Low back pain or low back pain is an experience that every middle-aged and elderly person has, and it is also a common clinical symptom, but not every friend is aware of its pathogenesis and diagnosis. Here are some questions to talk with you:
1. Common causes:
Low back pain is not a simple disease. It’s a symptom caused by many diseases,
1. Those who are negative on X-ray
1) Overworked or sprained lumbosacral joint or sacroiliac joint
2), myofasciitis, cold or fatigue
5), bad posture
2. Those who need X-ray film for diagnosis:
Lumbar disc herniation, spinal cord tumors, tuberculosis, aneurysms, spinal degeneration, old vertebral fractures, osteoporosis, spondylolisthesis, ankylosing spondylitis, congenital malformations, syphilis, typhoid and other infectious spondylitis, double sacroiliac Joint disease, spinal stenosis, etc.
3. Caused by lower limb disorders:
Flat feet, foot pads, corns, polio, congenital dislocation of the hip, etc.
4. Caused by medical diseases:
1) Gynecology: Uterine fibroids
2) Urinary: Prostatitis, prostate tumor, kidney stones
3) Gastrointestinal diseases: ulcers, tumors, perforations, appendicitis of the posterior cecum, hernias, chronic constipation, visceral ptosis, hemorrhoids, colitis, perianal inflammation, sigmoid colon, rectal spasm.
4) Cholecystitis: Perigallbladder inflammation, gallstones,
5) Infection: cold, flu, malaria, typhoid fever
6) Neurological disorders: fraud.
Therefore, if you want to treat low back pain as soon as possible, you must first diagnose the cause and avoid blindness.
2. Bone spurs or bone hyperplasia
Middle-aged and elderly patients in the clinic often complain that they have bone spurs, as if bone spurs are the culprit of all lumbar diseases, in fact
it's not true. Bone spurs often grow in areas with a large range of motion, such as cervical spine, lumbar spine, knees, heels, etc. Not all bone spurs produce symptoms, and many symptoms are not caused by bone spurs. Bone spurs are the product of the human body's compensation mechanism, which is to increase the force area and stabilize the joint. From the perspective of biomechanics, different biomechanical effects produce bone spurs of different shapes. Such as (1) tensile stress The direction of the spine is the direction of the tensile force. (2) Compressive stress According to the principle of piezoelectricity, the negative charge increases and Ca++ moves in its direction, resulting in the deposition of Ca++, which gradually hardens and calcifies. (3) Increased stress. The fibrous annulus under the force of the intervertebral disc swells around, producing bone spurs and Lusska`s joint hyperplasia at the edge of the vertebral body. The traction of the anterior longitudinal ligament and the posterior longitudinal ligament will also form bone spurs. In the orthographic image of the knee joint, proliferation of the intercondylar spine is often found, which is caused by the tension of the "cross" ligament.
Treatment cannot focus on bone spurs. The formation of bone spurs is the result of pathological changes rather than the cause. Biomechanical disorders are the cause. Restoring the balance of biomechanics is the fundamental treatment. On the other hand, bone spurs are not the cause of all diseases, so we must not eliminate bone spurs. Treatment should focus on the whole, focus on biomechanical balance, and focus on soft tissue injuries such as muscles, ligaments, and fascia.
Three, herniated disc
Intervertebral disc herniation can occur in the neck, chest, and waist, especially the frequency of the neck and waist. The chances of cervical and lumbar protrusions are not equal. C4-7, L4, 5, and L5S1 are more likely to occur, and there is less chance of thoracic disc herniation, because the protruding part is often the part with a large force and a large range of motion. The thoracic spine has very little mobility, so the chance of occurrence is also very small.
Another problem is that not all intervertebral discs with multi-segment herniation cause clinical symptoms, but which segment caused the symptoms must be comprehensively judged based on symptoms, signs and imaging examinations.
The third problem is that the herniated disc cannot be viewed in isolation. Due to the coordination and compensation between the biomechanics of the various joints of the human body, some small imbalances will be repaired and compensated by the human body. Once decompensated, the dynamic balance is disrupted, and it will not be reflected only in the intervertebral disc. Pathological changes will occur in the surrounding soft tissues, facet joints, and spine. At the same time, the diseases of these surrounding tissues will also cause protrusions. Therefore, prominence is only one link in the chain of occurrence of prognosis, not all of the symptoms. Frequently referred to as intervertebral disc herniation includes two-sided symptoms, on the one hand, lesions within the spinal canal, and on the other hand, lesions outside the spinal canal. Intraspinal lesions generally refer to spinal cord compression or cauda equina nerve compression, nerve root canal stenosis, distraction, etc.; extraspinal lesions refer to soft tissue lesions such as muscles, ligaments, and fascia. The lesions in the spinal canal are generally treated with surgery, and the lesions outside the spinal canal are treated with non-surgical treatment.
The human body is an organic whole, and the entire skeleton structure is also a whole. Intervertebral disc herniation, the mechanical balance of the spine unit is out of balance, pain stimulates the body's self-protection mechanism, and produces painful scoliosis of the spine. Scoliosis causes pelvic tilt, pelvic tilt causes bilateral hip joint mechanics imbalance, and hip joint mechanics imbalance is transmitted to the knee joint. Uneven force on the knee joint will cause knee joint soft tissue injuries, such as aseptic inflammation of the collateral ligaments, bursae, subfat pads and other tissues. By the same token, the ankle joint can also be injured. Conversely, shoulders, hips, knees and ankles can also cause discomfort in the head, neck and waist. Intricate, intertwined up and down, intertwined inside and outside, and left and right are the characteristics of this type of disease. This phenomenon often occurs clinically. Hip joint diseases do not cause hip pain, but are manifested as knee joint pain.
Due to the influence of traditional habits, individual doctors still have sciatica when they diagnose patients. So some patients say they have sciatica as soon as they have low back and leg pain. In fact, sciatica is only a symptom, not a disease. Many diseases can cause sciatica, such as lumbar disc herniation, spondylolisthesis, piriformis injury, lumbar degeneration, etc. The pathological changes at the exit of the sciatic nerve and along the pathway will cause sciatica to stimulate the sciatic nerve. Therefore, the treatment of the sciatic nerve alone is not enough.