Почему болит спина? Полный осмотр и диагностика пациента за 1 час

For back pain, the primary examination is a trigger point examination (musculoskeletal examination or myofascial assessment). The patient first provides two categories of complaints: painful and non-painful. Painful complaints are filled out in red on a form, indicating the severity and duration of the pain. Other colors may be used to indicate complaints such as changes or decreased sensitivity, tingling, burning, and so on. The nature of the pain is assessed: stabbing, cutting, dull, shooting, throbbing, and so on. Each characteristic provides a better understanding of the source and type of pain. As a reminder, not every pain will be inflammatory. Next, previous examinations are considered: MRI, CT, ultrasound, blood tests, etc., if any. If indicated, further examinations may be ordered. Next, a functional diagnosis is performed: 1. Searching for and palpating trigger points in healthy areas of the body to help the patient understand the nature of the muscle pain. 2. Search for and palpate trigger points in the areas where the patient is experiencing pain. The goal is to locate the sources of pain and understand their nature (muscular or not). 3. Functional diagnostics: stretch test. Stretching the affected muscles should produce the familiar pain. 4. Trigger prick test - to elicit a localized spasm. This will indicate that a trigger point exists in the painful area and is responsive to this treatment method. 5. Other types of pain are assessed: inflammatory (based on the presence of swelling and redness, a stabbing pain), neuropathic (accompanied by changes in sensitivity and decreased strength in muscle groups), vascular (evaluation of limb size: decrease or increase, skin: pallor or cyanosis), organ pain: pain due to internal organ disease (accompanied by dysfunction of the affected organ, for example, problems with urine or digestion). Contents: 00:00 Introduction 00:17 History, collecting complaints from patient Roman 03:05 Complaints of numbness in the lower leg 03:55 Pain severity on a scale of 1 to 10 08:15 Evaluating the lumbar MRI 12:25 Objective of myofascial examination 14:15 Objective: determine the source of pain and the type of pain 18:00 Find the drawing on Roman 19:00 Palpation of painless (latent) trigger points 22:50 Vertebral crunching - one manifestation of muscle triggers 24:20 Pain from shifting a fold of fat 25:05 Comparative palpation on a healthy limb 28:28 Palpation of the affected area 33:05 Searching for pain from stretching - functional diagnostics 36:50 Searching for and diagnosing inflammatory spinal pain 40:30 Dry needling test for trigger points in the gluteal region 46:32 Changing position - searching for triggers on the side 51:48 Deep kneading test for trigger points 55:03 Sensation from kneading trigger points 57:12 What to supplement a myofascial examination with 59:17 Palpation of the piriformis muscle 01:00:50 Palpation of the gluteal muscles 01:03:07 Diagnostics of the hamstring muscles 01:05:22 What was the purpose of the examination? 01:07:10 About the combination of types of back pain (using an example) 01:10:10 How Roman's disc herniation likely developed 01:10:53 How sore muscles can push out a disc herniation 01:12:02 Muscle tone is one of the manifestations of muscle disease 01:13:18 The purpose of the initial examination My personal contacts (we are in Moscow): Message me on WhatsApp: https://wa.me/79263845098 Telegram: https://t.me/eduardkonkin https://www.vk.com/edkonkin Our administrator: https://wa.me/79032127779 https://t.me/mioclinic You can also contact us via the website: https://mioclinic.ru/