Beresford Zach M, Kendall Richard W, Willick Stuart E
University of Utah Orthopaedic Center, Division of Physical Medicine and Rehabilitation, Salt Lake City, UT 84108, USA.
Curr Sports Med Rep. 2010 Jan-Feb;9(1):50-6. doi: 10.1249/JSR.0b013e3181caba05.
Low back pain is a common presenting complaint to sports medicine providers. The lumbar spine is a complex anatomic structure with multiple potential pain generators. Epidemiologic studies have shown that the intervertebral disc is the most common pain generator in all patients with low back pain. The facet joints may account for 15%-40% of low back pain. It can be challenging at times to establish a firm diagnosis of facet pain. Facet pain can have different presentations, and pain emanating from other lumbopelvic structures can present similarly as facet joint pain. This article reviews the anatomy and biomechanics of the lumbar facet joints, presenting symptoms and physical examination findings seen with facet pain. We also will discuss diagnostic and treatment paradigms that are helpful to the clinician treating low back pain in athletes.
腰背痛是运动医学从业者常见的就诊主诉。腰椎是一个复杂的解剖结构,有多个潜在的疼痛源。流行病学研究表明,椎间盘是所有腰背痛患者中最常见的疼痛源。小关节可能导致15% - 40%的腰背痛。有时很难对小关节疼痛做出确切诊断。小关节疼痛可能有不同的表现,而来自其他腰骶部结构的疼痛可能与小关节疼痛表现相似。本文回顾了腰椎小关节的解剖和生物力学,介绍了小关节疼痛的症状和体格检查结果。我们还将讨论有助于治疗运动员腰背痛的临床医生的诊断和治疗模式。