[Clinical manifestations]
In the acute stage, patients have severe waist pain and burning sensation, and the symptoms are aggravated when the waist moves, and the local tenderness is more obvious, mostly at the starting and ending points of the diseased muscles. Some patients have elevated body temperature, and blood tests show leukocytosis. After an acute attack, a few patients can get a complete regression of symptoms, and most patients will leave pain or have another attack after several months or years. Chronic cases are characterized by low back pain, muscle stiffness and heaviness. When the weather changes, such as rainy days, nights or wet areas, the pain often gets worse. Lumbar pain is aggravated every morning, which can be relieved with a little exercise and aggravated after fatigue. Lumbar tenderness is widespread, and there is no localized tenderness. The waist function can be normal, but the waist is stiff and sore during exercise.
[therapy]
There are many treatments for lumbar myofascitis. Physical therapy can relieve symptoms to varying degrees or temporarily eliminate symptoms, but it is easy to relapse. Only when the condition is serious, the pain is severe and the ability to work is lost can surgery be performed. Surgery involves removing diseased tissue and separating tissue adhered by the lesion.
References:
How to carry out functional exercise for patients with lumbar myofascitis?
Patients with psoas myofascitis can do exercises such as waist wind swinging lotus leaf posture and carp standing posture.
Wind shakes the lotus leaf: ① Stand with your feet slightly open, with your hands akimbo so that the trunk bends forward and stretches back, from small to large, and relax the waist muscles during activities. ② Stand with your feet slightly open, and bend your torso with your hands akimbo. The range of activities is from small to large until the maximum, and the lumbar muscles should be relaxed during the activity.
Carp standing upright: prone position, legs straight, hands attached to the side, head raised and extended, legs straight and extended, so as to lengthen the waist as much as possible.
What are the manipulative treatments for lumbar myofascitis?
Lumbar myofascitis is usually treated by the following methods:
(1) Moxibustion: Moxibustion should be applied to the patient's waist along the direction of spinous muscle fibers of sacrospinous process. The manipulation should be gentle and gentle, rolling for 8 minutes continuously, and then tendon separation should be carried out on the affected part. If there are obvious cord-like changes, the manipulation should be slightly heavier, and the thumb should be moved along the direction of muscle fibers for about 2 minutes.
(2) Palm kneading method: The doctor exerts force on thenar and thenar, and makes a circular kneading motion on the soft tissue of low back pain. From top to bottom, with a little force, repeatedly knead for 7-8 minutes, and then massage the back for 2 minutes to improve the local blood supply, so as to achieve the effects of warming meridians, promoting blood circulation, removing blood stasis, diminishing inflammation and relieving pain.
(3) Massage method: the doctor touches the patient's skin from the ulnar side of the forearm and rubs it in a circular or semi-circular way. This method has a large contact area and can be treated for 5-7 minutes each time. Then apply local reinforcement method, from top to bottom reinforcement for about 5 minutes.
(4) Pressing method: press with both hands, with both hands overlapping, and press hard with the thenar of the palm or the whole palm. When pressing, the action should continue to be gentle. When pressed to a certain depth, it can rotate for about 10 minute at a time.
Myofascitis of back and waist
Symptoms:
Medical history-a few patients have a history of acute injury or repeated chronic injury, while the vast majority of patients have a long-lasting history of chronic injury caused by special posture work.
2. Pain-not very serious, starting with pain and discomfort, weakness, light and heavy, intermittent attacks, followed by burning, tingling, numbness, numbness, and progressive aggravation; It becomes heavier when tired, lighter after rest, and the range is also increasing, which is related to climate change, which leads to the limitation of patients' waist activity, from bending to bending, from bending to straight, and it is difficult to stand, sit and lie down. It is difficult for patients to accurately describe the location of pain, but the pain is very radioactive.
3. Posture is not only a manifestation of myofascitis of the back, but also a stiff waist shaped like a plate. When walking, the upper body moves less, and when standing, it is biased.
All patients have tender points, which is of great significance to clinical diagnosis and treatment. According to the degree of tenderness, it can generally be considered as the injury of its corresponding tissue.
Can lower back myofascial fibrositis cause low back pain?
The myofascia of the lower back is woven by longitudinal connective tissue fibers, covering the muscles of the lower back, which can protect the muscles and strengthen the support for the waist. Under the influence of cold, dampness, chronic strain, long-term mental stress and other factors, the fascia and muscles of the lower back are congested, swollen, exudative and fibrotic, and corresponding clinical manifestations such as diffuse pain, locally palpable nodular or cord-like changes appear. The nonspecific inflammatory changes of these tissues are called lower back myofascial fibrositis.
The main causes of lower back myofascial fibrositis are: (1) cold, which is the most common cause. In cold areas, cold seasons and the attack of cold wind, the blood circulation in the back of the waist changes, blood vessels contract, ischemia, congestion and edema, which leads to inflammatory changes in local fibrous tissues, which will be aggravated or alleviated with climate change. (2) Humidity: another common cause. In humid environment, due to the imbalance of skin metabolism, especially the decline of perspiration function, the blood flow velocity under skin and fascia slows down, leading to microvascular congestion, congestion and exudation, forming fasciitis. (3) Chronic injury: As various chronic strain factors repeatedly act on the back, the tension of soft tissue on the back increases, resulting in mild tear-like injury, forming this disease. (4) Long-term mental stress and single and persistent working posture can induce this disease. (5) Rheumatism and gout: This disease is easy to be accompanied by some viral infections.
The main features of this disease are as follows: (1) Most patients with diffuse pain complain of diffuse pain in the back and buttocks, and the pain is often triggered by the external edge of bilateral sacrospinous muscles and 7cm above the iliac crest, sacroiliac joints, 1, 2/3 lumbar vertebrae, and 12 rib stop. After a certain point in the trigger zone is compressed, it can cause pain, tenderness and muscle tension around the point or in the reflex zone. When you get up in the morning, the pain is severe, which can be alleviated after mild activity and aggravated after fatigue. (2) Nodules or cords of different sizes can be felt on the back of the waist during palpation. Nodules with a diameter of 5 ~ 6 mm are oval flat objects, mostly located near the sacral foramen and sacroiliac joint; Small nodules are 2 ~ 3 mm in diameter, mostly located on lumbosacral fascia, with a distance of 1 ~ 2 cm from the midline. (3) There are many definite inducing factors, such as cold, humidity and fatigue. (4) Blocking with procaine can relieve or eliminate pain.
After the onset of myofascial fibrositis in the lower back, the pain can last for several days or weeks, and it can be relieved automatically without leaving traces, but it is easy to recur. Sometimes it can cause the deep fascia to split and make the underlying adipose tissue protrude, forming a "fascia fat hernia". This disease generally does not produce serious complications and sequelae.