Do you think that all the low back pain is caused by lumbar disc herniation? Do you think that you have to sleep on a wooden bed? Do you think that the elderly low back pain is caused by bone hyperplasia? Do you think that bone hyperplasia will definitely cause low back pain? Or low back pain is bone hyperplasia? … Are these common senses correct? Are they correct? According to statistics, 80% of people’s lives will have low back pain experience. Some patients will have recurrent episodes of low back pain, which cannot be completely cured and become chronic low back pain, which seriously affects the normal life and work of ordinary people. In recent years, low back pain is no longer a patent for the elderly, not only for office workers, but even some students are shouting “back pain” and frequently recruiting. Low back pain has become a common phenomenon in modern life, and it is gradually showing a trend of rejuvenation. However, if there is low back pain, it will give the next diagnosis of lumbar disc herniation. It is natural to think that my waist is not good. I have to change the bed into a wooden board. It is also taken for granted that lumbar vertebrae hyperplasia is the cause of lumbar disc herniation. The main reason, even hope that doctors can give a certain drug or paste a magical plaster, can eliminate bone spurs and cure lumbar disc herniation. There are actually many reasons for low back pain. How do we tell when low back pain occurs? How do you simply judge your cause? We need to know the reasons for low back pain, according to the clinical incidence rate as follows: common causes of low back pain (a) typical cases of low back pain (flash waist) after acute lumbar sprain (describe the condition of patients with common acute lumbar sprain) “Doctor Zhang, moved home at home yesterday Lifting things and flashing waist, a sharp pain in the waist, rested for one night, getting up in the morning hurts more seriously, turning over, standing is difficult, how to twist it how serious?” “Dr. Zhang, got off work last night to get a little express Heavy, the waist was slightly twisted. I didn’t feel too much about my back pain. I slept for a night. I couldn’t stand my back pain, I couldn’t twist, cough, sneeze, I didn’t dare to use the toilet. Incomparably, what is going on?” The main symptoms of acute lumbar sprains are more common in young adults, and the common people describe them as “waist flashes.” There are often incentives to lift heavy objects or twists, muscles contraction too much, or force posture is not correct, muscle overload or excessive contraction. If the sprain is very heavy, there will be persistent lumbar pain at the time. The next day, due to local bleeding, swelling, and low back pain in the waist muscles; if the sprain of the waist is very slight, there may be no obvious pain at that time, and the pain in the lower part of the waist will worsen the next day. When standing after injury, you often need to hold your waist with your hands. You need to use your hands to lift the seat back to sit down. The waist activity is obviously limited, the waist can’t be straight, the waist is difficult to twist, coughing, sneezing, and waist force can make the pain worse. However, there is no radiation pain in the lower extremities (this is different from lumbar disc herniation), and rest or taking general analgesics can not be alleviated. Treatment method Acute lumbar sprain is important in prevention. If you accidentally sprain, you must pay great attention to your thoughts. Many patients have acute lumbar sprains. X-ray films show no problems in lumbar vertebrae. They think that they have little problem and cannot be treated regularly. Low back pain Prolonged unhealed, which evolved into chronic low back pain, leaving behind sequelae, causing great difficulties in treatment. When treating, it is necessary to distinguish the degree of sprained waist. Generally lighter sprains, muscles or ligaments are only subjected to excessive traction, not torn patients, rest with oral or topical non-steroidal anti-inflammatory analgesics, pain can disappear within a few days, and soon recover activity. For patients with heavier lumbar sprained soft tissue, rest should be rested for 3-4 weeks until the damaged tissue is completely restored and the pain symptoms subsided. If you are eager to resume activity, it will delay healing. (2) Typical cases of lumbar muscle strain (lumbar myofasciitis) (description of patients with common lumbar muscle strain) “Doctor Zhang, I am a little tired, the waist starts to sore, pain, can not sit for a long time, rest for a good night One point, the waist has not been traumatized. I have done a lot of checks and said that it is no problem. What happened to my waist?” “Dr. Zhang, I started to have low back pain after giving birth, and the child will hurt even more, and the waist is cold. Feeling that the waist can not bear their own weight, the feeling of empty, stimulated by a little cold, the waist is painful, sore and weak.” The main symptoms of lumbar muscle strain is also one of the low back pains that people often hang on their lips.Lumbar muscle strain, also known as myofascial inflammation, is a clinically common, often overlooked or misdiagnosed low back pain. Mainly the aseptic inflammatory reaction of the lumbar muscle and its attachment point fascia or periosteum. If it is not thoroughly treated in the acute phase, it will be transferred to chronic, leaving sequelae; or because the waist is subjected to repeated strain and long-term fixed posture work, Sitting for a long time, cold and other bad stimuli, there may be persistent or intermittent chronic lumbar muscle pain, soreness and other symptoms. Pain is aggravated after exertion or cold, can be relieved after rest or warmth, when it is light and heavy, lumbar muscle strain is different from the low back pain caused by the acute lumbar sprain mentioned above: low back pain of lumbar muscle strain, when pressing pain Part, give him a massage or hyperthermia, the pain will be significantly reduced; but the acute lumbar sprain is the opposite of the back pain, the symptoms of pressing the pain area are intensified, can not tolerate, the more painful the compression. In addition, lumbar muscle strain rarely has lower extremity radiation pain (ie, sciatica), which can be distinguished from low back pain caused by lumbar disc herniation. Treatment The treatment of this disease is mainly based on conservative treatment, and rarely requires surgery. 1. The acute onset of pain is mainly bed rest and physical therapy (massage, hot bath, physiotherapy, traction, acupuncture, cupping, etc.). 2. The combination of anti-inflammatory analgesia, swelling and antispasmodic drugs and topical plaster can quickly alleviate the symptoms, especially for patients with acute phase. Commonly used such as Fenbid, Futalin Sustained Release Tablets, Celecoxib Capsules, Hydrochloric Acid B Piperazine tablets and the like. If there is a fixed point of pain in the lower back, local closure therapy can also achieve miraculous effects, but care should be taken to prevent possible complications. 3. Interventional or surgical treatment: For a very small number of clinically persistent symptoms, patients with long-term treatment may consider intervention or surgery. Interventional therapy is a minimally invasive treatment, in which ultrasound-guided small needle knife or radiofrequency muscle relaxation treatment is good. However, myofasciitis is often a multiple lesion, surgery can only solve one symptom, so surgical indications should be strictly controlled. (3) Typical cases of lumbar disc herniation (a description of the condition of patients with common lumbar disc herniation) “Dr. Zhang, I have been suffering from low back pain. After a few days of cold and cough, my back pain is aggravated. I feel the outside of the buttocks and the back of the thighs and calves. It hurts, I don’t dare to cough hard, I don’t dare to lift my legs in bed, I feel comfortable when my legs are bent. What is the problem?” “Dr. Zhang, I had a low back pain for a while, and I had a good rest for a few days. I was tired of doing things. The back pain is very powerful, and the outside of the leg is as severe as the electric shock. The toes are still numb and the waist is not straight. What is going on?” The main symptoms of lumbar disc herniation are common diseases of orthopedics. The onset is also one of the most common causes of low back pain. Lumbar disc herniation often occurs in young and middle-aged patients, and some elderly patients can also develop disease. Unlike other causes of low back pain, low back pain is accompanied by radiation pain on one or both lower extremities, and individual patients have only low back pain or leg pain. Coughing, sneezing, and stool movements can cause pain. If the course of disease is too long, there will be numbness on the outer side of the calf and the skin on the back of the foot. In severe cases, there may be symptoms such as numbness in the perineal area and loss of control over the urine. Treatment methods In general, 80% of patients do not need surgery, most patients with lumbar disc herniation, whether treated or not, over time, the prominent lumbar disc tissue usually (but not all) will shrink / degeneration, The improvement of clinical symptom relief function means that the disease has a certain self-healing ability, which may subvert the cognition of most patients. The vast majority of drugs and rehabilitation can be restored to normal life and work, but there may be recurrence. When regular conservative treatment (bed rest + drug + rehabilitation physiotherapy) for more than 6 months, the symptoms of low back and leg pain have no obvious relief, affect rest and sleep, nerve damage is obvious, muscle strength is significantly reduced, you should surgery as soon as possible. 1. Proper bed rest during an acute attack to maintain daily activities within the tolerance range. After the symptoms are relieved, it is feasible to take a slow-moving, swimming, and walking-out exercise. Avoid sedentary and standing for a long time, avoid moving heavy objects, avoid rotating the waist, and choose a medium-hard mattress. 2. Traction, massage, hyperthermia, acupuncture, low-intermediate frequency electrotherapy, and spinal manipulation can be used to improve low back pain by improving local blood circulation and relieving muscle spasm.3. Drug treatment of oral acetaminophen and non-steroidal anti-inflammatory drugs (commonly used such as Fenbid, Futalin sustained-release tablets, celecoxib capsules, etc.), nutritional neuropharmaceuticals (methylcobalamin tablets, vitamin B12), Intravenous dehydration (20% mannitol) relieves symptoms of acute pain. 4. Interventional and surgical treatment Most of the symptoms of lumbar disc herniation can be relieved by themselves. If your symptoms are severe, you should be treated with active and regular conservative treatment for 6 months, and MRI will show that the imaging findings are consistent with the physical signs, indicating your condition. It is not a group that can heal itself. At this time, don’t hesitate, let alone blindly seek the “ancestor secret recipe”. It is recommended to perform surgery within 6 months. The available evidence indicates that if surgery is necessary, patients who have surgery in the early stage of the disease (June-December) will have faster recovery, better surgical outcome, better neurological recovery, and less risk of surgery. (4) Typical cases of osteoporosis (description of patients with common osteoporosis) “Dr. Zhang, my mother-in-law is 72 years old, often screaming low back pain. Three days ago, the cold made a sneeze and started to have low back pain. Exacerbation, accompanied by ribs and chest pain, can not be relieved, pain is difficult to sleep, my mother-in-law what is this?” “Dr. Zhang, my family is 83 years old, has not suffered any trauma, waist, back, rib pain, Just like there is a “small gas” to wander around, where the pain is going to increase there. Especially at night, lying down, the back and back pain is so bad that I can’t fall asleep. What am I doing?” The main symptoms of osteoporosis or vertebral Compressive fractures can also cause low back pain, which is more common in women over 60 years of age. This kind of low back pain is characterized by extensive pain in the chest and back, and the pain position is not fixed. The elderly often describe that there is a “one gas” in the lower back, and the pain is aggravated at night or during activities. Because the bone strength drops, a slight fall, even a cough, a sneeze, can cause compression fractures of the thoracolumbar spine, resulting in increased back pain, the hunchback, spine deformation will gradually appear in the course of the disease. Considering that most of the patients have no obvious history of trauma, they do not think about the possibility of spinal fractures. They often choose to rest at home for a few days. As a result, the rest of the pain does not improve, but the more they lie. This is the main symptom of low back pain caused by osteoporosis. Most of the treatments are conservative. If the new compression fracture causes low back pain, the minimally invasive surgery of the lumbar spine can stabilize the fracture and relieve pain. In the acute phase of pain, anti-inflammatory analgesic drugs can also be used to control pain. Wear the lumbar support as early as possible. Bed activity. Standardized use of calcium, vitamin D and anti-osteoporosis drugs, so that long-term, effective and safe relief of low back pain. (5) Typical cases of inflammatory low back pain (a description of the condition of patients with common inflammatory low back pain) “Dr. Zhang, I have a pain in my waist for almost a year, especially when I have a good night’s sleep. It will be a lot easier to get up. It’s better when it’s warmer, and it’s obviously worse after the day and the cold. What’s going on?” “Dr. Zhang, I had a little back pain when I was in high school. Now I have a lot of low back pain in college, and my waist is stiff and inflexible in the morning. I couldn’t sleep for too long at night. I started again last night. It was difficult to get up and get up. It took only two painkillers to relieve. I can’t get up this morning. I am still so young. How is this going? Main symptoms Typical inflammatory low back pain has the following characteristics: (1) low back pain occurs before the age of 40; (2) slow onset, rarely sudden back pain; (3) symptoms last for at least 3 months; 4) The back and back are stiff with the morning; (5) Rest can not improve the symptoms of low back pain, but the back pain is reduced after the activity. If any of the above 4 items are met, the possibility of inflammatory low back pain should be considered. Need to note If there is an indication of inflammatory low back pain and the symptoms have lasted for 3 months or more, it is best to go to the rheumatology and immunology department as soon as possible, especially for young people under the age of 40. Non-rheumatic Doctors, especially spine surgeons, should also pay attention to the occurrence of inflammatory low back pain to avoid delay in diagnosis. Treatment of inflammatory low back pain is mainly to keep warm, insist on reasonable and effective physical exercise, and maintain the best position of spinal joints. Enhance the strength of the paravertebral muscles, where swimming is considered a good and effective exercise.Usually pay attention to sitting posture, stand as much as possible to maintain a chest and abdomen when standing; choose a hard mattress when sleeping; can give non-steroidal anti-inflammatory analgesic drugs orally, with hot compress, massage, acupuncture and other physical treatment options. Need to pay attention to regular review, especially for young people with inflammatory low back pain, we must be alert and exclude such ankylosing spondylitis, spinal arthritis and other such rheumatoid immune diseases, to avoid serious disability caused by the development of the disease. In addition to the above five common waist disorders can cause low back pain, there are many clinical diseases related to lumbar pain, and even some visceral diseases can cause low back pain. People have a low back pain experience in their lives. For the cause of low back pain, the common people are familiar with lumbar disc herniation. In addition, there are many reasons for low back pain. How do we distinguish it? The cause of low back pain is based on the cause of pain. If accompanied by lifting weight, lumbar sprain or other induced factors causing waist muscle contracture, this situation is more likely to consider acute lumbar sprain or lumbar muscle strain; of course, for elderly patients with osteoporosis, it may just be A sneezing or coughing may also induce low back pain. This type of low back pain should be alert to lumbar compression fractures caused by osteoporosis. Suffering from cold and low back pain, or low back pain accompanied by local fear of cold, fear of hair loss, more consideration of lumbar fasciitis. The time of low back pain Low back pain is mainly night, wake up at night, be alert to inflammatory low back pain. Pain is aggravated after daytime activities, relieved after rest at night, considering the possibility of lumbar disc herniation or fasciitis. Accompanied by low back pain, low back pain accompanied by hip pain, lower limb pain, numbness, and more consideration of lumbar disc herniation; if accompanied by lumbar stiffness, spinal mobility is more likely to consider the possibility of inflammatory low back pain; elderly patients with low back pain accompanied by systemic pain, turned Pain, cough and pain are more likely to consider osteoporosis. In addition, in addition to the disease of the waist itself, diseases of other organs can cause pain in the lower back. Such as duodenal ulcer, pancreatitis can cause radiation pain in the waist; urinary tract infection, kidney stones, gynecological inflammation, menstrual tension can also cause low back pain. However, since the lesion is not in the spine, the activity of the waist is generally unaffected. In summary, there are many reasons for low back pain. The above methods are only for initial self-judgment. If you want to determine the cause, you should go to the hospital to combine the specific examination and make a diagnosis by the doctor. Low back pain prevention strategy prevention strategy No matter which cause the low back pain, in addition to the corresponding treatment measures to alleviate the acute phase symptoms, it should also do daily health care and prevention, give correct health education, prevent recurrence, prevent aggravation, relieve symptoms All have a role. (1) Maintain a correct sitting posture, avoid fixing a certain posture for a long time, avoid sedentary, standing for a long time, pay attention to sitting posture in the office, and regularly get up and move the waist, stretch the muscles and bones, and relieve the fatigue of the back muscles. (2) Pay attention to climate change, keep warm at the waist, and prevent cold and wet invasion; long-term desk workers or driver friends suggest increasing the lumbar pillow to help the waist maintain normal physiological curvature. (3) patients with low back pain suggest to choose a hard mattress, such as hard Simmons, mat, can not sleep on a wooden bed. (4) Master the correct moving posture: first lift the heavy object, then hold the heavy object and stand up, then move the legs to the designated place, then lower the weight. Avoid moving heavy objects frequently. (5) Control weight, warm-up exercise should be done before physical exercise to avoid sprain of the waist, and the intensity should be gradual. When performing professional training or high-intensity exercise, the waist circumference should be used reasonably and the waist circumference should be used in an acute period. It is not recommended for long-term use. (6) The elderly pay attention to reasonable diet, adequate sunshine, quit smoking, limit alcohol, avoid excessive drinking of coffee and carbonated beverages, ensure adequate calcium in the diet, and when supplemented with insufficient dietary intake, you can supplement calcium and vitamin D to maintain correct daily activities. Posture to avoid vertebral fractures. (7) Appropriate muscle exercise, walking, swimming, lumbar rehabilitation exercise and other sports is a very suitable rehabilitation prevention method. Action essentials: prone, belly to the ground, head and legs rhythmically up. The essentials of leaning over the leg: prone, belly to the ground, the head and legs are rhythmically up. The supine and abdomen movement essentials: supine, knees, feet flat on the ground, the abdomen stretched up the hips, the back and the thighs in a straight line.