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DOI: 10.1055/a-1298-0294
Rückenschmerz
Neuropathisch, nozizeptiv oder beides?Back painNeuropathic, nociceptive or both?ZUSAMMENFASSUNG
Rückenschmerz ist ein häufiges Krankheitsbild in der Gesellschaft und stellt die zweithäufigste Ursache für Berufsunfähigkeit in Deutschland dar. Vor allem akuter Rückenschmerz kann Anzeichen einer behandlungsbedürftigen Situation sein, wichtige Differenzialdiagnosen sollten abgeklärt werden. Häufig chronifizieren Rückenschmerzen im Verlauf. Die beschriebenen Symptome sind meist nicht eindeutig nozizeptiv oder neuropathisch, oft zeigt sich ein Mischbild beider Schmerzkomponenten. Dies spielt eine Rolle bei der Therapie, weshalb wegweisende Symptome erfragt werden sollten. Wichtige Schlüsselwörter, die einen neuropathischen Schmerz vermuten lassen, sind u. a. Brennschmerz und einschießender Schmerz sowie das Auftreten von Parästhesien wie Kribbeln und Ameisenlaufen. Die Schmerztherapie sollte leitliniengerecht erfolgen und aktivierende Maßnahmen beinhalten. Eine regelmäßige Bewertung von Verlauf und Therapie ist erforderlich.
ABSTRACT
Back pain is a common disease in society and represents the second most common reason for occupational disability in Germany. Especially acute back pain can indicate a situation requiring treatment, important differential diagnoses should be clarified here. Often back pain becomes chronic over time. The symptoms described are usually not clearly nociceptive or neuropathic, often a mixture of both pain components is found. This affects the therapy, which is why the indicative symptoms should be asked for. Important key words that suggest neuropathic pain include burning pain and shooting pain as well as the appearance of paresthesias such as tingling and formication. Pain management should follow guidelines and include activating therapies. Frequent evaluation of course and therapy is required.
Publication History
Article published online:
09 March 2021
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