Radiating pain in lower extremities
Introduction
Introduction Symptoms of lower extremity radiation pain: can be along the lower back, buttocks, the back of the thigh, the front of the calf or the posterior lateral to the heel. The nature of pain is mainly radioactive sting. Radiation pain in the lower extremities can occur before low back pain or after the onset of low back pain. These two conditions vary from person to person.
Cause
Cause
It is well known that lumbar intervertebral discs are subjected to strong compressive stress during the load and movement of the spine. After about 20 years of age, the intervertebral disc begins to degenerate and constitute the basic cause of lumbar disc herniation. In addition, lumbar disc herniation is related to the following factors:
(1) Trauma: Observation of clinical cases shows that trauma is an important factor in the herniation of the intervertebral disc, especially in children and adolescents, and it is closely related to it. When the spine is lightly loaded and rotates rapidly, it can cause horizontal rupture of the annulus fibrosus. The compressive stress mainly causes the endplate of the cartilage to rupture. It is also believed that the trauma is only the cause of the herniated disc. The original lesion is that the painless nucleus pulposus protrudes into the inner annulus, and the trauma causes the nucleus to protrude further to the outer part. The outer fiber loop causes pain.
(2) Occupation: The relationship between occupation and lumbar disc herniation is very close. For example, the driver of the car and the tractor is in a sitting position and bumpy state for a long time, so that when driving the car, the pressure in the intervertebral disc is relatively high, up to 0.5 kPa/ Cm2. The pressure can be increased to 1 kPa/cm2 when the clutch is applied, which tends to cause lumbar disc herniation. Those who are engaged in heavy physical labor and weightlifting are more likely to cause degeneration of the intervertebral disc due to excessive load. In the case of bending, if the weight of 20kg is raised, the pressure in the intervertebral disc can be increased to more than 30 kPa/cm2.
(3) Genetic factors: There are reports of familial morbidity in lumbar disc herniation, and there are few materials in China. In addition, statistics show that the incidence of Indians, African blacks and Inuit is significantly lower than that of other ethnic groups. The reason for this is for further study.
(4) congenital anomalies of the lumbosacral lumbosacral lumbosacral deformity can increase the incidence, including lumbar vertebrae, lumbar vertebrae, vertebral deformity, facet joint deformity and axon asymmetry. The above factors can change the stress on the lower lumbar vertebrae, which constitutes one of the factors of increased intravertebral disc pressure and prone to degeneration and injury.
Examine
an examination
Related inspection
Supine and abdominal test neurological examination
(1) Low back pain symptoms: More than 90% of patients have this performance. The pain range is mainly in the lower back and lumbosacral region, and persistent dull pain is most common. The pain can be alleviated in the supine position, and the pain can be aggravated when standing and sitting.
(2) Lower extremity radiation pain symptoms: can be along the lower back, buttocks, the back of the thigh, the front of the calf or the posterior lateral to the heel. The nature of pain is mainly radioactive sting. Radiation pain in the lower extremities can occur before low back pain or after the onset of low back pain. These two conditions vary from person to person.
(3) Lower limbs feeling and motor function weakening symptoms: Due to the damage of nerve roots, the sensory and motor function of the dominant somatosensory area is weakened or even lost. Common manifestations are: numbness of the skin, coldness, decreased skin temperature, etc., when severe, muscle atrophy or even muscle spasm.
Symptoms of cauda equina: These symptoms are characterized by numbness in the perineum, dysuria, and incontinence.
Diagnosis
Differential diagnosis
Neuropathic pain in the lower extremities: Neuropathic pain refers to a pain syndrome caused by a primary lesion or dysfunction of the central or peripheral nervous system. It can be caused by injury to the peripheral nerve, the posterior root of the spinal cord, the spinal cord and other parts of the central nervous system caused by trauma or / and disease.
Low back pain caused by low limb pain or radiation pain: Chronic low back pain is mainly caused by pain in the back, lumbosacral and ankle, and there is simple low back pain and low back pain accompanied by lower limb induced pain or radiation pain. Points.
(1) Low back pain symptoms: More than 90% of patients have this performance. The pain range is mainly in the lower back and lumbosacral region, and persistent dull pain is most common. The pain can be alleviated in the supine position, and the pain can be aggravated when standing and sitting.
(2) Lower extremity radiation pain symptoms: can be along the lower back, buttocks, the back of the thigh, the front of the calf or the posterior lateral to the heel. The nature of pain is mainly radioactive sting. Radiation pain in the lower extremities can occur before low back pain or after the onset of low back pain. These two conditions vary from person to person.
(3) Lower limbs feeling and motor function weakening symptoms: Due to the damage of nerve roots, the sensory and motor function of the dominant somatosensory area is weakened or even lost. Common manifestations are: numbness of the skin, coldness, decreased skin temperature, etc., when severe, muscle atrophy or even muscle spasm.
Symptoms of cauda equina: These symptoms are characterized by numbness in the perineum, dysuria, and incontinence.
