最近审阅: 28 十月 2020
最近更新: 07 十一月 2016

小结

定义

病史和体格检查

关键诊断因素

  • 肥胖、应激和精神共病
  • 下腰痛发作史
  • 下腰痛既往治疗史
  • 病史时间<12周
  • 疼痛向下肢放射未超过膝关节
  • 缺乏“红旗征”
  • 无发热、波动感或精细轻触觉丧失
  • 感觉、运动以及深肌腱反射在正常范围内
  • 直腿抬高实验或交叉直腿抬高实验阴性

其他诊断因素

  • 与肌肉痉挛相关的钝痛、咬痛、撕裂痛、烧灼痛或电击痛
  • 屈曲位疼痛不明显或伸展位疼痛减轻
  • 脊柱侧弯或驼背
  • FABER试验、Gaenslen试验或Schober试验阴性

危险因素

  • 肥胖
  • 退行性椎间盘病变家族史
  • 社会压力和精神共病
  • 年龄增长,最高至60-65岁
  • 女性
  • 重体力劳动或重职业性活动
  • 吸烟

诊断性检查

需考虑的检查

  • 腰椎X光片
  • 腰椎核磁
  • 腰椎CT
  • 脊髓造影
  • 全血细胞计数
  • 血沉(ESR)
  • C反应蛋白
  • 尿分析及培养
  • 血液培养
  • 放射性核素骨扫描
  • 肌电图
更多 需考虑的检查

治疗流程

撰稿人

Interim Chairman and Professor

Department of Physical Medicine and Rehabilitation

University of Miami Miller School of Medicine

Miami

FL

利益声明

RWI declares that he has no competing interests.

Professor and Vice Chair

Department of Physical Medicine & Rehabilitation

University of Miami Miller School of Medicine

Miami

FL

利益声明

AS declares that he has no competing interests.

Dr Robert Irwin and Dr Andrew Sherman would like to gratefully acknowledge Dr Louise Thwaites, Dr Karen Walker-Bone, Dr Joanne Borg-Stein, and Dr Philip Chiou, the previous contributors to this monograph. LT, KWB, JBS, and PC declare that they have no competing interests.

同行评议者展开全部内容

Staff Physiatrist

Orthopedic and Arthritis Center

Brigham and Women's Hospital

Chestnut Hill

MA

利益声明

JB declares that she has no competing interests.

Interventional Spine Physiatrist

Pain Medicine Specialist

Medical Director

Spine Center

Lahey Clinic

Burlington

MA

利益声明

AGC declares that he has no competing interests.

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