Unterscheidungsmerkmale somatisch bedingter Übertragungs- versus neuropathischer Schmerzen bei Rückenschmerzpatienten mit oder ohne ausstrahlende Beinschmerzen^[1]

Zusammenfassung

Low back pain (LBP) ist ein weitverbreitetes Beschwerdebild, das häufig mit Ausstrahlungen ins Bein einhergeht. Für derartige Beinschmerzen können direkt vom Nervensystem verursachte (neuropathische) bzw. fortgeleitete Schmerzen aus somatischen lumbalen Strukturen (Referred pain) verantwortlich sein. Das Erkennen der jeweiligen Schmerzursache ist essenziell für die entsprechende Behandlungsstrategie.

Ziel dieses Systematic Reviews war es, die Literatur hinsichtlich Unterscheidungsmerkmalen der klinischen Präsentation zwischen „somatisch Referred Pain bedingten“ und „neuropathisch bedingten“ Rückenschmerzen mit oder ohne Ausstrahlung ins Bein zu analysieren. Anhand der Unterscheidungsmerkmale „Schmerzqualität“ und „physische Funktionsuntersuchung“ kann zwischen somatisch Referred Pain bedingten und neuropathisch bedingten Rückenschmerzen unterschieden werden, anhand der „Schmerzausbreitung“ ist keine Differenzierung möglich.

Abstract

Low back pain is a prevalent clinical presentation, which often coincides with radiating leg pain. Nervous system related (neuropathic) or transferred pain from somatic lumbar structures (referred pain) may be responsible for this leg pain. Identification of the particular pain source is essential for the relevant treatment strategy.

The aim of this systematic review was to analyse the literature with a view towards the distinguishing features of the clinical presentation of “somatic referred pain related” and “neuropathic related” back pain with or without radiating leg pain. The distinguishing features “pain quality” and “physical function assessment” can differentiate between somatic referred pain related and neuropathic related back pain, on the basis of “pain distribution” differentiation is not possible.

Schlüsselwörter

Low back pain - Referred pain - neuropathischer Schmerz - Beinschmerz - Unterscheidungsmerkmale

Keywords

low back pain - referred pain - neuropathic pain - leg pain - distinguishing features

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