| Abstract | Lumbalna bol vodeći je uzrok onesposobljenosti radno aktivne populacije, a time i veliki socioekonomski problem. Opisuje se kao bol, napetost u mišićima ili osjećaj nelagode koji je prisutan u području ispod interkostalne linije i iznad donjih glutealnih brazdi. Pri tome nekad može doći do širenja boli u donje ekstremitete. Klasificira se kao nespecifična bol kojoj je uzrok nepoznat i kao specifična kojoj je patofiziološki uzrok poznat. Bol u trajanju do tri mjeseca naziva se akutnom, između 7. i 12. tjedna subakutnom, a duža od tri mjeseca kroničnom. Javlja se u svim rasama i dobnim skupinama, a najčešće između 30. i 50. godine života, te podjednako pogađa oba spola. Životna prevalencija iznosi 60% do 85%. Mogućih uzroka za pojavu bolesti je mnogo, međutim, uzrok se otkrije samo u 10% slučajeva. U mlađih osoba najčešće se radi o akutnoj herniji intervertebralnog diska, a kod starijih o sporo progradirajućim degenerativnim promjenama kralješnice. Faktori rizika dijele se na individualne (dob, opće zdravstveno stanje i dr.), psihosocijalne (stres, depresija i sl.) i faktore povezane s fizičkim opterećenjem (stupanj i način opterećenja i dr.), a teško je odrediti koji faktori i u kolikoj mjeri su odgovorni za nastanak bolesti. 90% bolesnika s akutnom lumbalnom boli oporavi se nakon mjesec dana, a rizik za razvoj kronične boli iznosi u prosjeku oko 10%. Kako bi se postavila dijagnoza najvažniji su anamneza i klinički pregled. U najvećem broju slučajeva to je dovoljno kako bi se isključila ozbiljna patologija. Veliku pažnju treba posvetiti i psihosocijalnim čimbenicima jer značajno doprinose razvoju kroniciteta. Osnovni ciljevi liječenja su smanjiti bol i poboljšati funkcioniranje u aktivnostima svakodnevnog života. Fizioterapijska procjena uključuje subjektivnu, objektivnu procjenu i provedbu kliničkih funkcijskih testova, temeljem čega se određuje plan fizioterapije. Kod akutne lumbalne boli uz modifikaciju određenih aktivnosti najvažnije je da bolesnik ostane aktivan, te koliko je god moguće, da nastavi s uobičajenim dnevnim aktivnostima. Kod kronične lumbalne boli glavna i najkorisnija fizioterapijska metoda je terapijsko vježbanje. |
| Abstract (english) | Lumbar pain is the most common cause of disability in the working population, making it a major socioeconomic problem. It is described as pain, muscle tension, or a feeling of discomfort that occurs in the area below the intercostal line and above the inferior gluteal folds. At the same time, the pain can sometimes spread to the lower extremities. It is classified as non-specific pain, whose cause is unknown, and specific pain, whose pathophysiological cause is known. Pain lasting up to three months is termed acute, between weeks 7 and 12 is termed subacute, and longer than three months is termed chronic. It occurs in all races and age groups, most commonly between the ages of 30 and 50 years, and affects both sexes equally. Lifetime prevalence is 60% to 85%. There are many possible causes for the onset of the disease, however, the cause is discovered in only 10% of cases. In younger people, it is usually an acute intervertebral disc herniation; in older people, it is a slowly progressive degenerative change in the spine. Risk factors are classified as individual (age, general health, etc.), psychosocial (stress, depression, etc.), and physical stress-related (extent and type of stress, etc.), and it is difficult to determine which factors are responsible for the occurrence of the disease and to what extent. 90% of patients with acute lumbar pain recover after one month, and the risk of developing chronic pain averages about 10%. To make a diagnosis, the anamnesis and clinical examination are most important. In most cases, this is sufficient to rule out a serious pathology. Great attention should also be paid to psychosocial factors, because they contribute significantly to the development of chronicity. The main goals of treatment are to reduce pain and improve functioning in activities of daily living. Physiotherapy assessment includes subjective and objective assessment and the implementation of clinical function tests, based on which the physiotherapy plan is determined. For acute lumbar pain, in addition to modifying certain activities, the most important thing is for the patient to remain active and perform his usual daily activities as much as possible. For chronic lumbar pain, the main and most useful physiotherapy method is therapeutic exercise. |
