rygsmerter (LH Indholdsside)

<Provider Id="sundheddkcms">
  <Item Id="{928F8FF0-A32E-4C8E-8E22-E4FAAAAB8878}" Name="rygsmerter" Type="LHContentPage" ParentProviderId="sundheddkcms" ParentItemId="{0DC18AC1-8322-42DA-BF54-C4D06C1501CE}" SortOrder="1500" PublishDate="2010-05-03T09:49:00" DeleteDate="2999-12-31T00:00:00" PotItemType="">
    <Content>
      <HtmlField Name="PageContent"><![CDATA[<h2>Basisoplysninger<a title="National Klinisk Retningslinje: Ikke-kirurgisk behandling af nylig opstået lumbal nerverodspåvirkning (lumbal radikulopati). Sundhedsstyrelsen 2016" data-url="https://www.sst.dk/da/udgivelser/2016/lumbal-nerverodspaavirkning-ikke-kirurgisk-behandling" data-value="National Klinisk Retningslinje: Ikke-kirurgisk behandling af nylig opstået lumbal nerverodspåvirkning (lumbal radikulopati). Sundhedsstyrelsen 2016" data-type="other-reference" href="https://www.sst.dk/da/udgivelser/2016/lumbal-nerverodspaavirkning-ikke-kirurgisk-behandling"><sup>1</sup></a><sup>,</sup><a href="https://www.sst.dk/-/media/Udgivelser/2016/NKR-lænderygsmerter/Endelig-NKR_lænderyg---med-Forside---til-hjemmesiden.ashx?la=da&amp;hash=A1CD9459AAD6BF0E4DB8EE5B0C2585F78A295336 " data-type="other-reference" data-value="SST 2016, National Klinisk Retningslinje for behandling af nyopståede lænderygsmerter" data-url="https://www.sst.dk/-/media/Udgivelser/2016/NKR-lænderygsmerter/Endelig-NKR_lænderyg---med-Forside---til-hjemmesiden.ashx?la=da&amp;hash=A1CD9459AAD6BF0E4DB8EE5B0C2585F78A295336 " title="SST 2016, National Klinisk Retningslinje for behandling af nyopståede lænderygsmerter"><sup>2</sup></a><sup>,</sup><a href="https://www.sst.dk/-/media/Udgivelser/2017/NKR-lumbal/NKR-Lumbal-Spinalstenose-13,-d-,10,-d-,17.ashx?la=da&amp;hash=66D4F4702895589AB1610CDFC9E14FA755A1AFBB " data-type="other-reference" data-value="SST 2017: National Klinisk Retningslinje for behandling af lumbal spinalstenose" data-url="https://www.sst.dk/-/media/Udgivelser/2017/NKR-lumbal/NKR-Lumbal-Spinalstenose-13,-d-,10,-d-,17.ashx?la=da&amp;hash=66D4F4702895589AB1610CDFC9E14FA755A1AFBB " title="SST 2017: National Klinisk Retningslinje for behandling af lumbal spinalstenose"><sup>3</sup></a></h2>
<h3>Definition</h3>
<ul>
    <li>Rygsmerter kan inddeles i nyopst&aring;ede og l&aelig;ngerevarende rygsmerter</li>
    <li>Akutte (nyopst&aring;ede) rygsmerter har varighed under 6 uger </li>
    <li>Kroniske (l&aelig;ngerevarende) rygsmerter har varighed over 12 uger </li>
</ul>
<h3>Forekomst</h3>
<ul>
    <li>Er en af de almindeligste kontakt&aring;rsager i almen praksis </li>
    <li>Livstidspr&aelig;valens er 60-80 %, mens den &aring;rlige incidens er op til 45 %<a href=" " data-type="journal-reference" data-value="Speed C, Low back pain. BMJ 2004;328: 1119-21" data-value-piped="Speed C|Low back pain.|BMJ|2004|328|1119-21|15130982" data-url="reference-link" data-pubmedid="15130982" title="Speed C, Low back pain. BMJ 2004;328: 1119-21"><sup>4</sup></a> </li>
    <li>Alder
    <ul>
        <li>Hyppigst mellem 35 og 55 &aring;r</li>
    </ul>
    </li>
    <li>K&oslash;n
    <ul>
        <li>Kvinder og m&aelig;nd er lige udsatte </li>
        <li>Under og efter svangerskab er omkring en femtedel af kvinderne plaget af rygsmerter</li>
    </ul>
    </li>
    <li>Social- og sygeudbetalinger
    <ul>
        <li>Ryglidelser er den st&oslash;rste enkeltdiagnose for social -og sygeudbetalinger, og st&aring;r for n&aelig;sten 15 % af langtidssygemeldingerne og mere end 10 % af f&oslash;rtidspensionerne</li>
    </ul>
    </li>
</ul>
<h3>Diagnostisk udredning</h3>
<ul>
    <li>Grov inddeling af &aring;rsager til akutte rygsmerter:
    <ul>
        <li>Uspecifikke l&aelig;nderygsmerter (80-90 %) </li>
        <li>Nerverodsaffektion (5-10 %) </li>
        <li>Andre og mulige alvorlige &aring;rsager, ikke-mekaniske (&lt; 1 %)</li>
    </ul>
    </li>
    <li>Afventende udredning?
    <ul>
        <li>De fleste bliver spontant raske i l&oslash;bet af de f&oslash;rste uger. Omfattende udredning er gerne uhensigtsm&aelig;ssig i den mest akutte fase </li>
        <li>Ogs&aring; majoriteten af patienter med lumbale rodsmerter bliver spontant raske, 70 % i l&oslash;bet af 2-4 uger </li>
    </ul>
    </li>
    <li>Alarmsymptomer
    <ul>
        <li>Hvilesmerter, konstante smerter, smerter som tiltager og torakale smerter </li>
        <li>Almensymptomer, feber og v&aelig;gttab </li>
        <li>Traume</li>
        <li>Kendt kr&aelig;ftsygdom</li>
        <li>Kendt osteoporose</li>
        <li>Brug af steroider, immunsuppressiva, alkohol- og stofmisbrug </li>
        <li>Udbredte neurologiske udfald, evt. deformitet i kolumna </li>
        <li>Udtalt morgenstivhed i mere end 1 time, h&oslash;j SR </li>
        <li>Alder under 20 eller over 55 &aring;r</li>
        <li>Nylig spinalpunktur (unders&oslash;gelse af v&aelig;sken fra rygmarvskanalen)</li>
        <li>Nyopst&aring;ede vandladningsproblemer eller anden alvorlig progredierende neurologisk udfald</li>
    </ul>
    </li>
</ul>
<h3>Hvorfor henvender patienten sig?</h3>
<ul>
    <li>De f&aelig;rreste med akutte ryg-gener s&oslash;ger l&aelig;ge </li>
</ul>
<h3>Diagnostiske faldgruber</h3>
<ul>
    <li>Kr&aelig;ftsygdom </li>
</ul>
<h3>ICPC-2</h3>
<p>[ICPC]</p>
<h3>ICD-10/SKS-kode</h3>
<p>[ICD10] </p>
<h2>Differentialdiagnoser</h2>
<h3>
<a href="~/link.aspx?_id=74E03C59199940A0B4E188E5C2758423&amp;_z=z">Akut lumbago</a> </h3>
<ul>
    <li>&Aring;rsag
    <ul>
        <li>&Aring;rsagen kan v&aelig;re vertebrogen, diskogen eller muskul&aelig;r </li>
        <li>Resultat af kropsvrid, overbelastning, direkte traume, fald </li>
        <li>Degenerative forandringer hos &aelig;ldre</li>
    </ul>
    </li>
    <li>Forekomst
    <ul>
        <li>Hyppigst i aldersgruppen 35-55 &aring;r </li>
        <li>Udg&oslash;r 80-90 % af patienterne med akutte rygsmerter</li>
    </ul>
    </li>
    <li>Symptomer og tegn
    <ul>
        <li>Akut start, tidligere episoder </li>
        <li>Smerter eller ubehag lokaliseret til lumbosakralkolumna med eller uden udstr&aring;ling til s&aelig;deregionen eller diffust til l&aring;ret </li>
        <li>Smerten varierer, den er ofte mindre, n&aring;r patienten er&nbsp;i ro</li>
    </ul>
    </li>
    <li>Kliniske fund
    <ul>
        <li>God almentilstand </li>
        <li>Ingen neurologiske udfald</li>
    </ul>
    </li>
    <li>Andre unders&oslash;gelser
    <ul>
        <li>I akutfasen som regel ingen</li>
    </ul>
    </li>
</ul>
<h3>
<a href="~/link.aspx?_id=74E03C59199940A0B4E188E5C2758423&amp;_z=z">Kronisk lumbago</a> </h3>
<ul>
    <li>&Aring;rsag
    <ul>
        <li>Muskul&aelig;r insufficiens, degeneration af diskus, midtstillet prolaps eller facetledsartrose</li>
    </ul>
    </li>
    <li>Forekomst
    <ul>
        <li>Hyppig</li>
    </ul>
    </li>
    <li>Symptomer og tegn
    <ul>
        <li>Recidiverende eller kroniske lave rygsmerter </li>
        <li>Ofte sammensat smertebillede</li>
    </ul>
    </li>
    <li>Kliniske fund
    <ul>
        <li>Ingen specifik patologi, specielt ingen neurologiske udfald</li>
    </ul>
    </li>
    <li>Andre unders&oslash;gelser
    <ul>
        <li>Afh&aelig;nger af sygdomsbilledet, men differentialdiagnostisk kan r&oslash;ntgen, CT v&aelig;re aktuelt</li>
    </ul>
    </li>
</ul>
<h3>
<a href="~/link.aspx?_id=BA77007FD5454D78BF5B5701D82C0135&amp;_z=z">Lumbale rodaffektioner, iskias</a> </h3>
<ul>
    <li>&Aring;rsag
    <ul>
        <li>Diskusprolaps med tryk mod nerver</li>
    </ul>
    </li>
    <li>Forekomst
    <ul>
        <li>Udg&oslash;r 1-5 % af patienter med akutte rygsmerter</li>
    </ul>
    </li>
    <li>Symptomer og tegn
    <ul>
        <li>Ofte akut start </li>
        <li>Udstr&aring;lende smerter og par&aelig;stesier, som f&oslash;lger dermatomet til nedenfor kn&aelig;et </li>
        <li>Med eller uden rygsmerter - underbensmerterne som regel v&aelig;rre </li>
        <li>Oftere hvilesmerter, forv&aelig;rring ved hoste og nysen</li>
    </ul>
    </li>
    <li>Kliniske fund
    <ul>
        <li>Motoriske og/eller sensoriske tegn p&aring; ensidig rodaffektion </li>
        <li>Over 90 %&nbsp;har udfald i L4, L5 eller S1 </li>
        <li>Positiv Lasegues test (sensitivitet &gt; 80 %, specificitet &lt; 30 %)</li>
    </ul>
    </li>
    <li>Andre unders&oslash;gelser
    <ul>
        <li>MR eller CT</li>
    </ul>
    </li>
</ul>
<h3>
<a href="~/link.aspx?_id=F69469A4F6B44C6AAF4A998FFBE0CB82&amp;_z=z">Kompressionsbrud</a> </h3>
<ul>
    <li>&Aring;rsag
    <ul>
        <li>Opst&aring;r som regel hos personer med generaliseret osteoporose </li>
        <li>Under halvdelen kan berette om udl&oslash;sende traume</li>
    </ul>
    </li>
    <li>Forekomst
    <ul>
        <li>Hyppigst blandt &aelig;ldre kvinder</li>
    </ul>
    </li>
    <li>Symptomer og tegn
    <ul>
        <li>Akutte, vedvarende rygsmerter</li>
    </ul>
    </li>
    <li>Kliniske fund
    <ul>
        <li>Smerter ved bev&aelig;gelse og evt. ogs&aring; i hvile</li>
    </ul>
    </li>
    <li>Andre unders&oslash;gelser
    <ul>
        <li>R&oslash;ntgen bekr&aelig;fter osteoporose og fraktur</li>
    </ul>
    </li>
</ul>
<h3>
<a href="~/link.aspx?_id=2B3022F9A5604E188E7E032EDBB010FC&amp;_z=z">Bechterews sygdom</a> </h3>
<ul>
    <li>&Aring;rsag
    <ul>
        <li>Er en inflammatorisk tilstand som hovedsageligt afficerer rygskelet, men ogs&aring; led og ekstraartikul&aelig;re strukturer </li>
    </ul>
    </li>
    <li>Forekomst
    <ul>
        <li>Forekommer hyppigere, og debuterer tidligere hos m&aelig;nd end kvinder </li>
        <li>Pr&aelig;valens er ca. 1-2 promille i den voksne befolkning, og incidensen er 3-400 nye tilf&aelig;lde per &aring;r i Norge</li>
    </ul>
    </li>
    <li>Symptomer og tegn
    <ul>
        <li>Gradvist tiltagende smerter og stivhed i l&aelig;nderyggen </li>
        <li>Smerten er ofte lokaliseret til hele rygs&oslash;jlen og iliosakralled </li>
        <li>Natlige smerter og morgenstivhed dominerer. Symptomerne lindres ofte op ad dagen og ved fysisk aktivitet</li>
    </ul>
    </li>
    <li>Kliniske fund
    <ul>
        <li>Nedsat bev&aelig;gelighed i et eller flere afsnit af ryggen </li>
        <li>Palpations&oslash;mhed over torntappene og iliosakralled </li>
        <li>Affektion af senef&aelig;ster i h&aelig;l, siddeknude og hoftekam</li>
    </ul>
    </li>
    <li>Andre unders&oslash;gelser
    <ul>
        <li>Kun 1-2 % af alle som er HLA-B27-positive, har sygdommen </li>
        <li>R&oslash;ntgen vil efter nogen tids sygdom bekr&aelig;fte diagnosen</li>
    </ul>
    </li>
</ul>
<h3>
<a href="~/link.aspx?_id=6AB4877EB60C4AD09C3FAC771904179E&amp;_z=z">Spondylolyse, spondylolistese</a> </h3>
<ul>
    <li>&Aring;rsag
    <ul>
        <li>Defekt i hvirvelbuen, medf&oslash;dt eller som f&oslash;lge af tr&aelig;thedsbrud (spondylolyse) </li>
        <li>Tilstanden giver symptomer f&oslash;rst og fremmest hos unge (15-19 &aring;r), og er associeret med idr&aelig;t med hyperekstension, rotation og torsion (jf. kastere, h&aring;ndbold) </li>
        <li>Glidning (spondylolistese) forekommer hos 30-80 %</li>
    </ul>
    </li>
    <li>Forekomst
    <ul>
        <li>Pr&aelig;valens er ca. 7 % i den voksne befolkning (spondylolyse), men kun 10 % af disse har symptomer</li>
    </ul>
    </li>
    <li>Symptomer og tegn
    <ul>
        <li>L&aelig;nderygsmerter med udstr&aring;ling til glutealmuskulaturen og til l&aring;r </li>
        <li>Smerterne forv&aelig;rres gerne op ad dagen</li>
    </ul>
    </li>
    <li>Kliniske fund
    <ul>
        <li>Smerterne kan forv&aelig;rres ved hyperekstension men ikke ved fleksion </li>
        <li>Et-bens hyperekstension af kolumna, st&aring;ende eller liggende, kan udl&oslash;se smerte</li>
    </ul>
    </li>
    <li>Andre unders&oslash;gelser
    <ul>
        <li>R&oslash;ntgen kan bekr&aelig;fte tilstanden</li>
    </ul>
    </li>
</ul>
<h3>
<a href="~/link.aspx?_id=D03A2A34FDAC4A3DB243AFD8F6175A70&amp;_z=z">Scheuermanns sygdom</a> </h3>
<ul>
    <li>&Aring;rsag
    <ul>
        <li>Mest sandsynlig skyldes lidelsen en aseptisk knoglenekrose i hvirvellegemet med reduceret blodforsyning til v&aelig;kstzonen </li>
        <li>Nekrosen er mest udtalt fortil og f&oslash;rer til, at hvirvellegemerne f&aring;r en kileform </li>
        <li>Hos 70 % er forandringerne lokaliseret til torakalkolumna</li>
    </ul>
    </li>
    <li>Forekomst
    <ul>
        <li>Opst&aring;r almindeligvis i pubertetsv&aelig;kstspurten </li>
        <li>Er hyppigere hos drenge end piger</li>
    </ul>
    </li>
    <li>Symptomer og tegn
    <ul>
        <li>De fleste med moderate forandringer i torakalkolumna har ingen smerter, mens en st&oslash;rre andel med lumbal affektion kan have smerter</li>
    </ul>
    </li>
    <li>Kliniske fund
    <ul>
        <li>&Oslash;get kyfose i torakal- eller torakolumbalkolumna</li>
    </ul>
    </li>
    <li>Andre unders&oslash;gelser
    <ul>
        <li>Diagnosen bekr&aelig;ftes ved r&oslash;ntgen</li>
    </ul>
    </li>
</ul>
<h3>
<a href="~/link.aspx?_id=2DB7758B2B4E4C82B5AD9964909D028F&amp;_z=z">Skoliose</a> </h3>
<ul>
    <li>&Aring;rsag
    <ul>
        <li>Krumning i frontalplanet </li>
        <li>Skelnes mellem strukturelle (oftest idiopatisk) og ikke-strukturelle skolioser (oftest anisomeli)</li>
    </ul>
    </li>
    <li>Forekomst
    <ul>
        <li>Pr&aelig;valens er 3 %, men behandlingskr&aelig;vende skolioser udg&oslash;r kun 3 promille </li>
        <li>Idiopatisk skoliose er langt hyppigere blandt piger</li>
    </ul>
    </li>
    <li>Symptomer og tegn
    <ul>
        <li>Skoliose patienter har normalt ikke flere rygsmerter end andre </li>
        <li>M&aring;ske kan de lettere f&aring; sekund&aelig;r slidgigt i ryggen</li>
    </ul>
    </li>
    <li>Kliniske fund
    <ul>
        <li>Ved strukturel skoliose vil fremoverb&oslash;jning vise asymmetri, torsion i ryggen</li>
        <li>Ved ikke-strukturel skoliose for&aring;rsaget af anisomeli vil skoliosen ikke v&aelig;re tilstede i siddende stilling</li>
    </ul>
    </li>
    <li>Andre unders&oslash;gelser
    <ul>
        <li>R&oslash;ntgen bekr&aelig;fter og klassificerer tilstanden</li>
    </ul>
    </li>
    <li>Indikation for behandling af den idiopatiske adolescente skoliose afh&aelig;nger bl.a. af sk&aelig;vheden m&aring;lt som Cobbs vinkel. Ved konservativ behandling med korset kan nightbrace anvendes i stedet for full-time brace, men anbefalingsstyrken er svag, idet der kun er enkelte prospektive unders&oslash;gelser med anvendelse af nightbrace<a href="https://www.ortopaedi.dk/wp-content/uploads/2016/10/KKR-Scoliose.pdf " data-type="other-reference" data-value="Kort Klinisk Retningslinje fra Dansk Ortopædisk Selskab 2016 vedrørende valget mellem natkorset eller døgnkorset ved adolescente idiopatiske scolioser." data-url="https://www.ortopaedi.dk/wp-content/uploads/2016/10/KKR-Scoliose.pdf " title="Kort Klinisk Retningslinje fra Dansk Ortopædisk Selskab 2016 vedrørende valget mellem natkorset eller døgnkorset ved adolescente idiopatiske scolioser."><sup>5</sup></a></li>
</ul>
<h3>
<a href="~/link.aspx?_id=7D3EA50DDC2E4035B6A28D62167D5280&amp;_z=z">Spondylose</a> </h3>
<ul>
    <li>&Aring;rsag
    <ul>
        <li>Degenerative forandringer i rygs&oslash;jlen, hovedsageligt i disci</li>
    </ul>
    </li>
    <li>Forekomst
    <ul>
        <li>Findes hos de allerfleste over 40 &aring;r, men kun et f&aring;tal har symptomer </li>
    </ul>
    </li>
    <li>Symptomer og tegn
    <ul>
        <li>Spondylose er ofte ikke forbundet med s&aelig;rlige ryg-gener </li>
        <li>Lumbal spondylose kan give smerter som forv&aelig;rres ved fysisk belastning </li>
    </ul>
    </li>
    <li>Kliniske fund
    <ul>
        <li>Evt. nedsat bev&aelig;gelighed, ellers gennemg&aring;ende normale kliniske fund </li>
    </ul>
    </li>
    <li>Andre unders&oslash;gelser
    <ul>
        <li>R&oslash;ntgen bekr&aelig;fter diagnosen</li>
    </ul>
    </li>
</ul>
<h3>
<a href="~/link.aspx?_id=7E0B7340303E4D7282E3D9E2FD46BBB3&amp;_z=z">Spinalstenose</a> </h3>
<ul>
    <li>&Aring;rsag
    <ul>
        <li>Skyldes som regel degeneration af disci og facetled med forkalkninger, som giver trange forhold for rygmarv eller nerverod </li>
        <li>Medvirkende &aring;rsager kan v&aelig;re spondylolistese, tidligere brud, rygoperation</li>
    </ul>
    </li>
    <li>Forekomst
    <ul>
        <li>Optr&aelig;der almindeligvis hos &aelig;ldre personer over 60 &aring;r</li>
    </ul>
    </li>
    <li>Symptomer og tegn
    <ul>
        <li>Rygsmerter og morgenstivhed, udstr&aring;lende smerter, par&aelig;stesier og kraftsvigt relateret til aktivitet </li>
        <li>Kardinalsymptomet er reduceret gangdistance </li>
        <li>Smerten lindres typisk, n&aring;r patienten b&oslash;jer sig forover</li>
    </ul>
    </li>
    <li>Kliniske fund
    <ul>
        <li>Lasegues-test er sj&aelig;ldent positiv </li>
        <li>Motoriske udfald og bortfald af patellarefleksen er et hyppigt fund</li>
    </ul>
    </li>
    <li>Andre unders&oslash;gelser
    <ul>
        <li>MR vil bekr&aelig;fte diagnosen</li>
    </ul>
    </li>
</ul>
<h3>Andre og sj&aelig;ldne &aring;rsager</h3>
<ul>
    <li>Svulst
    <ul>
        <li><a href="~/link.aspx?_id=FEA337568D6743A3B6DAE50693FED1CA&amp;_z=z">Myelom</a> </li>
        <li>Metastase </li>
        <li>Spinal tumor</li>
    </ul>
    </li>
    <li>Inflammatorisk sygdom
    <ul>
        <li><a href="~/link.aspx?_id=422A648683274385AE4336D863341A05&amp;_z=z">Polymyalgia reumatika</a> </li>
        <li>Reiters syndrom </li>
        <li><a href="~/link.aspx?_id=01B73EDAEA6749029D805E9C5B9E687E&amp;_z=z">Psoriasis</a> </li>
        <li>Tarmsygdom (<a href="~/link.aspx?_id=7C3C6EF3B3BE4C7AA66DC32DA809FE83&amp;_z=z">Crohn</a>, <a href="~/link.aspx?_id=62540B9A858E40508D36FB82EDDEDD59&amp;_z=z">ulcer&oslash;s kolit</a>)</li>
    </ul>
    </li>
    <li>Infektion
    <ul>
        <li>Purulent diskit</li>
    </ul>
    </li>
    <li>Metabolisk knoglesygdom </li>
    <li>
    <a href="~/link.aspx?_id=5022C6009DAA4F739414DE007C6B5F16&amp;_z=z">Pankreatit</a> </li>
    <li>
    <a href="~/link.aspx?_id=E2AFE0134DBD4525ABA2C968A8DA7C52&amp;_z=z">Ulcus perforans</a> </li>
    <li>
    <a href="~/link.aspx?_id=F4FCDC4BC93747BAB9A9B384DDBDE7D9&amp;_z=z">Pyelonefrit</a> </li>
    <li>
    <a href="~/link.aspx?_id=6771FF7CB941461CB25A59F21BBC1677&amp;_z=z">Prostatit</a> </li>
    <li>
    <a href="~/link.aspx?_id=86C8023AEBC4402C8FC45B351C4B6490&amp;_z=z">Nyresten</a> </li>
    <li>
    <a href="~/link.aspx?_id=919B9AA6E522440090E8C0FA83079D12&amp;_z=z">Herpes zoster</a> </li>
    <li>
    <a href="~/link.aspx?_id=097177364DA84C79931EC09A189661C3&amp;_z=z">Endometriose</a> </li>
    <li>
    <a href="~/link.aspx?_id=4719A6BB2B29490499CC90EC00AA633F&amp;_z=z">Aortaaneurisme</a> </li>
</ul>
<h2>Sygehistorie</h2>
<h3>Centrale elementer</h3>
<h4>Akutte rygsmerter</h4>
<ul>
    <li>Tidligere ryggener?
    <ul>
        <li>Forl&oslash;b, behandling</li>
    </ul>
    </li>
    <li>Aktuelle anfald
    <ul>
        <li>Hvordan debuterede generne? </li>
        <li>Hvordan har tilstanden udviklet sig?</li>
    </ul>
    </li>
    <li>Smerterne?
    <ul>
        <li>Konstante? </li>
        <li>Hvilesmerter? </li>
        <li>Hvad lindrer? </li>
        <li>Hvad provokerer? </li>
        <li>Smertens karakter? </li>
        <li>Smertens intensitet?
        <ul>
            <li>Behov for medicin? </li>
            <li>Arbejdsevne?</li>
        </ul>
        </li>
        <li>S&oslash;vnbesv&aelig;r </li>
        <li>Udstr&aring;lende smerter?
        <ul>
            <li>Hvilken lokalisation? </li>
            <li>Ved hoste og nysen?</li>
        </ul>
        </li>
    </ul>
    </li>
    <li>Neurologiske udfald?
    <ul>
        <li>Kraft og f&oslash;lesans? </li>
        <li>Fungerer vandladning og aff&oslash;ring normalt?</li>
    </ul>
    </li>
    <li>Almensymptomer?
    <ul>
        <li>Tegn p&aring; underliggende sygdom?</li>
        <li style="text-align: left;">Nylig spinalpunktur eller operaton med spinal- eller epidural an&aelig;stesi?</li>
    </ul>
    </li>
</ul>
<h4>Kroniske rygsmerter</h4>
<ul>
    <li>Sygehistorien ved akutte rygsmerter har ogs&aring; relevans ved kroniske gener </li>
    <li>Lokalisation
    <ul>
        <li>Diffus udbredelse kan v&aelig;re tegn p&aring; somatisering </li>
        <li>Afgr&aelig;nsede smerter er oftere udtryk for organisk lidelse</li>
    </ul>
    </li>
    <li>Tidligere episoder
    <ul>
        <li>Hyppighed? </li>
        <li>Varighed? </li>
        <li>Behandling og effekt af denne?</li>
    </ul>
    </li>
    <li>Natlige smerter, langvarig morgenstivhed? </li>
</ul>
<h2>Klinisk unders&oslash;gelse</h2>
<h3>Generelt</h3>
<ul>
    <li>Grundig unders&oslash;gelse b&oslash;r foretages ved mistanke om underliggende sygdom og langtrukken tilstand - jf. nedenfor </li>
    <li>Ved akutte rygsmerter, afklar:
    <ul>
        <li>Det segmentale niveau for tilstanden </li>
        <li>Om der er tegn til nerverodsudfald </li>
        <li>Om der b&oslash;r foretages supplerende unders&oslash;gelser snarligt</li>
    </ul>
    </li>
    <li>Ved kroniske rygsmerter
    <ul>
        <li>Fors&oslash;g at stille en patoanatomisk diagnose</li>
    </ul>
    </li>
</ul>
<h4>Inspektion</h4>
<ul>
    <li>Ankomst
    <ul>
        <li>Gangen? </li>
        <li>Hvordan bev&aelig;ger patienten sig? </li>
        <li>Kan patienten&nbsp;b&oslash;je sig forover? S&aelig;tte sig?</li>
    </ul>
    </li>
    <li>Kolumna
    <ul>
        <li>Akseforhold. Skoliose? Studeres bedst n&aring;r patienten b&oslash;jer sig fremover </li>
        <li>Bev&aelig;gelsesm&oslash;nstret ved b&oslash;jning fremover, bagover, til siden og ved rotation </li>
        <li>Registr&eacute;r asymmetrier, hvad udl&oslash;ser smerter, hvad stopper bev&aelig;gelserne
        <ul>
            <li>Ensidig reduceret sidebev&aelig;gelighed kan tyde p&aring; affektion af facetled</li>
        </ul>
        </li>
    </ul>
    </li>
    <li>Kraft
    <ul>
        <li>H&aelig;lgang (L5), t&aring;gang (S1), kn&aelig;b&oslash;jning (L4) </li>
        <li>Tegn til muskelatrofi</li>
    </ul>
    </li>
</ul>
<h4>Funktionsunders&oslash;gelser</h4>
<ul>
    <li>Hofteleddet
    <ul>
        <li>Passiv bev&aelig;gelighed </li>
        <li>Isometriske test af fleksion, udadrotation, adduktion</li>
    </ul>
    </li>
    <li>Bl&oslash;ddele i hofte og b&aelig;kken
    <ul>
        <li>Palp&eacute;r for at afd&aelig;kke lokaliserede smerter</li>
    </ul>
    </li>
</ul>
<h4>Lasegues pr&oslash;ve (strakt benl&oslash;ft test)</h4>
<ul>
    <li>Er positiv ved affektion af L5- og S1-nerverod </li>
    <li>Pr&oslash;ven regnes som positiv, n&aring;r smerter str&aring;ler distalt for kn&aelig;et, f&oslash;r benet er eleveret over 60&deg; </li>
    <li>Krydset Lasegues pr&oslash;ve gennemf&oslash;res ved l&oslash;ft af det ikke-smertefulde ben </li>
    <li>Diagnostisk n&oslash;jagtighed
    <ul>
        <li>Som unders&oslash;gelse for prolaps har vanlig Lasegues pr&oslash;ve sensitivitet p&aring; 80 % og specificitet p&aring; 30 % </li>
        <li>Krydset Lasegues pr&oslash;ve har sensitivitet p&aring; 25 % og specificitet p&aring; 90 %</li>
    </ul>
    </li>
    <li>Omvendt Lasegues pr&oslash;ve udf&oslash;res ved at ekstendere i hofte
    <ul>
        <li>Testen er positiv, hvis dette f&oslash;rer til smerteudstr&aring;ling p&aring; forsiden af l&aring;r/underben (L4-affektion)</li>
    </ul>
    </li>
</ul>
<h4>Sensibilitet, motorik og reflekser</h4>
<ul>
    <li>L4-affektion kan give
    <ul>
        <li>Smerter og sensibilitetsudfald p&aring; l&aring;rets forside og medialt p&aring; underbenet </li>
        <li>Sv&aelig;kket kvadriceps </li>
        <li>Evt. nedsat patella-refleks </li>
        <li>Lasegues pr&oslash;ve er negativ, men omvendt Lasegues pr&oslash;ve er positiv</li>
    </ul>
    </li>
    <li>L5-affektion kan give
    <ul>
        <li>Smerter og sensibilitetsudfald langs lateralsiden af l&aring;r og underben, p&aring; fodryggen, langs mediale fodrand og ud i 1. t&aring; </li>
        <li>Sv&aelig;kkede ankelekstensorer (h&aelig;lgang) </li>
        <li>Ingen refleks&aelig;ndringer</li>
    </ul>
    </li>
    <li>S1-affektion kan give
    <ul>
        <li>Smerter og sensibilitetsudfald p&aring; bagsiden af l&aring;r og underben, mod h&aelig;len og p&aring; lateralsiden af foden og ud i 5. t&aring; </li>
        <li>Sv&aelig;kkede ankelfleksorer (t&aring;gang) </li>
        <li>Sv&aelig;kket eller manglende akillessenerefleks</li>
    </ul>
    </li>
</ul>
<h3>Specielt</h3>
<h4>Mistanke om cauda equina syndrom</h4>
<ul>
    <li>Median prolaps eller l&oslash;snet prolaps som presser p&aring; cauda equina (S2-S4 udfald), hvor udfald vil kunne v&aelig;re fra en blanding af lumbale og sakrale r&oslash;dder </li>
    <li>Affektion af S2-4
    <ul>
        <li>Udstr&aring;lende bilaterale smerter og nedsat sensibilitet i ridebukseomr&aring;det (mediodorsalt p&aring; l&aring;ret og perianalt) </li>
        <li>Bl&aelig;reparese (urinretention) og eventuelt rektumparese (obstipation) </li>
        <li>Erektionssvigt</li>
    </ul>
    </li>
    <li>Omfattende affektion af b&aring;de lumbale og sakrale nerver&oslash;dder
    <ul>
        <li>Bl&aelig;re-tarmparese </li>
        <li>Omfattende sensibilitetsudfald og lammelser i benene</li>
    </ul>
    </li>
    <li>Syndromet skal h&aring;ndteres som en akut situation for at afklare behovet for hurtig kirurgisk aflastning</li>
</ul>
<h2>Supplerende unders&oslash;gelser</h2>
<h3>I almen praksis</h3>
<ul>
    <li>Blodpr&oslash;ver er sj&aelig;lden indiceret ved f&oslash;rste konsultation </li>
    <li>Aktuelle pr&oslash;ver
    <ul>
        <li>Hb, CRP, SR, HLA-B27 </li>
    </ul>
    </li>
    <li>Ved mistanke om systemsygdom
    <ul>
        <li>Kalcium, fosfat,&nbsp;basisk fosfatase,&nbsp;PSA</li>
    </ul>
    </li>
    <li>Urinunders&oslash;gelse
    <ul>
        <li>Ved mistanke om urinvejssygdom</li>
    </ul>
    </li>
</ul>
<h3>Andre unders&oslash;gelser</h3>
<ul>
    <li>Billeddiagnostik er ikke indiceret ved uspecifikke rygsmerter<a href="https://www.sst.dk/da/udgivelser/2016/nkr-laenderygsmerter" data-type="other-reference" data-value="National klinisk retningslinje for behandling af nyopståede lænderygssmerter" data-url="https://www.sst.dk/da/udgivelser/2016/nkr-laenderygsmerter" title="National klinisk retningslinje for behandling af nyopståede lænderygssmerter"><sup>6</sup></a>&nbsp;</li>
    <li>Husk at billeddiagnostik har lav specificitet - mange patologiske fund er uden klinisk betydning&nbsp;<a href="https://vaelgklogt.dk/anbefalinger/laenderyg">L&aelig;nderyg | V&aelig;lg Klogt (vaelgklogt.dk)</a></li>
    <li>&nbsp;<span style="white-space: pre;">	</span>"V&aelig;lg klogt" anbefaling er:&nbsp;<span>"Undg&aring; billeddiagnostisk udredning med MR-scanning eller r&oslash;ntgenunders&oslash;gelse hos patienter med nyopst&aring;ede l&aelig;nderygsmerter, n&aring;r der ikke er mistanke om alvorlig lidelse".&nbsp;</span><span>Mistanke om alvorlig lidelse omfatter tegn p&aring; infektion eller bl&oslash;dning i rygmarvskanalen, knoglebrud, cancer eller afklemning af rygmarven. Symptomer p&aring; alvorlig lidelse, s&aring;kaldte "r&oslash;de flag", er feber eller anden tegn p&aring; infektion, historik om skade eller nylig spinalpunktur (unders&oslash;gelse af v&aelig;sken fra rygmarvskanalen), nyopst&aring;ede vandladningsproblemer eller anden alvorlig progredierende neurologisk udfald&nbsp;<a href="https://vaelgklogt.dk/anbefalinger/laenderyg" data-type="other-reference" data-value="Vælg klogt anbefaling: Lænderyg" data-url="https://vaelgklogt.dk/anbefalinger/laenderyg" title="Vælg klogt anbefaling: Lænderyg"><sup>7</sup></a></span></li>
    <li>Ved vedvarende og st&aelig;rke smerter i mere end 4-6 uger
    <ul>
        <li>B&oslash;r henvisning overvejes mhp. p&aring; at vurdere, om der skal foretages CT kombineret med rtg. kolumna, alternativt MR</li>
    </ul>
    </li>
    <li>Ved nerverodsaffektion uden bedring efter 4-6 uger
    <ul>
        <li>B&oslash;r der foretages&nbsp;MR (alternativt CT). Dette prim&aelig;rt hvis operation overvejes, og patienten ikke er unders&oslash;gt tidligere </li>
        <li>Hos tidligere prolapsopererede er MR f&oslash;rstevalg</li>
    </ul>
    </li>
    <li>Ved mistanke om underliggende sygdom eller brud
    <ul>
        <li>B&oslash;r der altid foretages billeddiagnostik </li>
        <li>MR foretr&aelig;kkes </li>
        <li>CT eller r&oslash;ntgen er alternativer </li>
        <li>Evt. scintigrafi - er nyttig ved infektion, brud, svulst eller inflammation og er i tidlig fase bedre end r&oslash;ntgen. Sensitivitet 90-95 %, specificitet 70 %</li>
    </ul>
    </li>
</ul>
<h4>Oversigtsr&oslash;ntgen af kolumna</h4>
<ul>
    <li>Giver information om degenerative forandringer, spondylolistese, tidligere frakturer eller kompressionsfrakturer </li>
    <li>Skoliose - rekvirer&nbsp;st&aring;ende billeder af hele kolumna, evt. f&oslash;rst efter vurdering ved ortop&aelig;dkirurg </li>
    <li>Scheuermann - tages sidebilleder af torakalkolumna</li>
</ul>
<h4>Lumbal CT</h4>
<ul>
    <li>Giver god fremstilling af facetleddene og spondylolyse </li>
    <li>Fremstiller ogs&aring; paravertebral muskulatur</li>
</ul>
<h4>MR</h4>
<ul>
    <li>MR-skanning af kolumna lumbalis er&nbsp;mere sensitiv end CT-skanning af kolumna lumbalis&nbsp;</li>
    <li>Er bedst ved mistanke om malignitet, diskit, spinalstenose </li>
    <li>Har h&oslash;j sensitivitet for begyndende degeneration i disci eller discusprotrusion, men fundene er ofte uspecifikke </li>
    <li>Ved recidivprolaps er MR med kontrast bedre end CT for at skelne mellem arv&aelig;v og ny prolaps</li>
</ul>
<h4>Knogle- og leukocyt-scintigrafi samt PET-CT</h4>
<ul>
    <li>Bruges ved mistanke om infektion, malignitet, tr&aelig;thedsbrud</li>
    <li>Degenerative forandringer, tendinitter og aseptiske knoglenekroser vil ogs&aring; give &oslash;get optagelse</li>
</ul>
<h2>Tiltag og r&aring;d</h2>
<h3>Hvorn&aring;r b&oslash;r akut indl&aelig;ggelse eller billeddiagnostik overvejes</h3>
<ul>
    <li>Relevant traume</li>
    <li>Urinretention</li>
    <li>Flatus- / f&aelig;ces inkontinens</li>
    <li>F&oslash;leforstyrrelser i ridebuks-omr&aring;det</li>
    <li>Udbredte eller progredierende pareser</li>
    <li>Gangproblemer p&aring; grund af pareser eller cauda equina syndrom
    <ul>
        <li>Patienter med akut bl&aelig;re- eller rektumparese b&oslash;r opereres indenfor 12 timer</li>
    </ul>
    </li>
    <li>Iskiaspatienter med aftagende smerte samtidig med progredierende pareser, tegn p&aring; forv&aelig;rring af tilstanden, er i fare for varig funktionsneds&aelig;ttelse </li>
    <li>Intraktable smerter</li>
    <li>Ved underliggende sygdom
    <ul>
        <li>Cancer sygdom</li>
        <li>Osteoporose</li>
    </ul>
    </li>
    <li>Smerter ved perkussionstest</li>
</ul>
<h3>Henvisninger</h3>
<ul>
    <li>Ved vedvarende og st&aelig;rke smerter i mere end 4-6 uger eller&nbsp;manglende bedring efter 6-8 uger</li>
    <li>Henvisning til tv&aelig;rfaglig rygklinik (evt. neurokirurg, reumatolog, neurolog)</li>
    <li>Henvisning til ortop&aelig;dkirurg
    <ul>
        <li>Ved kyfose eller strukturel skoliose</li>
    </ul>
    </li>
    <li>Henvisning til reumatolog
    <ul>
        <li>Ved mistanke om Bechterews sygdom eller anden inflammatorisk sygdom</li>
    </ul>
    </li>
</ul>
<h3>Ved mistanke om inflammatorisk ryglidelse</h3>
<ul>
    <li>Form&aring;l
    <ul>
        <li>Diagnostik? Terapi?</li>
    </ul>
    </li>
    <li>Sygehistorie
    <ul>
        <li>Debut? </li>
        <li>D&oslash;gnvariation? Natlige smerter? Lokalisation? Morgenstivhed? </li>
        <li>Arvelig disposition? HLA-B27? Psoriasis? Perifere ledsmerter/h&aelig;velser? </li>
        <li>Alder over 45 - debut af inflammatorisk rygsygdom er lidet sandsynlig </li>
        <li>Effekt af tr&aelig;ning? Effekt af <a href="https://pro.medicin.dk/Laegemiddelgrupper/Grupper/213010">NSAID</a>?</li>
    </ul>
    </li>
    <li>Kliniske fund
    <ul>
        <li>Rygstatus</li>
    </ul>
    </li>
    <li>Supplerende unders&oslash;gelser
    <ul>
        <li>Hb, leukocytter, trombocytter, CRP, SR, Kreatinin, ALAT, u-stix, HLA-B27</li>
    </ul>
    </li>
    <li>Andre unders&oslash;gelser
    <ul>
        <li>Rtg. total kolumna og SI-led </li>
        <li>Hvis st&aelig;rk mistanke om aktiv inflammation, foretag ogs&aring; MR-total kolumna og SI-led</li>
    </ul>
    </li>
</ul>
<h3>R&aring;d</h3>
<ul>
    <li>De allerfleste med akutte rygsmerter bliver raske i l&oslash;bet af 1-2 uger uden behandling. Rutinem&aelig;ssig&nbsp;billeddiagnostik er ikke n&oslash;dvendigt i denne fase</li>
    <li>Ved f&oslash;rste konsultation
    <ul>
        <li>Efter n&oslash;je overvejelse gives smertelindring i form af svage <a href="https://pro.medicin.dk/Laegemiddelgrupper/Grupper/226500">analgetika</a>, evt. <a href="http://pro.medicin.dk/Laegemiddelgrupper/grupper/213010">NSAID</a> </li>
        <li>Tilbyd kun [DliActiveSubstance;6381;paracetamol], <a href="https://pro.medicin.dk/Laegemiddelgrupper/Grupper/213010">NSAID</a> eller <a href="https://pro.medicin.dk/Laegemiddelgrupper/Grupper/315123">opoider</a> i till&aelig;g til vanlig behandling til patienter med nyopst&aring;ede l&aelig;nderygsmerter efter n&oslash;je overvejelse, da der ikke er dokumenteret gavnlig effekt m&aring;lt 0-12 uger efter endt behandling</li>
        <li>Vanlig aktivitet opmuntres, og kun undtagelsesvis tilr&aring;des ro og sengeleje&nbsp; </li>
        <li>Tidlig tilbagevenden til job er god "medicin"</li>
        <li>Passive behandlingsindsatser
        <ul>
            <li>Overvej at tilbyde patienter med nyopst&aring;ede l&aelig;nderygsmerter manuel ledmobiliserende behandling i till&aelig;g til vanlig behandling</li>
            <li>Tilbyd kun akupunktur teknikker i till&aelig;g til vanlig behandling til patienter med nyopst&aring;ede l&aelig;nderygsmerter efter n&oslash;je overvejelse, da den gavnlige effekt er usikker</li>
        </ul>
        </li>
        <li>Aktive behandlingsindsatser
        <ul>
            <li>Overvej at tilbyde patienter med nyopst&aring;ede l&aelig;nderygsmerter superviseret fysisk tr&aelig;ning i till&aelig;g til vanlig behandling</li>
        </ul>
        </li>
    </ul>
    </li>
    <li>Kontrol og opf&oslash;lgning
    <ul>
        <li>For alle med f&oslash;rstegangs rygsmerter </li>
        <li>Alle som er sygemeldte </li>
        <li>Foretag en ad&aelig;kvat klinisk unders&oslash;gelse </li>
        <li>Vurd&eacute;r behovet for yderligere udredning </li>
        <li>Opstart af aktiv behandling hvis generne vedvarer - fysioterapi, kiropraktik</li>
    </ul>
    </li>
    <li>For patienter med neurogene smerter p&aring; baggrund af spinalstenose g&aelig;lder<a title="National Klinisk Retningslinje: Ikke-kirurgisk behandling af nylig opstået lumbal nerverodspåvirkning (lumbal radikulopati). Sundhedsstyrelsen 2016" data-url="https://www.sst.dk/da/udgivelser/2016/lumbal-nerverodspaavirkning-ikke-kirurgisk-behandling" data-value="National Klinisk Retningslinje: Ikke-kirurgisk behandling af nylig opstået lumbal nerverodspåvirkning (lumbal radikulopati). Sundhedsstyrelsen 2016" data-type="other-reference" href="https://www.sst.dk/da/udgivelser/2016/lumbal-nerverodspaavirkning-ikke-kirurgisk-behandling"><sup>1</sup></a>:&nbsp;
    <ul>
        <li>Der er generelt gavnlige helbredseffekter af tr&aelig;ning, men det er mest hensigtsm&aelig;ssigt at fokusere p&aring; generel konditionering for at bedre patienternes samlede helbredstilstand, da der ikke er evidens for tr&aelig;ning som behandling for neurogene smerter. Patienterne b&oslash;r l&oslash;bende revurderes og viderehenvises til kirurgisk vurdering, hvis de ikke bedres. Har symptomerne st&aring;et p&aring; igennem mere end 3-6 m&aring;neder, b&oslash;r patienterne viderehenvises direkte til kirurgisk vurdering</li>
        <li>Behandling af neurogene smerter med ledmobiliserende behandling, [DliActiveSubstance;6381;paracetamol], <a href="https://pro.medicin.dk/Laegemiddelgrupper/Grupper/213010">NSAID</a> eller <a href="https://pro.medicin.dk/Laegemiddelgrupper/Grupper/315123">opioder</a> kan ikke anbefales, da den gavnlige effekt er usikker, og da der er risiko for&nbsp;bivirkninger. Ledmobiliserende behandling og <a href="https://pro.medicin.dk/Laegemiddelgrupper/Grupper/226500">analgetika</a> i en kort periode kan overvejes, hvis der er samtidige rygsmerter<a href="https://www.sst.dk/da/udgivelser/2016/nkr-laenderygsmerter" data-type="other-reference" data-value="National klinisk retningslinje for behandling af nyopståede lænderygssmerter" data-url="https://www.sst.dk/da/udgivelser/2016/nkr-laenderygsmerter" title="National klinisk retningslinje for behandling af nyopståede lænderygssmerter"><sup>6</sup></a></li>
    </ul>
    </li>
    <li>For patienter med nylig opst&aring;et lumbal nerverodsp&aring;virkning (lumbal radikulopati) g&aelig;lder<a href="https://www.sst.dk/-/media/Udgivelser/2017/NKR-lumbal/NKR-Lumbal-Spinalstenose-13,-d-,10,-d-,17.ashx?la=da&amp;hash=66D4F4702895589AB1610CDFC9E14FA755A1AFBB" data-type="other-reference" data-value="SST 2017: National Klinisk Retningslinje for behandling af lumbal spinalstenose" data-url="https://www.sst.dk/-/media/Udgivelser/2017/NKR-lumbal/NKR-Lumbal-Spinalstenose-13,-d-,10,-d-,17.ashx?la=da&amp;hash=66D4F4702895589AB1610CDFC9E14FA755A1AFBB " title="SST 2017: National Klinisk Retningslinje for behandling af lumbal spinalstenose"><sup>3</sup></a>:
    <ul>
        <li>Patienter b&oslash;r opfordres til normal fysisk aktivitet frem for reduceret aktivitet i form af sengeleje</li>
    </ul>
    </li>
    <li>Der kan tilbydes &oslash;velsesterapi eller manuelle ledmobiliserende teknikker, da det ikke kan underbygges, at der er klinisk relevant forskel p&aring; de to interventioner</li>
    <li>MR-skanning b&oslash;r kun tilbydes efter n&oslash;je overvejelse, da den gavnlige effekt heraf er usikker</li>
</ul>
<h2>Illustrationer</h2>
<h3>Billeder</h3>
<ul>
    <li>
    <a href="~/link.aspx?_id=7F255A026B874B04BC43459D50AC15AB&amp;_z=z">Lumbalcolumna, side, normalt, rtg.</a> </li>
</ul>
<h3>Plancher eller tegninger</h3>
<ul>
    <li>
    <a href="~/link.aspx?_id=13351A65350B4107AF72217E35035D49&amp;_z=z">Lumbalcolumna (med prolaps), tegning</a> </li>
    <li>
    <a href="~/link.aspx?_id=1D8A64029A3044949F484B8BD6C612F0&amp;_z=z">Prolaps, tv&aelig;rsnit</a></li>
</ul>
<h3>Tr&aelig;ningsfilm for l&aelig;nderyggen</h3>
<ul>
    <li><a href="~/link.aspx?_id=E6907ACE746044D89F2AB5C1757CB471&amp;_z=z">&Oslash;velsesprogram, 3 &oslash;velser</a><br>
    &nbsp;<br>
    <a href="~/link.aspx?_id=3F37EE5C2C4C4078896641E521E6506D&amp;_z=z"><img alt="Klik for at se introduktionsvideoen" src="9C5B771B780A41A19989427EB606036A-135-84" title="Klik for at se introduktionsvideoen" style="height: 84px; width: 135px;" height="84" width="135"></a><br>
    <br>
    </li>
    <li><a href="~/link.aspx?_id=D15793BECC314248B5832D9BA9CF956B&amp;_z=z">&Oslash;velsesprogram, 3 &oslash;velser med arabisk tale - فيديوهات تمارين رياضية باللغة العربية</a><br>
    <br>
    <a href="~/link.aspx?_id=475FEDB6C4FC460DBE85104E216E5B65&amp;_z=z"><img alt="Klik for at se introduktionsvideoen med arabisk tale" src="737E9F0FEE87480FBBB49E2FF87F2196-135-84" title="Klik for at se introduktionsvideoen" style="height: 84px; width: 135px;" height="84" width="135"></a></li>
</ul>
<h2>Patientinformation</h2>
<h3>Hvad b&oslash;r man informere patienten om</h3>
<ul>
    <li>Akutte rygsmerter er normalt ufarlige og g&aring;r over uden behandling </li>
    <li>Undg&aring; langvarigt sengeleje, passivitet </li>
    <li>Varieret fysisk aktivitet. Det at bev&aelig;ge sig er god behandling </li>
    <li>Billeddiagnostik er ikke&nbsp;n&oslash;dvendigt i den f&oslash;rste fase&nbsp;ved uspecifikke rygsmerter</li>
</ul>
<h3>Hvad findes der af skriftlig patientinformation</h3>
<ul>
    <li>
    <a href="~/link.aspx?_id=DA335A5C65D943ED8596B2B863643622&amp;_z=z">Akutte rygsmerter</a> </li>
</ul>
<h3>Animationer</h3>
<ul>
    <li>
    <a href="~/link.aspx?_id=982CBF34ED1541DABCEF40DF31E0F463&amp;_z=z">Lave rygsmerter</a> </li>
    <li>
    <a href="~/link.aspx?_id=03F15453C5C447CE9E552B7C3054D503&amp;_z=z">Ryggens anatomi</a> </li>
    <li>
    <a href="~/link.aspx?_id=570BD8062EAC49029B81A2E526BF78D1&amp;_z=z">CT-skanning</a> </li>
    <li>
    <a href="~/link.aspx?_id=3025D95BCC19450DBCE014132FDC0BBC&amp;_z=z">MR-skanning</a> </li>
    <li>
    <a href="~/link.aspx?_id=E1AAB92264F44862A148AB95BDF7F8A0&amp;_z=z">Discusprolaps</a> </li>
    <li>
    <a href="~/link.aspx?_id=1AA22C59CBAE48F185F1EE0B592651FE&amp;_z=z">Spinalstenose</a> </li>
</ul>
<h2>Kliniske vejledninger</h2>
<ul>
    <li>DSAM - vejledning i <a rel="noopener noreferrer" href="https://www.dsam.dk/vejledninger/laendesmerter" target="_blank">diagnostik og behandling af l&aelig;ndesmerter</a></li>
    <li>V&aelig;lg Klogt . Anbefaling om l&aelig;nderyg.&nbsp;<a href="https://vaelgklogt.dk/anbefalinger/laenderyg">L&aelig;nderyg | V&aelig;lg Klogt (vaelgklogt.dk)</a></li>
    <li>V&aelig;lgt Klogt. Anbefaling om opioider.&nbsp; &nbsp;<a href="https://vaelgklogt.dk/anbefalinger/opioider">Opioider | V&aelig;lg Klogt (vaelgklogt.dk)</a></li>
</ul>]]></HtmlField>
      <LinkListField Name="Spot2">
        <LinkField linktype="internal">{99A85AFD-2F7A-4B5D-A1C9-C2701D5E7D30}</LinkField>
      </LinkListField>
      <TextField Name="DoctorsHandbookID">11482</TextField>
      <TextField Name="PageTitle">Rygsmerter</TextField>
      <TextField Name="NavigationTitle">Rygsmerter</TextField>
      <CheckBoxField Name="ShowInMenu">true</CheckBoxField>
      <CheckBoxField Name="ShowInContentField">true</CheckBoxField>
      <DateTimeField Name="RevisedDate">2025-03-24T13:29:00</DateTimeField>
      <LinkListField Name="Authors">
        <LinkField linktype="internal">{CE2BA99D-50C9-4893-9B3A-504CFF36BD80}</LinkField>
        <LinkField linktype="internal">{ED7CEC94-3F7A-4FB5-BBB0-A3681BCFC481}</LinkField>
      </LinkListField>
      <LinkListField Name="Organization">
        <LinkField linktype="internal">{CF77E8B9-9937-42B2-85DF-76B0F4E401F0}</LinkField>
      </LinkListField>
      <TextField Name="ICD10">M45, M46, M47, M48, M51, M54, M54.0, M54.1, M54.2, M54.3, M54.4, M54.5, M54.6, M54.8, M54.9</TextField>
      <TextField Name="ICPC2">L02, L03, L84, L86</TextField>
      <LinkListField Name="SearchAreaID">
        <LinkField linktype="internal">1</LinkField>
      </LinkListField>
      <TextField Name="Description">Rygsmerter kan inddeles i akutte og kroniske. En af de almindeligste kontaktårsager i almen praksis.</TextField>
      <LinkListField Name="LHPHEditor">
        <LinkField linktype="internal">{C70DFB71-BE40-455A-BD6B-5AFF199797D9}</LinkField>
      </LinkListField>
      <TextField Name="__Updated by">sitecore\niko</TextField>
      <TextField Name="MetaKeywords">lændesmerter, lumbalsmerter, myalgi, Rygsmerter, lumbago, lænderygsmerter</TextField>
      <LinkListField Name="InformationCategory">
        <LinkField linktype="internal">IC_12</LinkField>
      </LinkListField>
      <LinkListField Name="InformationType">
        <LinkField linktype="internal">7</LinkField>
      </LinkListField>
      <LinkListField Name="SearchTargetGroup">
        <LinkField linktype="internal">2</LinkField>
      </LinkListField>
    </Content>
    <Medias>
      <Media Id="9C5B771B780A41A19989427EB606036A-135-84" Name="hofteøvelser thumbnail med playknap" MimeType="image/jpeg" Extension="jpg" Width="135" Height="84"><![CDATA[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]]></Media>
      <Media Id="737E9F0FEE87480FBBB49E2FF87F2196-135-84" Name="laenderygoevelser-arabisk-play" MimeType="image/jpeg" Extension="jpg" Width="135" Height="84"><![CDATA[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]]></Media>
    </Medias>
  </Item>
</Provider>

88.507 characters