Rückenschmerz und Kräftigungsansätze

Zusammenfassung

Die sozialmedizinische Bedeutung von Rückenschmerzen ist unbestritten. Dagegen bestehen erhebliche Diskussionen bezüglich der Entstehungsmechanismen. Wir gehen davon aus, dass unterschiedliche bio-psycho-soziale Faktoren Rückenprobleme auslösen. Letztendlich münden diese in einer reduzierten Kraft der lumbalen Rückenstrecker. In dem Beitrag wird ein Überblick über den Forschungsstand zu Kräftigungsverfahren gegeben.

Abstract

The social and economic significance of back pain is undisputed. On the other hand there is a considerable discussion regarding the possible pathological mechanisms. We assume that different bio-psycho-social aspects are contributing etiological factors. These factors flow in a final common pathway: the reduced strength of the lumbal extensors. We use this model for a comprehensive overview of the available literature.

Stichworte:

Rückenschmerzen - Entstehungsmechanismen - bio-psycho-soziale Faktoren - lumbale Rückenstrecker

Key words:

Back pain - pathological mechanisms - bio-psycho-social aspects - lumbal extensors

Literatur

• 1 Borenstein D G et al. The value of magnetic resonance imaging of the lumbar spine to predict low-back pain in asymptomatic subjects.  Journal of Bone and Joint Surgery. 2001;  83-A (9) 1306-1311
• 2 Elliot A M, Smith B H, Penny K I, Smith W C, Chambers W A. The epidemiology of chronic pain in the community.  The lancet. 1999;  354 1248-1252
• 3 Van Tulder M, Koes B. Low back pain and sciatica: Acute.  Clinical Evidence. 2002;  8 1156-1187
• 4 Klaber J K, Moffett J A. What is the value of physical therapies for back pain?.  Best Practice & Research Clinical Rheumatology. 2004;  19 (4) 623-638
• 5 Lenhart U, Elkeles T, Rosenbrock R. Rückenschmerzen - Befunde epidemiologischer Forschung.  Z Allg Med. 1994;  70 561-565
• 6 Byrns G E, Bierma T J, Agnew J, Curbow B. A new direction in low-back pain research.  AIHA J. 2002;  63 (1) 55-61
• 7 Lee P, Helewa A, Goldsmith C, Smynthe H, Stitt L. Low Back Pain: Prevalence and Risk Factors in an Industrial Setting.  J Rheumatol. 2001;  28 346-351
• 8 Pincus T, Burton A K, Vogel S, Field A P. A Systematic Review of Psychological Factors as Predictors of Chronicity/Disability in Prospective Cohorts of Low Back Pain.  Spine. 2002;  27 (5) E109-E120
• 9 Chaffin D B, Stump B S, Nussbaum M A, Baker G. Low-back stresses when learning to use a materials handling device.  Ergonomics. 1999;  42 (1) 94-110 (17)
• 10 Sjolie A N, Ljunggren A E. The significance of high lumbar mobility and low lumbar strength for current and future low back pain in adolescents.  Spine. 2001;  26 (23) 2629-2636
• 11 Keller A, Johansen J G, Hellesnes J, Brox J I. Predictors of isokinetic back muscle strength in patients with low back pain.  Spine. 1999;  24 (3) 275-280
• 12 Mark E B, Cheralynne T. Five facts and five concepts for rehabilitation of mechanical low back pain.  Br J Sports Med. 2000;  34 261
• 13 Hilde G, Hagen K B, Jamtvedt G, Winnem M. Advice to stay active as a single treatment for low-back pain and sciatica (Cochrane Review). In: The Cochrane Library. Issue 3. Chichester: John Wiley & Sons; 2004
• 14 Hayden J A, van Tulder M W, Malmivaara A, Koes B. Exercise therapy for treatment of non-specific low back pain (Cochrane Review). In: The Cochrane Library. Issue 1. Chichester: John Wiley & Sons; 2006
• 15 Rainville J, Hartigan C, Martinez E, Limke J, Jouve C, Finno M. Exercise as a treatment for chronic low back pain.  Spine. 2004;  4 (1) 106-115
• 16 Hildebrandt J. Ökonomische Auswirkungen chronischer Rückenschmerzen.  Der Schmerz. 2001;  15 205-206
• 17 van Tulder M W. Die Behandlung von Rückenschmerzen. Mythen und Fakten.  Der Schmerz. 2001;  15 499-503
• 18 Guzmán J, Esmail R, Karjalainen K, Malmivaara A, Irvin E, Bombardier C. Multidisciplinary bio-psycho-social rehabilitation for chronic low-back pain (Cochrane Review). In: The Cochrane Library. Issue 3. Chichester: John Wiley & Sons; 2004
• 19 Schonstein E, Kenny D T, Keating J, Koes B W. Work conditioning, work hardening and functional restoration for workers with back and neck pain (Cochrane Review). In: The Cochrane Library. Issue 3. Chichester: John Wiley & Sons; 2004
• 20 Leggett S, Mooney V, Matheson L N et al. Restorative exercise for clinical low back pain. A prospective two-center study with 1-year follow-up.  Spine. 1999;  24 (9) 889-898
• 21 Graves J E, Webb D C, Pollock M L et al. Pelvic stabilization during resistance training: its effect on the development of lumbar extension strength.  Arch Phys Med Rehabil. 1994;  75 (2) 210-215
• 22 Pollock M L, Leggett S H, Graves J E, Jones A, Fulton M, Cirulli J. Effect of resistance training on lumbar extension strength.  Am J Sports Med. 1989;  17 (5) 624-629
• 23 Graves J E, Pollock M L, Foster D et al. Effect of training frequency and specificity on isometric lumbar extension strength.  Spine. 1990;  15 (6) 504-509
• 24 Carpenter M, Nelson B. Low back strengthening for the prevention and treatment of low-back pain.  Medicine and Science in Sports and Exercise. 1999;  31 (1) 18-24
• 25 Tucci J T, Carpenter D M, Pollock M L, Graves J E, Leggett S H. Effect of reduced frequency of training and detraining on lumbar extension strength.  Spine. 1992;  17 (12) 453-458
• 26 Helewa A, Goldsmith C H, Lee P, Smythe H A, Forwell L. Does strengthening the abdominal muscles prevent low back pain - a randomized controlled trial.  J Rheumatol. 1999;  26 (8) 1808-1815
• 27 De Michele P L, Pollock M L, Graves J E, Foster D N, Carpenter D, Garzarella L, Brechue W, Fulton M. Archives of Physical Medicine and Rehabilitation.  1997;  78 (1) 64-69
• 28 Risch S V, Norvell N K, Pollock M L. Lumbar strengthening in chronic low back pain patients. Physiologic and psychological benefits.   Spine. 1993;  18 (2) 232-238
• 29 Carpenter D M, Nelson B W. Low back strengthening for the prevention and treatment of low back pain.  Med Sci Sports Exerc. 1999;  31 (1) 18-24
• 30 Handa N, Yamamoto H, Tani T, Kawakami T, Takemasa R. The effect of trunk muscle exercises in patients over 40 years of age with chronic low back pain.  J Orthop Sci. 2000;  5 (3) 210-216
• 31 Fiatarone Singh M A. Exercise and aging.  Clin Geriatr Med. 2004;  20 (2) 201-221
• 32 Keller A, Brox J I, Gunderson R, Holm I, Friis A, Reikeras O. Trunk muscle strength, cross-sectional area, and density in patients with chronic low back pain randomized to lumbar fusion or cognitive intervention and exercises.  Spine. 2004;  29 (1) 3-8
• 33 Maniadakis N, Gray A. The economic burden of back pain in the UK.  Pain. 2000;  84 (1) 95-103
• 34 Torstensen T A, Ljunggren A E, Meen H D et al. Efficiency and costs of medical exercise therapy, conventional physiotherapy, and self-exercise in patients with chronic low back pain. A pragmatic, randomized, single-blinded, controlled trial with 1-year follow-up.  Spine. 1998;  23 (23) 2616-2624
• 35 Loisel P, Lemaire J, Poitras S et al. Cost-benefit and cost-effectiveness analysis of a disability prevention model for back pain management: a six year follow up study.  Occup Environ Med. 2002;  59 807-815
• 36 Karjalainen K, Malmivaara A, Mutanen P, Pohjolainen T, Roine R, Hurri H. Outcome determinants of subacute low back pain.  Spine. 2003;  28 (23) 2634-2640
• 37 Stevans J, Hall K G. Motor skill acquisition strategies for rehabilitation of low back pain.   J Orthop Sports Phys Ther. 1998;  28 (3) 165-167
• 38 Mannion A F, Taimela S, Muntener M, Dvorak J. Active therapy for chronic low back pain. Part 1. Effects on back muscle activation, fatigability, and strength.   Spine. 2001;  26 (8) 920-929
• 39 Hayden J A, van Tulder M W, Malmivaara A, Koes B. Exercise therapy for treatment of non-specific low back pain (Cochrane Review). In: The Cochrane Library. Issue 1. Chichester: John Wiley & Sons; 2006

Korrespondenzadresse