Generalized pain in the lower back and hips that radiates downward

Introduction The clinical pain of gluteal epithelial nerve pain is extensive pain in the buttocks and hips. It is usually from the middle of the sputum and radiates downward to reach the posterior lateral thigh. The gluteal epithelium is a group of skin branches consisting of the lateral branches of the posterior branch of the spinal 1, 2, and 3 spinal nerves. When it passes through the fascia of the lower back, it reaches the subcutaneous surface and crosses the middle of the iliac crest to the buttocks under the skin. It is distributed on the outer side of the buttocks and the skin of the large trochanter. The skin feels function in this area. More common in trauma, cold areas and manual workers.

Cause

(1) Causes of the disease:

More common in trauma, cold areas and manual workers.

(2) Pathogenesis:

1. Hip fibrositis: When the gluteal epithelial nerve trunk passes through the tough thick back fascia, if there is fibrositis in this place, causing local fibrosis, it is susceptible to compression and causing symptoms.

2. Trauma: Acute or chronic trauma of the lumbosacral region may cause edema of the gluteal epithelium, congestion, congestion, or hemorrhage, resulting in loss of function, or compression due to late fibrosis (including surrounding soft tissue involvement).

an examination

Related inspection

CT imaging scan

Examination of generalized pain and downward radiation in the lower back and hip:

1. Pain: It is characterized by extensive pain in the buttocks and hips. It usually starts from the middle of the sputum and radiates downwards to the posterior lateral thigh.

2. Closed test: 5 to 10 ml of 1% procaine was injected into the upper and middle of the middle of the sputum, and the symptoms were relieved.

According to the history of the disease, the clinical manifestations are extensive pain in the lower back and hip, and the radiation is downward, and the closure test is positive, and a diagnosis can be established.

Differential diagnosis

Generalized pain in the lower back and hips and confusing symptoms down:

Lumbar spine pain: A kind of low back pain that is concentrated in the lumbar spine. Low back pain refers to a symptom of the side of the waist or bilateral pain and even the spine. Both men and women occur, and women are mostly. In addition to spinal pain, the waist becomes sunken, swelled, and hardened. In severe cases, the bed cannot be lifted.

Pain in the back or hip of the thoracolumbar: may be the main symptom of spinal vascular malformation, spinal vascular malformation is less common, the most common manifestation is subarachnoid hemorrhage or spinal cord hemorrhage. Spinal vascular malformations can occur in any segment of the spinal cord, but the most common are the cervical segments and cones.

Low back pain caused by low limb pain or radiation pain: Chronic low back pain is mainly caused by pain in the back, lumbosacral and ankle, and there is simple low back pain and low back pain accompanied by lower limb induced pain or radiation pain. Points. Low back pain is mainly caused by pain in the back, lumbosacral and ankle, and there is simple low back pain and low back pain associated with lower limb induction pain or radiation pain. The nature of pain is mostly dull pain, dull pain, tingling, local tenderness or radiation pain, unfavorable activities, inconvenient pitching, inability to hold weight, difficulty walking, fatigue and limb fatigue, and even the functions of lumbar flexion, extension, and lateral bending. Obstacles, severe cases of spinal deformity, manifested as: " . Because the cause of low back pain is more complicated, there are more diseases that cause low back pain in the clinic. Each disease has its own specific history, signs and clinical manifestations.

Diffuse low back pain: one of the symptoms of plasma cells. Plasmacytoma is a primary and systemic malignant tumor originating from the bone marrow. It is derived from B lymphocytes and has the property of differentiating into plasma cells. Isolated solitary cell tumors are rare and can be cured. Among them, multiple plasmacytoma is the most common, characterized by osteolytic lesions and plasma cell infiltration of bone marrow. In addition, often associated with anemia, hyperglobulinemia, hypercalcemia, impaired renal function and predisposition to infection. 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.

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