Chronic low back pain with lower extremity numbness

Introduction Lumbar spondylolisthesis is prone to chronic low back pain and radioactive numbness in one or both lower extremities. Lumbar spondylolisthesis refers to a condition in which part or all of the lumbar vertebrae are dislocated. It is generally called the vertebral body in the clinic, and the upper vertebral body is generally slipped forward. The incidence of lumbar spondylolisthesis is 3 to 7% in Europe. There is still no accurate statistical data in China. It is generally believed that routine X-ray examination of patients with low back pain has found that about 5% of adults have a tendency to lumbar spondylolisthesis.

Cause

At present, the cause of lumbar spondylolisthesis is still unclear. The most common cause of lumbar spondylolisthesis is degenerative lumbar spondylolisthesis, which is also called pseudo-slippery with age. Secondly, lumbar spondylolisthesis caused by sports injury, congenital or unexplained lumbar spondylolisthesis, also known as true spondylolisthesis; Lumbar spondylolisthesis occurs between the 4~5 vertebral bodies and the 5~1 vertebral bodies.

an examination

Related inspection

CT examination of bone and joint MRI

Most lumbar spondylolisthesis is asymptomatic and is often unintentionally found during physical examinations. Some patients also found lumbar spondylolisthesis when taking X-ray films due to low back pain, but some people with lumbar spondylolisthesis may gradually develop symptoms of low back pain and radiation pain in lower extremities.

Differential diagnosis

Low back pain, radiation to the lower extremities, low back pain, such as "burst", and radiate to the back of the thigh, the armpit, the outside of the calf, acupuncture or electric shock-like feeling, the lower extremity feels numb after the back pain. After the patient lie down, the symptoms are relieved. Standing, walking, and even coughing and sneezing. When the bowel movement is forced, the back pain is aggravated, suggesting that it may be lumbar disc herniation. Low back pain, especially in the 4th to 5th lumbar vertebrae, and radiate to one side of the lower extremity, and even have obvious numbness. When lying down, the lower limbs of the affected side cannot lift straight legs, suggesting that it may be root sciatica.

One side of the waist and abdomen suddenly "knife cut" like colic

Sudden "knife-cut" colic in one side of the waist and abdomen, radiating along the ureter to the lower abdomen, perineum and inner thigh, which can last from a few minutes to a few hours. During the onset of low back pain, the patient bends over the back, rests restlessly, pale, sweating. After the pain, there are many different degrees of hematuria, which are more common in urinary stones.

Low back pain with frequent urination, urgency, dysuria, low back pain accompanied by frequent urination, urinary urgency, and dysuria, suggesting that it may be a urinary tract infection. Low back pain with pain in the kidney area. Low back pain, when the slamming of the waist is particularly painful, kidney disease such as pyelonephritis, kidney tuberculosis, and peri-renal abscess should be considered.

Back pain in bed is aggravated: low back pain is aggravated when lying in bed, but it is relieved after getting up, and lumbar fibrosis should be considered.

Low back pain and vaginal discharge increase, many women with back pain, leucorrhea more often, due to inflammation of the reproductive system. Such as cervicitis, pelvic inflammatory disease, annex inflammation and so on. Room labor, excessive back pain after birth, excessive sexual intercourse, excessive childbearing of children or excessive abortion, waist pain, other tests are normal, this is the Chinese medicine said kidney deficiency, Yaofu deficiencies To. In summary, through the above discussion, we know that the causes of low back pain are various. In clinical practice, doctors must pass laboratory tests in addition to understanding symptoms and physical examinations to make a diagnosis. Therefore, when there is low back pain, you should go to the hospital for examination, symptomatic treatment, and do not abuse the supplement.

Diffuse low back pain: Clinically, patients with over 40 years of age may have skeletal or diffuse low back pain, fatigue, paleness, and mild weight loss. The possibility of myeloma should be suspected. Typical and advanced plasmacytoma are easy to diagnose, but early plasmacytoma is difficult to diagnose. Plasmacytoma can be painless in the early stages, with only minor or insignificant signs, which can last for months, even years.

Persistent low back pain with morning stiffness: non-ocular clinical manifestations of ankylosing spondylitis: the most typical early manifestation of persistent low back pain (at least 3 months), unilateral occult, blunt or intermittent, Accompanied by morning stiffness and reduced after activities.

Low back pain when bending over: When bending hard, lifting heavy objects or lifting heavy objects, sudden low back pain occurs, and the muscles on both sides of the lumbar vertebrae are cramped and tender, suggesting that it may be an acute lumbar sprain or lumbar muscle strain.

Low back pain: The pain point indicated by the patient is equivalent to the level of the buttocks area, and a few are in the lower half of the humerus, often accompanied by symptoms of lower abdominal pain. It is aggravated by premenstrual, long standing and sexual intercourse. It is a symptom of the pelvic blood stasis.

Most lumbar spondylolisthesis is asymptomatic and is often unintentionally found during physical examinations. Some patients also found lumbar spondylolisthesis when taking X-ray films due to low back pain, but some people with lumbar spondylolisthesis may gradually develop symptoms of low back pain and radiation pain in lower extremities.

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