Schwill C
Praxis am Markt, Markt 7, 23611, Bad Schwartau, Deutschland.
Internist (Berl). 2021 Jan;62(1):34-46. doi: 10.1007/s00108-020-00919-5. Epub 2020 Dec 23.
Back pain is a common reason for consulting a general practitioner. For 80% of patients, the back pain is nonspecific. Specific back pain has a determinable cause that needs to be rapidly identified. The diagnostic work-up to clarify spinal pain involves a detailed patient history taking into account the "red flags", a clinical examination and further stepwise diagnostics. In addition to laboratory diagnostics, structured morphological imaging is necessary. Causes of specific back pain include: fractures, infections, radiculopathy, tumors, axial spondylarthritis, as well as extravertebral causes. The diagnosis, treatment and continuous follow-up of the patient with specific back pain is interdisciplinary and requires close communication with the relevant specialists.
背痛是患者咨询全科医生的常见原因。80%的患者背痛是非特异性的。特异性背痛有可确定的病因，需要迅速识别。明确脊柱疼痛的诊断检查包括详细询问患者病史并考虑“红旗征”、进行临床检查以及进一步的逐步诊断。除实验室诊断外，还需要进行结构化的形态学成像检查。特异性背痛的病因包括：骨折、感染、神经根病、肿瘤、轴性脊柱关节炎以及椎体外病因。特异性背痛患者的诊断、治疗及持续随访需要多学科协作，并且需要与相关专科医生密切沟通。
