Possible answer (2)

5, the occurrence of low back pain and the development process (for details, see the original book)

6, how to check back pain patients, low back pain diagnostic procedures

6,1 distinguish between types
Soft tissue, in accordance with the scientific theory, the human pain from lumbar disease most of the soft tissue damage caused by internal and external. These two types of damage can exist alone or mixed, clinical characteristics based on history, physics and imaging characteristics and performance of EMG can make distinction. This treatment method of choice is essential.

6,1,1 history characteristics
(1). Resting pain and movement pain. Lumbar spinal canal, soft tissue damage due to muscle cramps, muscle contracture adhesion of pathological degeneration change, if the body is a long-term position, especially supine state, it is bound to add to ischemic damage, which eventually led to the soft tissue lesions aseptic inflammation intensifies . Under such circumstances, as long as the appropriate body activities or walking to the waist soft tissue to improve blood supply, and the pain can be gradually eased. And the lumbar spinal canal, the dural sac and nerve root sheath, the fatty connective tissue inflammatory reaction, only to the prone position under braking (no vertical pressure on the spine) can be controlled or inflammation dissipated. Erect any of the activities under the state can only make the nerve sheath aseptic inflammation of the soft tissue exacerbated because prominent disc or thickening of the ligamentum flavum is dural sac and nerve root stimulant. The more the movement will intensify pain, sometimes for sports performance after sudden pain, in the supine, can alleviate the pathological stimulus.

(2). Abdominal pressure increased on the impact of pain. Spinal lesions due to the increased CSF pressure on the nerve root compression or epidural have a direct role in the neural Jire state, it will naturally result of forced defecation, cough, sneeze, etc. exacerbate pain. If worn at waist lumbar spine reduce axial pressure will be increased to offset part of the abdominal pressure, thus easing the resulting pain. Spinal soft tissue damage, pain caused by the rare abdominal pressure by the change.

(3). Pain on the 1st change. Chen Qi obviously low back pain, even at times because of the pain and not wake up 15 minutes to get up after activities can ease the pain, general daytime work and activities without prejudice. This is the lumbar spinal soft tissue damage, pain characteristics. And in patients with lumbar spinal canal in a day of Chen Qi Waist-Leg feeling is the best moment, painless or minor pain, as bed while the afternoon or evening activities most obvious pain, pain sitting posture also increased faster.

(4) the nature of lower extremity pain. Lower limb pain (in the broad sense of sciatica) is involved regardless of the pain or Radioactive pain are from within the vertebral canal sinus dominated by the epidural nerve, the posterior longitudinal ligament, the ligamentum flavum induced by the regional involves pain, nerve root involvement led to the Radioactive pain , or spinal canal, muscle, ligament damage caused by nerve stimulation from Anzhi Fangshetong its own regional damage caused pain involved. But their lower extremities Radioactive pain, contraction of the spinal canal can vertebral venous plexus in the extreme increased venous pressure, this can increase the involvement epidural nerve root and exacerbated by the pressure of low back pain and leg pain. In quite a number of cases are described in the case of load because of lumbar pain and attack, but not their own ease. Spinal soft tissue damage, although Chizhong difficult, but small impact, the rest generally can be natural brake pain disappeared.

(6). Course of evolution characteristics. Spinal injury, pain can be sudden attack, but in general can be alleviated in the short term, and the intermittent period (symptomatic) in a self-limited Obviously, Moru special treatment. Spinal lesions caused frequent sudden low back pain, with intermittent attacks of gradually increasing the number of short, a long period of attack normally require 2-6 weeks after specialized treatment can alleviate. If symptoms of low back pain at the light, heavy, repeated attack. Even without significant incentives, increasing the frequency of seizures, intermittent period should be shortened. Attack from the beginning not eased their own mitigation turn, consideration should be given lumbar spinal lesions caused by internal and external mixed. Note the two different types of lumbar spinal damage in the stability of damage, but also the performance of severity.

(7). Cauda equina damage spinal lesion characteristics. Lumbar spinal canal stenosis, or spinal disc tremendous highlight tumors may also lead to cauda equina compression damage. For the early onset of ischemic limitations arachnoid Yan, functional damage, atypical clinical manifestations of the lower extremity tingling or pain Shen, almost all patients had intermittent claudication, once running time is too long or just walking that is lower extremity pain, and patients themselves or supine rest squat immediately ease the pain, symptoms such a cycle. Cauda equina serious damage, a step ladder at the upper and lower level or pull a foot. Rectal bladder dysfunction, the inability to urinate, constipation, and then develop incontinence, perineal patients with perianal feeling diminish or disappear.

(. Canal in the extreme conditions. If the sustained development of low back pain or leg pain, sexual aggravated, any non-surgical treatment of no avail, and a lower extremity weakness, heavy or shrink, would highly doubt the existence of spinal tumor, refused to tolerate. If in the course of sudden body or leg twitch, or even loss of consciousness, neck strong, and the area of back pain, lumbar spinal canal should be considered within the subarachnoid hemorrhage, which is of low back pain in a crisis, should be further Intradural Extramedullary exclude vascular tumor or variation.

(9). Involvement of low back pain. Primary abdominal or pelvic organ of the disease, with the lumbosacral back, or a few superficial or pain, at the same time, there segmental waist reflex muscle cramps, so patients can feel pain deep in the . Involved in the so-called low back pain patients are often as low back pain and misdiagnosis of primary, we should be vigilant. Such damage to patients in pain is not part of the organizations, these organizations also did not follow the domination of the afferent fibers, but some of its innervation and lumbosacral segmental related organizations in the internal organs, visceral Nociceptive pain can be aware of the Paper District. Clinical evidence, gynecological diseases (such as dysmenorrhea, ovarian disease, uterine prolapse, cervical cancer, etc.), the upper urinary tract disease (such as pyelonephritis, kidney stones, etc.), after-appendicitis, prostatitis can be involved in the disease or low back pain Mei sacral pain.

6,1,2 physical examination. Its proposed and recommended "lumbar spine three clinical trials" of lumbar spinal lesions have a distinct specificity, accuracy, with lumbar spinal soft tissue damage to the differential diagnosis of low back pain. Lumbar disc herniation, spinal canal stenosis, the dural sac and nerve root inflammation of tissue reaction, such as nerve tumor can be common in the three test positive signs. The clinical examination to be both specificity and sensitivity there, and the detection rate is a high one.
(1). Chest, abdomen with pillow pilot clinical significance
<1> chest pad pillow test positive, suggesting that the lesions of the lumbar spine.
<2> abdominal pad pillow test positive, could be considered for spinal soft tissue damage, and low back pain.
(2). Lumbar scoliosis pilot clinical significance
<1> ① triggered lumbosacral spine Wanxiang side with deep pain or hip and lower extremities Radioactive pain or Sore and numbness flu, compared with positive signs, can determine risk factors in the spinal canal.
② spinal bending to contralateral to extreme, to the original side of the scoliosis test leads lumbosacral pain and lower limb deep signs completely disappeared, this test also showed positive.
<2> If there spinal bending to contralateral side and waist pain, is liable for the lumbar spinal canal, soft tissue damage.
<3> if both the spine bending to the contralateral side or when it leads to the waist or lumbosacral pain, lumbar spinal canal for the judge inside and outside mixed lesions caused by low back pain.
(3). Tibial nerve plucked string pilot clinical significance
Where inspections plucked string tibial nerve stem a partial leg pain or who are Sore and numbness conduction of the test was positive. If neural stem finger re-mortgage or rear knee joint capsule, can be led to false positive signs.

ITs realy very very nice and really very best work done here that i ever found
great and massive sharing it is