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Långvarig ländryggssmärta

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Sakkunnig:
Definition:
Ländryggssmärtor (eller smärtor i ryggens nedre del) i minst 3 månader, utan tydlig organisk förklaring (såsom diskbråck eller spinal stenos).
Förekomst:
Ett vanligt tillstånd, upp till cirka 10 % av befolkningen.
Anamnes:
Förutom smärta och smärtpåverkan inriktas anamnesen på att hitta andra möjliga orsaker till kronisk ryggsmärta.
Kliniska fynd:
Oftast hittas inga specifika tecken på bakomliggande sjukdomar. Det är viktigt att bedöma förekomsten av fynd som kan tala för annan bakomliggande sjukdom.
Diagnos:
Diagnostiken baseras på anamnes och fynd. Bilddiagnostik bör enbart genomföras vid misstanke om särskild sjukdom, eller vid förekomst av vissa faktorer som kan tala för allvarlig sjukdom (röda flaggor) eller med hög risk för kronisk sjukdom (gula flaggor).
Behandling:
Patientundervisning och egenvård med fysisk träning är viktigast. Läkemedelsbehandling har en beskedlig roll. Andra paramedicinska åtgärder kan vara indicerade.
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  • Remy Waardenburg, specialist i allmänmedicin, medicinsk redaktör Medibas

Tidigare sakkunniga

  • Anne Söderlund, professor och leg fysioterapeut, Akademin för hälsa, vård och välfärd, Mälardalens högskola, Västerås