Kreuzschmerzen sind weltweit die führende Ursache für körperliche Beeinträchtigungen.
In über 80 % der Fälle finden sich keine organischen Ursachen. Bei 20 % gilt es, eine
spezifische Ursache frühzeitig zu erkennen, um potenziell gefährliche oder entsprechend
therapierbare Verläufe abzuwenden. Entscheidende Hinweise zur Ätiologie liefert eine
gründliche Anamnese, die oftmals durch die körperliche Untersuchung nur ergänzend
bestätigt wird.
Abstract
A systematic survey of the symptoms of back pain in terms of triggering event and
onset, nature and the extent of influenceability of the pain (lying or standing, under
stress, nocturnal pain, localized percussion tenderness, B- symptoms, etc.), as well
as structured clinical examination (segment height, radiance, projection, reflex status,
sensitivity and motor function) allows an initial and therefore orienting classification
of back pain as non-specific or specific. In the primary care setting many patients
can be treated extremely effectively and economically from a cost perspective. In
addition to the fastest possible pain relief, it is important to prevent the disease
becoming chronic. A wide range of pharmacological treatment can be combined with non-pharmacological
measures, such as early on exercises, promoting every day mobility, physiotherapy,
manual therapy etc.. 20 % of patients with lower back pain have a determinable cause
that needs to be rapidly identified. In addition to laboratory diagnostics, structured
morphological imaging is necessary. Causes of specific back pain include: fractures,
infections, radiculopathy, tumors, axial spondylarthritis as well as extravertebral
causes. In the further cause of treatment, it may be necessary to consult medical
specialists in the fields of radiology, orthopedics, neurology, neurosurgery, rheumatology,
psychotherapy, psychiatry, among others. Treatment is managed by the primary care
provider, who should also receive and re-evaluate all findings during the course of
the disease.
Schlüsselwörter
nichtspezifischer und spezifischer Rückenschmerz - unterer Rückenschmerz - Lumbago
- Diagnostikalgorithmus - chronifizierter Schmerz - multimodale Therapie
Key words
non specific and specific back pain - lumbago - lower back pain - diagnostic algorithm
- chronic pain - multimodal treatment
