Protocolo diagnóstico del dolor lumbar mecánico
- Movasat Hajkhan, A.
- Bohórquez Heras, C.
- Turrión Nieves, A.
- Álvarez de Mon Soto, M.
ISSN: 0304-5412
Année de publication: 2017
Titre de la publication: Enfermedades del sistema inmune y reumatológicas (III) Espondiloartritis. Manifestaciones cutáneas de las enfermedades reumatológicas
Serie: 12
Número: 26
Pages: 1541-1545
Type: Article
D'autres publications dans: Medicine: Programa de Formación Médica Continuada Acreditado
Résumé
Concept Low back pain is a clinical entity characterized by pain between the last rib and the gluteal folds. Clinical evaluation The origin of low back pain in most patients is usually non-specific. Such patients generally improve within a few weeks on conservative treatment and do not require further testing. Less than 1% of patients with low back pain will have a serious systemic etiology such as cancer or infection. Less than 10% will have less serious etiologies such as vertebral compression fracture, radiculopathy or spinal stenosis. A well-focused anamnesis and physical examination are usually sufficient to assess the majority of patients with mechanical low back pain lasting less than four weeks. Alarm criteria However, in any patient with radicular symptoms or compression of the horse's tail or severe neurological deficit, an immediate magnetic resonance imaging should be requested. Other patients requiring an immediate radiological or analytical study are those with a high suspicion of spinal infection, a current or recent history of cancer, risk factors for the development of a cancer, and those with a suspected vertebral fracture. Chronic low back pain Those patients who have not improved after four to six weeks of initial conservative treatment are reassessed and, depending on the present symptoms, opportune complementary tests are decided, as are patients with chronic back pain of more than 12 weeks Of evolution.
Références bibliographiques
- Katz JN. Lumbar disc disorders and low-back pain: socioeconomic factors and consequences. J Bone Joint Surg Am. 2006;88 Suppl 2:21.
- Chou R, Qaseem A, Snow V, Casey D, Cross JT Jr, Shekelle P, et al; Clinical Efficacy Assessment Subcommittee of the American College of Physicians, American College of Physicians, American Pain Society Low Back Pain Guidelines Panel. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann In-tern Med. 2007;147(7):478.
- García-Morales MA, Tena D, Gil AM, Fernández-Bravo C, Velasco AM. Dolor lumbar DTM grupo científico. En: Rodríguez JL, editor. Medicina Interna. Vol 2. Madrid: Marban; 2015. p. 1152-62.
- Chou R. In the clinic. Low back pain. Ann Intern Med. 2014; 160(11):ITC6-1.
- Chou R, Qaseem A, Snow V, Casey D, Cross JT Jr, Shekelle P, et al. Diagnosis and treatment of low back pain: a joint clinical practice guide-line from de American College of Phisicians and the American Pain Society. Ann Intern Med. 2007;147:478.
- Bradley WG Jr, Seidenwurm DJ, Brunberg JA, Davis PC, La Paz RL, Dormont D, et al. Low back pain. [Publicación online]. Reston (VA): American College of Radiology (ACR); 2005.
- Jarvik JC, Deyo RA. Diagnosis evaluation of low back pain with emphasis on imaging. Ann Intern Med. 2002;137:586.
- Protocolo diagnóstico de la lumbalgia aguda. Sanz Sanz J, Otón Sánchez MT, Esteban Campos J, Andreu Sánchez JL. Medicine. 2009;10(30): 2031-4.
- Protocolo diagnóstico de la lumbalgia mecánica crónica. Sanz Sanz J, Prada Ojeda A, Andreu Sánchez JL, Mulero Mendoza J. Medicine. 2009; 10(30):2035-7.