Differential therapy of lumbar back pain. Manual therapeutic aspects in the family practice setting

摘要

Background. Back pain patients present with complex symptomatology. To demonstrate the possibilities of primary treatment viewed from the perspective of manual medicine, treatment data covering a period of 2.5 years of patients consulting a general practitioner for complaints of "lumbar back pain" were analyzed. Results. In more than 90 of these patients, manual medical examination was able to detect conditions such as segment obstruction, myofascial trigger points, static imbalance, and psychosomatic disorders. Further paraclinical tests and imaging diagnostics were only needed in exceptional cases to distinguish potentially dangerous processes. It was not possible to prevent a decline in social status in only 1 of the cases due to lumbar back pain that was considerably influenced by psychosomatic factors. Conclusion. Differential therapy of the findings based on aspects of manual medicine including psychosomatic interventions proved to be extraordinarily effective, long-lasting, and without side effects when applied for primary treatment in the family practice setting.