Differenzialdiagnostik manualmedizinischer Syndrome bei unteren Rückenschmerzen unter Einbeziehung osteopathischer Verfahren^{[ * ]}

Manual-Medical Differential Diagnosis of Low Back Pain Including Osteopathic Procedures

The differential diagnostic evaluation of painful functional disorders of the lumbosacral and lumbopelvic region, i. e. the so-called "low back pain” is very extensive, but is often reduced to the question of chronicity. The manual medical diagnosis can make a valuable contribution in such cases for determination of structural and functional pathology. Early application of manual medical therapies seems to be effective for peracute complaints. The mobilization of restrictions of the pelvic visceral attachments should be included. In the following review manual medical syndromes are presented that summarize the findings from the musculoskeletal and visceral system. This is intended to facilitate the primary differential diagnostic evaluation, as well as treatment planning. The combination with osteopathic methods is very profitable. A necessary specialist differential diagnosis remains essential.

Zusammenfassung

Die differenzialdiagnostische Beurteilung schmerzhafter funktioneller Störungen der lumbosakralen und lumbopelvinen Region, also des sog. "unteren Rückenschmerzes" ist sehr weit gespannt, wird jedoch häufig auf die Frage einer Chronifizierung reduziert. Die manualmedizinische Diagnostik kann hier einen wertvollen Beitrag in der Abgrenzung von struktureller und funktioneller Pathologie leisten. Frühzeitige manualmedizinische therapeutische Maßnahmen scheinen für perakute Beschwerden effektiv zu sein. Die Mobilisation funktioneller Störungen der viszeralen Aufhängungen im kleinen Becken sollte dabei einbezogen werden. Im folgenden Beitrag werden manualmedizinische Syndrome vorgestellt, die Befundhäufungen aus dem muskuloskeletalen und viszeralen System zusammenfassen. Das erleichtert die primäre differenzialdiagnostische Beurteilung, ebenso aber auch die Therapieplanung. Die Kombination mit den osteopathischen Verfahren ist dabei sehr gewinnbringend. Eine notwendige fachärztliche Differenzialdiagnostik bleibt unumgänglich.

^* Dieser Artikel erschien erstmals als CME-Beitrag in der Zeitschrift Phys Med Rehab Kuror 2012; 22: 79–108

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