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Dolor musculoesquelético en la zona lumbar

ბოლო მიმოხილვა: 20 Aug 2025
ბოლო განახლება: 02 Jul 2025

შეჯამება

განსაზღვრება

ანამნეზი და გასინჯვა

ძირითადი დიაგნოსტიკური ფაქტორები

  • obesidad, estrés y comorbilidades psiquiátricas
  • antecedentes de dolor lumbar
  • la radiación del dolor no se extiende más allá de la rodilla
  • ausencia de síntomas de alarma
  • ausencia de fiebre, fluctuación, sensibilidad agudísima a la palpación
  • exámenes sensoriales, motores y de reflejos osteotendinosos profundos dentro de los límites normales
  • prueba negativa de elevación de pierna recta o cruzada recta
სრული ტექსტი

სხვა დიაგნოსტიკური ფაქტორები

  • dolor sordo, mordiente, desgarrador, de ardor o eléctrico asociado a espasmos musculares
  • ausencia de dolor con la flexión o alivio con la extensión
  • escoliosis o cifosis
  • pruebas FABER, de Gaenslen o de Schober negativas
სრული ტექსტი

რისკფაქტორები

  • obesidad
  • antecedentes familiares de discopatía degenerativa
  • poca flexibilidad musculotendinosa y postura anormal
  • estrés y comorbilidades psiquiátricas
  • mayor edad
  • sexo femenino
  • actividades físicas y laborales intensas
  • consumo de tabaco
  • permanecer de pie por períodos prolongados
  • niveles de la vitamina D
სრული ტექსტი

დიაგნოსტიკური კვლევები

1-ად შესაკვეთი გამოკვლევები

  • diagnóstico clínico
სრული ტექსტი

გასათვალისწინებელი კვლევები

  • resonancia magnética (IRM) de la columna lumbar
  • radiografía de la columna lumbar
  • tomografía computarizada (TC) de la columna lumbar
  • mielografía
  • hemograma completo (HC)
  • velocidad de sedimentación globular (VSG)
  • proteína C reactiva (PCR)
  • cultivo y análisis de orina
  • hemocultivos
  • gammagrafía ósea con radionucleidos
  • electromiograma (EMG)
სრული ტექსტი

მკურნალობის ალგორითმი

მწვავე

dolor lumbar agudo y subagudo (≤12 semanas)

მიმდინარე

dolor crónico en la zona lumbar (>12 semanas)

lumbalgia recurrente

კონტრიბუტორები

Authors

Andrew Sherman, MD, MS

Professor and Vice Chair

Department of Physical Medicine & Rehabilitation

University of Miami Miller School of Medicine

Miami

FL

Disclosures

AS declares that he has no competing interests.

Acknowledgements

Dr Andrew Sherman would like to gratefully acknowledge Dr Robert W. Irwin, Dr Louise Thwaites, Dr Karen Walker-Bone, Dr Joanne Borg-Stein, and Dr Philip Chiou, previous contributors to this topic.

Disclosures

RWI, LT, KWB, JBS, and PC declare that they have no competing interests.

Peer reviewers

Jennifer Baima, MD

Staff Physiatrist

Orthopedic and Arthritis Center

Brigham and Women's Hospital

Chestnut Hill

MA

Disclosures

JB declares that she has no competing interests.

Alexios G. Carayannopoulos, DO, MPH

Interventional Spine Physiatrist

Pain Medicine Specialist

Medical Director

Spine Center

Lahey Clinic

Burlington

MA

Disclosures

AGC declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

American College of Radiology. ACR appropriateness criteria: low back pain. 2021 [internet publication].Full text

Qaseem A, Wilt TJ, McLean RM, et al. Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2017 Apr 4;166(7):514-30.Full text  Abstract

National Institute for Health and Care Excellence. Low back pain and sciatica in over 16s: assessment and management. Dec 2020 [internet publication].Full text

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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