Abstract | U uvodnim podacima, termin lumbalni bolni sindrom se opisuje i obrađuje puno više od drugih
područja medicine. Prema tim podacima, može se zaključiti da je termin lumbalni bolni sindrom
oduvijek bio prisutan i poznat, a u posljednje vrijeme čak i više. Lumbalni bolni sindrom
označuje skup različitih sindroma povezanih u jednu cjelinu gdje se dešavaju promjene u
lumbalnom dijelu kralješnice. Danas je prisutan sve češće kod svih dobnih skupina, pa je zbog
toga lumbalni bolni sindrom veliki nacionalni, zdravstveni, socijalni i ekonomski problem.
Manifestacija simptoma i promjena je različita, ovisno o zahvaćanju dijela segmenta, struktura
i sustava. Promjene se mogu stvarati na kralješcima, u vertebralnom dinamičkom segmentu,
među intervertebralnim diskovima (diskogene), promjene i pritisak na živčani sustav
(radikulopatije) koje nastanu degenerativnim promjenama kralješnice. Uzroci nastanka
lumbalnog bolnog sindroma mogu biti: slaba aktivnost osobe koje prethodi slabom držanju
tijela (posture), nepravilnom dizanju tereta, genetika, nagli trzaji ili pretilost. Klinička slika se
razlikuje kod svake zasebne dijagnoze ovisno o uzroku nastanka i stanja osobe. Kada su
simptomi kao što su promjene držanja tijela, smanjena pokretljivosti i bol započele naglo govori
se o akutnom stanju, a kada promjene i bol traju duže od 14 dana prepisuje se kroničnom stanju
lumbalnog bolnog sindroma. Kao bitnu stavku pri zaključivanju procjene i plana rehabilitacije
ima bol. Bol koja projicira u području lumbalne kralješnice je pokazatelj degenerativnih
promjena vertebralnog dinamičkog segmenta. Promjene koje se nalaze u području same lezije
i boli, naziva se vertebralni bolni sindrom. Promjene koje se manifestiraju na ekstremitete i
šire se ovisno o zahvaćenosti, naziva se vertebrogeni bolni sindrom. Veliku važnost i ozbiljnost
pripada fizioterapijskoj procjeni gdje se ispituje postura kralješnice, hod, gibljivost kralješnice,
analiza boli, fiziološka simetričnost, manualno testiranje mišićne snage, klinički testovi i još
mnogo toga što je obrađeno u radu. Kao cilj dobre i uspješne rehabilitacije je rano
prepoznavanje simptoma i brzo reagiranje. Veliku učinkovitost u rehabilitaciji ima fizioterapija,
dekompresijska terapija, manualna terapija i ostale procedure kojima je cilj vratiti
funkcionalnost osobe za svakodnevni život i vraćanje u svoju profesionalnu sredinu. |
Abstract (english) | In introduction data is mentioned how more much term lower back pain is researched and
described than some other fields of medicine. Based on this data, it can be concluded that term
lower back pain is present and known for long time and more and more today. Lower back pain
includes a set of many different syndromes that describe changes in lower part of spine.
Syndrome is today more often present in all age groups and because of that, lower back pain is
large national, health, social and economic problem. Manifestation of symptoms and changes
is different, depending on part of segment, structure, system affected. Changes can occure in
vertebrae, vertebral dynamic segment, between intervertebral discs (discogens); they may also
occur as changes in pressure on nervous system (radiculopathies) which arrise from
degenerative changes of spine. Causes of arrisal of lower back pain can be many: low activity
of individual which precedes poor posture, incorrect lifting, genetics, sudden twiches or obesity.
Clinical picture is different by each individual diagnosis depending on cause of arrisal and state
of individual. When the symptoms such as poor posture, reduced mobility and pain occur
suddenly then we speak of acute state, on other side, when changes and pain are present more
than 14 days then we speak of cronic state of lower back pain. When concluding a change and
rehabilitation plan one of more important factors is pain. Pain which is projected in lumbar
spine indicates degenerative changes of vertebral dynamic segment. Changes which occur in
parts of lesions and pain are called vertebral pain syndrom. Changes that manifest on
extremities and are spreading depending on affected areas are called vertebrogenic pain
syndrome. In this thesis is described jus of how great importance is physiotherapeutic
assessment which includes spine posture and spinal mobility exams, pain analysis,
physiological symmetry, manual testing of muscle strength, clinical tests and many more. Goal
of good and successful rehabilitation is early detection of symptoms and fast respond. In
rehabilitation great effect has physiotherapy, decompression therapy, manual therapy and other
procedures with goal of restoring functionality for everyday life of individual and returning to
its professional enviroment. |