January 20, 2022
We've arrived
The last of the twenty-four solar terms
- Great Cold
It's cold at the end of the year
Pay more attention to physical health
The military doctor Xiaoyin brought it to everyone
Knowledge of "psoas muscle strain"
Dear comrades-in-arms
Let's raise the posture together
1. What is psoas muscle strain?
"Psoas muscle strain" refers to chronic and cumulative damage to soft tissues such as lumbosacral muscles, fascia, ligaments, etc., forming local aseptic inflammation and causing chronic and episodic pain in the waist as the main symptoms. It is one of the important causes of low back pain, common in young and middle-aged people aged 30-50 years, closely related to poor lifestyle, with a long course of illness and easy recurrence [1].
2. What are the symptoms of psoas muscle strain?
Psoas muscle strain is a common class of disorders whose symptoms include the following features [2]:
1. Pain or swelling of the lumbosacral region without obvious precipitating and recurrent episodes, pain on one or both sides of the spine is more obvious, and the pain can radiate to the buttocks.
2. Low back pain worsens when sitting or standing for a long time, which can be alleviated after activity; pain worsens after exertion or strenuous exercise, which can be relieved after rest; wet and cold weather and wind chill can lead to aggravated pain.
3. Tender points: Pressing one or more positions on both sides of the back and lumbar spine can cause or aggravate local pain, and the pain can be relieved after compression.
4. In severe cases, the range of motion of the waist may be reduced due to pain.
If you have recurrent low back pain but can't think of the cause, and the low back pain has the characteristics of "aggravation during sitting or exertion, and relief after rest", then it is highly suspicious that it is not a lumbar muscle strain.
Third, why does psoas muscle strain occur?
The essence of psoas muscle strain is chronic, cumulative damage to soft tissues such as lumbar back muscles, fascia, and ligaments, resulting in local aseptic inflammation, and its etiology can generally be classified into three categories [2]:
1. Chronic injury and inflammation
Long-term excessive weight bearing or poor posture in the waist, muscles and other soft tissues under abnormal mechanical load for a long time tension, fatigue, repeated occurrence of small tears and other different degrees of damage, gradually form a chronic aseptic inflammation, and eventually cause long-lasting and difficult to heal low back pain. For example, the porter's waist is often excessively heavy, excessive fatigue, long-term posture of the desk worker, bending over for too long working hours, etc., resulting in cumulative strain on the soft tissue around the lumbar spine.
2. Chronic prolongation of acute injury
After an acute sprain of the waist, there is a more serious damage to the local soft tissue, if there is a lack of timely and effective treatment, or if it is not healed, it will continue to work, and the injury will not be recovered and will become chronic.
3. Congenital malformations or acquired lesions of the lumbar spine
Soft tissues such as muscles and ligaments around the lumbar spine are essential for the stability and coordination of the lumbar spine, congenital malformations of the lumbar spine such as congenital scoliosis, as well as acquired lesions such as compressed fractures of the lumbar spine, dislocations and lumbar disc herniation, which can cause the mechanical balance of the soft tissues around the lumbar spine, resulting in long-term compensatory fatigue and injury of the soft tissues in the lumbar spine.
4. Is "low back pain" a "psoas muscle strain"?
Many comrades-in-arms often think that their low back pain is "lumbar muscle strain", and when they are uncomfortable, they will put a few plasters on them. As everyone knows, psoas muscle strain is not a simple plaster can be cured, and many other diseases have similar symptoms to "psoas muscle strain", which is easy to confuse and needs to be carefully identified. The following Xiaoyin briefly explains the key points of "psoas muscle strain" and other diseases to help you quickly determine whether you are a psoas muscle strain or other possible disease [3].
(1) Lumbar disc herniation: lumbar muscle strain usually only low back pain, often with fixed tender points, can be relieved after rest; and the typical symptoms of lumbar disc herniation are radiation pain in the legs ("throbbing pain" from the hip to the foot), numbness or weakness, while low back pain may be dispensable. The location of low back pain for psoas muscle strain is usually on the median lateral side of the lumbar region, while low back pain for lumbar disc herniation is generally near the midline of the lower back [3].
Comrades with long-term low back pain can also ask other comrades to help them do a "straight leg elevation test" for themselves: lie flat on your own, and another comrade will raise one of your legs in a straight state. Normal people can lift more than 70 degrees without special discomfort. If, at elevations of less than 70 degrees (e.g., 30-60 degrees), the posterior lateral side of the leg you elevate experiences throbbing or numbness from the base of the leg toward the foot (or if the throbbing pain that usually occurs on the leg is worse when lifting the leg), a positive straight leg elevation test suggests a possible "lumbar disc herniation."
(2) Lumbar tuberculosis: In addition to local symptoms such as low back pain, it is often accompanied by systemic symptoms such as low-grade fever, night sweats (abnormal sweating when asleep, stopping after waking), and sometimes there may be respiratory symptoms such as cough and sputum production [3].
(3) Occult lumbar fractures: occult lumbar fractures usually have traumatic experiences that cause spinal fractures, and discomfort such as low back pain will occur, but the pain will often increase when the fracture percusses the pain point, while the pain point of the lumbar muscle strain may be reduced after percussion.
(4) Ankylosing spondylitis: it is more likely to occur in young men, typically manifested by vague pain and stiffness in the lower back or buttocks, and often feel obvious waist stiffness and discomfort after getting up in the morning, which is effectively relieved after activity. The diagnosis of the disease also requires blood tests and other tests.
In addition, visceral diseases (such as nephritis, gynecological diseases) and other problems may also cause chronic low back pain, so to accurately diagnose whether it is a psoas muscle strain, you need to professional examination and judgment of doctors, and your comrades-in-arms should not judge on their own.
5. What should I do if I find psoas muscle strain?
Psoas muscle strain generally does not require surgery and is curable, but is prone to recurrence. We must not take it lightly, we must actively prevent it, and standardize treatment as soon as possible.
(1) Strengthen the exercise of the low back muscles
Exercising and strengthening the lower back muscles and improving the stability of the human spine and trunk are key to preventing and treating low back pain. We should usually develop the habit of exercise, for patients with low back pain, exercise is an important measure for effective treatment and prevention of recurrence.
Low back muscle exercise can be through a variety of exercise methods (such as hip bridge, flat support, etc.), detailed tutorial comrades can check the Internet by themselves, choose 2-3 kinds of movements that suit them, and insist on exercising.
XiaoYin teaches you a few actions today, which can effectively exercise the low back muscles and relieve low back pain.
Recommended Sport One: Snake Style
Action essentials: (1) lie prone, jaw point, arms naturally placed on the side of the body, both hands holding empty fists; (2) bend the elbows, palms of both hands down, fingertips forward, placed on both sides of the chest, the chin against the yoga mat; (3) inhale, slowly raise the upper body, try to keep the upper body perpendicular to the ground, straighten the arms, look upwards, and raise the chin as much as possible; (4) exhale, bend the elbow, and slowly restore the upper body to the initial posture. The process can be repeated 5-8 times.
Recommended exercise two: forward protrusion and posterior extension
Action essentials: four points to support the ground at the beginning; raise the left arm to try to reach forward, while raising the right leg to try to extend backwards, insist on 10 seconds after returning to the initial position, change the other side to perform the same action. Repeat 10 sets at a time.
Recommended exercise three: hyperextension
Action Essentials: This action is similar to "Little Swallow Fly", starting with a prone position; hands on your back, then lift your chest and feet off the ground. Hold for 5 seconds, repeating 10 sets at a time.
(2) Correct bad living habits
1. Adjust the exercise program
Comrades-in-arms should pay attention to scientific and reasonable arrangements for training intensity and frequency in training, and should warm up before vigorous exercise. In training, it is not advisable to be too "strong", act according to one's ability, gradually improve their own quality, if there is obvious low back pain and other injuries, they should rest and seek medical treatment in time, and timely standardize treatment to prevent the aggravation or extension of the disease into chronic.
2. Correct bad posture
As the saying goes: "Sitting still for a long time + sitting in the wrong posture = hurting the waist". Hunched over, too low, and long periods of stiff sitting will increase the load on the waist. When working or studying, the habitual head extension, shoulders towering, stilted legs, etc., will make the spine twisted, the lumbar spine and its surrounding soft tissues are unevenly stressed, and in the long run, lumbar muscle strain and low back pain will occur. Bad living habits are the root cause of psoas muscle strain, living habits do not improve, even if the drug is used, low back pain can not be cured, easy to recur.
Therefore, in order to alleviate the waist injury, all comrades-in-arms need to develop the habit of "sitting straight, standing straight, sleeping flat, and moving right":
(1) Sit straight: try to sit in a chair with a backrest, the hips and knees are flexed by 90 degrees, the waist and back are naturally straight, avoid bending over and hunching, or leaning forward in the upper half, skewed left and right.
(2) Standing straight: when standing, the back and neck are naturally straight, the abdomen is properly retracted, the legs are straight, the eyes are level ahead, avoiding the center of gravity on only one leg, the pelvis is crooked to the side, and avoiding the "inner eight characters" of the feet.
(3) Sleep flat: try to lie flat when sleeping, the pillow is based on comfort, and should not be too high. Comrades with long-term low back pain can lay a cushion under the calf when lying flat, so that the knee and hip joints are slightly bent. For those who are not accustomed to lying on their backs, the side position can be adopted, but the head and neck should be kept upright with a pillow. If you have low back pain, you can clip a soft object between your legs, so that the spine naturally bends, and the surrounding tissues are mechanically balanced, which is conducive to rest and rehabilitation.
(4) Move right: moving heavy objects should be straight waist and bending legs, squatting to lift heavy objects, rather than bending down to lift heavy objects; when moving, heavy objects should be close to the body, while keeping the waist and back straight, not bending, otherwise it is easy to cause acute or chronic waist soft tissue injuries.
3. Pay attention to lifestyle habits
(1) Smoking cessation, weight loss: smoking is also a factor causing low back pain and degenerative spinal diseases, and obesity will also add additional burdens to the waist and accelerate lumbar degeneration. Therefore, for the relief and prevention of low back pain, these two items can not be ignored.
(2) Cold protection and warmth: The cold will cause small blood vessels around the waist to contract and muscle spasms, resulting in muscles and other soft tissues being easily damaged or difficult to recover after injury. Cold can also lower the nervous system's threshold and tolerance to pain, making low back pain more pronounced. Warm compresses on painful areas can help with recovery. Today is the "big cold", comrades with waist pain should pay more attention to keep warm!
In training and work, bad habits such as incorrect posture and sedentary habits may unconsciously cause psoas muscle strain, resulting in difficult diseases such as long-term back pain, and we must not despise or misjudge Oh. Early prevention and treatment, timely medical treatment if necessary, pay attention to the combination of work and leisure, enhance the strength of the lower back muscles, improve living habits, let us get rid of the "lumbar muscle strain" together!
After the great cold, it was another year
Caring for the body, health is always accompanied
Today's "psoas muscle strain" health trivia
Have you learned?
Resources:
Ye Qibin. Pathogenesis and prevention of psoas muscle strain[J].Armed Police Medicine,2017,28(11):1081-1084.
[2] Maher C, Underwood M, Buchbinder R. Non-specific low back pain[J]. Lancet. 2017 Feb 18;389(10070):736-747.
Chen Xiaoping,Wang Jianping,Zhao Jizong. Surgery (9th Edition)[M]. Beijing:People's Medical Publishing House,2018.]
[4] Johns Hopkins Medicine. Low Back Pain[EB/OL].
Youth League Committee of the Basic Medical College of the Air Force Military Medical University
Military Doctor Xiaoyin Studio
Instructor
Department of Orthopedics, First Affiliated Hospital of Air Force Military Medical University
Attending physician of Hu Xiaofan
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Text: Wang Mo Guo Mengke Zheng Yiting
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