may be that the increase of intraosseous pressure in the interfascial compartment leads to the disappearance of the inferior fascial space, decreased muscle blood flow, and loose adipose tissue degeneration. Because of this damage, the patient will have a backache, whether it is walking more, sitting more or lying more, that is, maintaining a posture for a long time is prone to back pain.
Examine
an examination
Related inspection
Renal dynamic imaging renal function examination spine palpation spine motion test spine vertebral body plain scan
Clinically, patients with over 40 years of age may have skeletal or diffuse low back pain, fatigue, paleness, and mild weight loss. The possibility of myeloma should be suspected.
Low back pain radiates to the lower extremities: low back pain is as painful as "explosion", and radiates to the back of the thigh, the armpit, the outside of the calf, and has a feeling of acupuncture or electric shock. After the low back pain, the lower extremity feels numb. After the patient lie down, the symptoms are relieved. Standing, walking, and even coughing and sneezing. When the bowel movement is forced, the back pain is aggravated, suggesting that it may be lumbar disc herniation. Low back pain, especially in the 4th to 5th lumbar vertebrae, and radiate to one side of the lower extremity, and even have obvious numbness. When lying down, the lower limbs of the affected side cannot lift straight legs, suggesting that it may be root sciatica.
One side of the waist and abdomen suddenly "knife cut"-like colic, one side of the waist and abdomen suddenly "knife cut" like colic, radiating along the ureter to the lower abdomen, perineum and inner thigh, can last from a few minutes to a few hours. During the onset of low back pain, the patient bends over the back, rests restlessly, pale, sweating. After the pain, there are many different degrees of hematuria, which are more common in urinary stones.
Low back pain with frequent urination, urgency, dysuria : low back pain accompanied by frequent urination, urinary urgency, dysuria, suggesting that it may be a urinary tract infection.
Low back pain with kidney area sputum pain: low back pain, when the slamming of the waist is particularly painful, kidney disease such as pyelonephritis, kidney tuberculosis, and peri-renal abscess should be considered.
Back pain in bed is aggravated : low back pain is aggravated when lying in bed, but it is relieved after getting up, and lumbar fibrosis should be considered.
Low back pain with increased vaginal discharge: Many women with back pain, vaginal discharge more often, caused by inflammation of the reproductive system. Such as cervicitis, pelvic inflammatory disease, annex inflammation and so on.
Lodging after excessive labor and childbirth : excessive sexual intercourse, excessive childbearing of children or excessive abortion, waist pain, other tests are normal, this is the Chinese medicine said kidney deficiency, Yaofu deficiencies To. In summary, through the above discussion, we know that the causes of low back pain are various. In clinical practice, doctors must pass laboratory tests in addition to understanding symptoms and physical examinations to make a diagnosis. Therefore, when there is low back pain, you should go to the hospital for examination, symptomatic treatment, and do not abuse the supplement.
Persistent low back pain with morning stiffness: non-ocular clinical manifestations of ankylosing spondylitis: the most typical early manifestation of persistent low back pain (at least 3 months), unilateral occult, blunt or intermittent, Accompanied by morning stiffness and reduced after activities.
Low back pain when bending over : When bending hard, lifting heavy objects or lifting heavy objects, sudden low back pain occurs, and the muscles on both sides of the lumbar vertebrae are cramped and tender, suggesting that it may be an acute lumbar sprain or lumbar muscle strain.
Low back pain : The pain point indicated by the patient is equivalent to the level of the buttocks area, and a few are in the lower half of the humerus, often accompanied by symptoms of lower abdominal pain. It is aggravated by premenstrual, long standing and sexual intercourse. It is a symptom of the pelvic blood stasis. Chronic low back pain with lower extremity numbness lumbar spondylolisthesis is prone to chronic low back pain and radioactive numbness in one or both lower extremities.
Diagnosis
Differential diagnosis
Typical and advanced plasmacytoma are easy to diagnose, but early plasmacytoma is difficult to diagnose. Plasmacytoma can be painless in the early stages, with only minor or insignificant signs, which can last for months, even years.
Clinically, patients with over 40 years of age may have skeletal or diffuse low back pain, fatigue, paleness, and mild weight loss. The possibility of myeloma should be suspected.
For the diagnosis of plasmacytoma, it is often necessary to examine X-ray films of the skull, spine, pelvis and proximal limbs, bone scan, serum protein electrophoresis and immunoprotein electrophoresis (calcemia, uric acidemia), looking for Bence-Jones Proteinuria and 24-hour urine protein electrophoresis (kidney clearance), bone marrow puncture of the sternum and tibia, feasible in cases of obvious osteolytic cases, cases of spinal cord compression and cases of single plasmacytoma Or needle biopsy.
Serum immunoprotein electrophoresis is the most important diagnostic test, with globulin abnormalities in most cases, and cases of single and diffuse plasmacytoma are rarely negative. Urine protein electrophoresis can be positive in the case of negative serum protein electrophoresis.
Bone marrow puncture can be negative in the initial or single lesion of the lesion. Bone marrow puncture results can only show undifferentiated atypical components, such as only bone marrow puncture results, can be misdiagnosed as lymphoma.
According to the clinical manifestations, the characteristics of skin lesions and histopathological features can be diagnosed.
