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<Provider Id="sundheddkcms"> <Item Id="{9D7DC8C6-3D6A-4161-A0D6-96FAC7A354F6}" Name="laendesmerter" Type="PHContentPage" ParentProviderId="sundheddkcms" ParentItemId="{8CEE1F07-880E-47A3-B9AF-0B26136E8B2C}" SortOrder="800" PublishDate="2010-05-25T13:18:00" DeleteDate="2999-12-31T00:00:00" PotItemType=""> <Content> <LinkListField Name="Spot2"> <LinkField linktype="internal">{A12FFEB9-7D21-4130-9428-1457C5AB696B}</LinkField> </LinkListField> <HtmlField Name="FactContent"><![CDATA[<h2>Fakta</h2> <ul> <li>Smerter i lænden (nederste del af ryggen) er en folkesygdom</li> <li>Smerterne kan være kortvarige eller vare ved over længere tid. De fleste tilfælde er ikke alvorlige, og prognosen er god </li> <li>Nerver kan blive klemt af og give smerter ned i det ene ben</li> <li>Hvis du har smerter i lænden i længere tid, bør du kontakte læge</li> <li>Hvis du har føleforstyrrelse ned i benet eller besvær med at styre benet, bør du ses af læge inden for kort tid</li> <li>Hvis du får problemer med vandladning eller afføring, samtidig med smerter i ryg eller ben, skal du ses af en læge med det samme</li> </ul>]]></HtmlField> <HtmlField Name="PageContent"><![CDATA[<h2>Hvad er lændesmerter?</h2> <ul> <li>Lændesmerter er smerter i nedre del af ryggen, lokaliseret i lænd og/eller balder</li> <li>Smerterne kan inddeles i nyopståede og kroniske smerter <ul> <li>Nyopståede smerter er smerter af op til 12 ugers varighed, uanset om man tidligere har haft lændesmerter eller ej</li> <li>Længerevarende kroniske smerter varer mere end 12 uger</li> </ul> </li> <li>I tillæg til smerter i lænd og/eller baller kan der være smerter ned i ben</li> </ul> <h3>Forekomst</h3> <ul> <li>Lændesmerter er en af de hyppigste årsager til at søge kontakt med praktiserende læge </li> <li>Man anslår, at 60-80 % af befolkningen i løbet af livet vil opleve en episode med smerter i lænden. Op til halvdelen af alle voksne har haft en episode med smerter i lænden inden for det sidste år</li> <li>Det er især personer mellem 35 og 55 år, som søger læge på grund af smerter i lænden. Kvinder og mænd er lige udsatte</li> <li>Under graviditet får 1 ud af 5 kvinder smerter i lænden</li> <li>Lændesmerter er den største enkelte diagnose for forsikringsudbetalinger og står for næsten 15 % af langtidssygemeldingerne og mere end 10 % af alle førtidspensioner</li> </ul> <h3>Årsager og vigtige symptomer</h3> <ul> <li>En grov inddeling af årsager til akutte rygsmerter: <ul> <li>Uspecifikke lændesmerter (80-90 %), det vil sige, at det ikke er muligt at pege på en bestemt årsag til smerterne i lænden, uanset hvilke undersøgelser der laves</li> <li>Nerverodspåvirkning (5-10 %), også kaldet lumbal radikulopati <ul> <li>Tegn på nerverodspåvirkning er bensmerter i et radikulært (svarende til nerver) mønster, kraftnedsættelse, manglende reflekser samt ændring af følesans </li> </ul> </li> <li>Andre og mulige alvorlige årsager (færre end 1 %) så som kræft eller betændelse</li> </ul> </li> <li>Vent med udredning <ul> <li>De allerfleste bliver raske af sig selv i løbet af de første uger. Det er som regel ikke nødvendigt med en omfattende udredning inden for de første 12 uger</li> <li>Også de fleste personer med nerverodspåvirkning bliver raske af sig selv</li> </ul> </li> <li>Symptomer og tegn som der lægges stor vægt på er: <ul> <li>Smerter i hvile, konstante smerter, smerter som tiltager</li> <li>Personen føler sig syg, feber</li> <li>Vægttab </li> <li>Skade</li> <li>Kendt kræftsygdom </li> <li>Brug af steroider (binyrebarkhormon), immunhæmmende midler, alkohol- og stofmisbrug </li> <li>Stor kraftnedsættelse i bestemte muskelgrupper og/eller bortfald af følesans, eventuelt større skævheder i rygsøjlen </li> <li>Udtalt morgenstivhed i mere end 1 time, <a href="~/link.aspx?_id=DD6806AD9EB344BEB20E33F47EE7CAEA&_z=z">høj blodsænkning (SR)</a> </li> <li>Alder under 20 eller over 55 år</li> <li>Manglende evne til at lade vandet eller manglende evne til at holde på afføring</li> <li>Ved disse symptomer samtidigt med lænderygsmerter bør man søge læge hurtigt</li> </ul> </li> </ul> <h2>Hvad kan årsagen være?</h2> <h3>Hyppige årsager</h3> <ul> <li> <a href="~/link.aspx?_id=DA335A5C65D943ED8596B2B863643622&_z=z">Akutte lave rygsmerter</a> <ul> <li>Kan skyldes vrid i kroppen, overbelastning, direkte skade, fald, slidforandringer i rygsøjlen, men ofte finder man ikke en årsag</li> <li> Er hyppigst i alderen 20-55 år og udgør 80-90 % af alle personer med akutte rygsmerter </li> <li>Symptomerne opstår akut, ofte hos en person som har haft lignende gener før. Smerterne stråler sommetider ned i ballerne eller diffust til låret </li> <li>Smerten varierer, den er ofte mindre i hvile</li> </ul> </li> <li> <a href="~/link.aspx?_id=3CA71D03D86146D89408DA9D0EB55F6D&_z=z">Kroniske lave rygsmerter (kronisk lumbago)</a> <ul> <li>Hyppig tilstand med stadigt tilbagevendende eller kroniske lave rygsmerter, ofte uden kendt årsag</li> </ul> </li> <li> <a href="~/link.aspx?_id=51E70D5841314AA2ABA61684D3068DD2&_z=z">Diskusprolaps</a> <ul> <li>Skyldes skade på diskus og prolaps af diskus, som medfører tryk på en nerverod </li> <li>Tilstanden opstår ofte akut og giver udstrålende smerter og følelsesløshed/prikken ned i benet til nedenfor knæet</li> <li>Rygsmerter vil ofte være tilstede, men smerter i underbenene er som regel værre</li> <li>Ofte smerter i hvile, smerterne forværres, når man hoster og nyser</li> </ul> </li> <li> <a href="~/link.aspx?_id=1295BF6127CD4BCEAE1EF3FAD8147747&_z=z">Sammenfald af ryghvirvel ved knogleskørhed (kompressionsbrud)</a> <ul> <li>Opstår som regel hos personer med udtalt knogleskørhed (osteoporose), som regel ældre kvinder</li> <li>Under halvdelen kan berette om, af en skade udløste sammenfaldet</li> <li>Tilstanden giver akutte, vedvarende rygsmerter og smerter ved bevægelse</li> </ul> </li> <li> <a href="~/link.aspx?_id=7CCD0D254CFD42BDB2668E6D6AE2ECA7&_z=z">Bechterews sygdom </a> <ul> <li>En kronisk betændelsessygdom hovedsagelig i rygskelettet, men også i led og andre organer</li> <li>Mænd har hyppigere Bechterew end kvinder, og det opstår tidligere hos mænd end kvinder</li> <li>Rammer ca. 1-2 promille af den voksne befolkning </li> <li>Tilstanden er karakteriseret ved gradvis forværring af smerter og stivhed i lænderyggen, smerter som ofte sidder i hele rygsøjlen og bækkenet. Natlige smerter og morgenstivhed dominerer. Symptomerne bedres ofte hen ad dagen og ved fysisk aktivitet</li> </ul> </li> <li> <a href="~/link.aspx?_id=14379BD6A86F4257B6D59438779F705C&_z=z">Scheuermanns sygdom</a> <ul> <li>En tilstand som normalt opstår mod slutningen af puberteten. Er en vækstforstyrrelse i ryghvirvlerne som bevirker, at ryggen bliver lidt mere krum end normalt</li> <li>De fleste personer med moderate forandringer i brystdelen af ryggen har ingen smerter, mens en større andel med forandringer på de nedre ryghvirvler kan have smerter</li> </ul> </li> <li> <a href="~/link.aspx?_id=B44E92BA6EA6475F98D3C402D1909810&_z=z">Skæv ryg (skoliose)</a> <ul> <li>Sideskævhed i ryggen som for det meste opstår i puberteten og oftere blandt piger</li> <li>Forekommer hos 3 %, men kun 1 af 10 har behov for behandling </li> <li>Normalt har personer med skoliose ikke flere smerter i ryggen end andre. Måske kan de lettere udvikle såkaldt degenerative forandringer i ryggen</li> </ul> </li> <li> <a href="~/link.aspx?_id=C3D5DC38BA574F4D905212D9D6F12B40&_z=z">Rygslidgigt (spondylose)</a> <ul> <li>Slidforandringer i rygsøjlen, i hovedsagen i leddene mellem ryghvirvlerne og ved disci</li> <li>Findes hos de allerfleste over 40 år, men kun et fåtal har symptomer </li> <li>Kan betragtes som ryggens rynker og grå hår. Ryggen må gerne bruges alligevel, ligesom man godt må smile, når man har rynker omkring munden </li> <li>Tilstanden er ofte ikke forbundet med særlige gener fra ryggen. Slidforandringer i nedre del af ryggen kan dog give smerter, som forværres ved fysisk belastning</li> </ul> </li> </ul> <h3>Sjældnere årsager</h3> <ul> <li> <a href="~/link.aspx?_id=935BB22D6ECB4659A6EAD778429F95B7&_z=z">Spondylolyse, spondylolistese</a> <ul> <li>Skyldes en defekt i en ryghvirvel, medfødt eller som følge af træthedsbrud (spondylolyse)</li> <li>Hos 30-80 % glider de to dele af den defekte hvirvel fra hinanden (spondylolistese) </li> <li>Tilstanden giver først og fremmest symptomer hos yngre mennesker (15-19 år) - det gælder specielt kastesportsgrene som spydkast og håndbold</li> <li>Giver smerter i lænden med udstråling til ballerne og til lår. Smerterne forværres gerne op af dagen</li> </ul> </li> <li> <a href="~/link.aspx?_id=B2209450F0714771B298E5E3620362E8&_z=z">Snæver rygmarvskanal (spinalstenose)</a> <ul> <li>Skyldes som regel slidforandringer som giver snævre forhold for rygmarven eller nerverødder</li> <li>Ses normalt hos ældre mennesker over 60 år. Det mest typiske tegn er, at man har klart nedsat gangdistance. Smerten lindres normalt, når man bøjer sig fremover </li> <li>Tilstanden kan give rygsmerter og morgenstivhed, udstrålende smerter til et eller begge ben, følelsesløshed og prikken, og besvær med at styre benene i forbindelse med aktivitet</li> </ul> </li> <li> <a href="~/link.aspx?_id=B451150965134E20938D75731B62B201&_z=z">Kræftspredning (metastaser)</a> <ul> <li>Flere kræftsygdomme kan sprede sig til rygsøjlen</li> </ul> </li> </ul> <table summary="Tabel med grøn baggrund"> <tbody> <tr> <td style="background-color: #e1f0e1;"> <h2>Hvad kan jeg selv gøre?</h2> <ul> <li>De allerfleste mennesker med nyopståede smerter i ryggen bliver raske i løbet af 6-12 uger uden behandling</li> <li>Smertestillende medicin ændrer ikke på forløbet. Hvis du tager smertestillende, skal det være kortvarig brug af paracetamol eller eventuelt, hvis du er yngre, medicin af typen <a href="~/link.aspx?_id=9598E70BEC694FC292FE9D0C1F701494&_z=z">NSAID</a></li> <li>Du bliver normalt hurtigere rask ved at være i fysisk aktivitet</li> <li>Begræns sengeleje til et minimum</li> <li>At være i arbejde er en god behandling for de fleste med ukomplicerede rygsmerter</li> <li>Hold dig i god form. Sørg især for at have stærke mave- og rygmuskler, så mindsker du sandsynligheden for, at det sker igen</li> <li>Se <a href="~/link.aspx?_id=3F37EE5C2C4C4078896641E521E6506D&_z=z">film med øvelser for lænderyg</a></li> </ul> </td> </tr> </tbody> </table> <table summary="Tabel med gul baggrund"> <tbody> <tr> <td style="background-color: #fdf3d5;"> <h2>Kontakt egen læge</h2> <ul> <li>Ved stærke smerter i ryggen</li> <li>Ved besvær med at styre benet </li> <li>Ved udstrålende smerter i det ene ben nedenfor knæet</li> <li>Ved længerevarende gener som ikke bedres med de råd som står ovenfor</li> </ul> </td> </tr> </tbody> </table> <h2>Kontakt læge med det samme</h2> <ul> <li>Ved rygsmerter og smerter i ben med samtidig manglende evne til at lade vandet eller holde på afføring</li> </ul> <ul> </ul> <h2>Hvad gør lægen?</h2> <h3>Sygehistorie</h3> <h4>Hvad kan lægen finde på at spørge om:</h4> <ul> <li>Hvor længe har der været smerter? </li> <li>Har der tidligere været rygsmerter? <ul> <li>Hvordan forløb tilstanden? </li> <li>Hvordan blev tilstanden behandlet?</li> </ul> </li> <li>Det aktuelle anfald <ul> <li>Hvordan opstod smerterne? </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>Kan du beskrive smerten? </li> <li>Smertens intensitet? <ul> <li>Behov for medicin? </li> <li>Evne til at arbejde?</li> </ul> </li> <li>Søvnbesvær, natlige smerter? </li> <li>Udstrålende smerter? <ul> <li>Hvorfra i kroppen kommer smerterne? </li> <li>Ved hoste og nysen?</li> </ul> </li> </ul> </li> <li>Tegn på nerveskade? <ul> <li>Har du mærket nedsat kraft og følesans? </li> <li>Fungerer vandladning og afføring normalt?</li> </ul> </li> <li>Almene symptomer? <ul> <li>Har du tegn på anden sygdom?</li> </ul> </li> </ul> <h3>Lægeundersøgelsen</h3> <ul> <li>Ved tilbagevendende smerter, hvor du er grundigt undersøgt tidligere, er det ofte ikke nødvendigt at foretage en ny undersøgelse</li> <li>Ved vedvarende gener eller ved en sygehistorie som giver mistanke om, at en nerve er kommet i klemme, vil lægen foretage en grundig undersøgelse: <ul> <li>Undersøge om der er påfaldende skævheder, og om du går normalt </li> <li>Vurdere bevægelighed i ryggen og området omkring hoften</li> <li>Hvis lægen har mistanke om nerverodspåvirkning, vil lægen undersøge kraft, følesans, reflekser og hvordan det påvirker smerterne, når benet hæves</li> <li>Hvis du har problemer med at lade vandet eller holde på afføringen, og der er ændret følesans i ridebukseområdet, vil lægen undersøge din evne til at bruge endetarmsmuskulaturen</li> </ul> </li> </ul> <h3>Andre undersøgelser</h3> <ul> <li>Blodprøver er sjældent nødvendige tidligt i forløbet, men ved vedvarende gener kan man overveje blodprøver </li> <li>Ved vedvarende og stærke smerter i mere end 12 uger <ul> <li>Vurderer din egen læge om der skal foretages røntgen, alternativt <a href="~/link.aspx?_id=F72FE5D587B5466CBF1385AB3167A96D&_z=z">MR-skanning</a></li> </ul> </li> <li>Ved nerverodsskade uden bedring efter 12 uger <ul> <li>Lægen vil overveje MR-skanning. Dette gælder især, hvis operation overvejes, og du ikke er undersøgt tidligere </li> <li>Hos personer som tidligere er opereret for prolaps, er MR-skanning førstevalg</li> </ul> </li> <li>Ved mistanke om anden sygdom eller knoglebrud <ul> <li>Her vil du næsten altid få taget MR-skanning. CT-skanning eller røntgen er alternativer, eventuelt <a href="~/link.aspx?_id=5E33262689E64F42B2BB1455DCBD2D49&_z=z">scintigrafi</a></li> </ul> </li> </ul> <h3>Henvisning til specialist eller hospital</h3> <ul> <li>Henvisning til tværfagligt rygcenter - fx fysioterapeut, neurokirurg, reumatolog, ortopædkirurg, neurolog <ul> <li>Ved manglende bedring efter 12 uger</li> <li>Hvis du har tegn på nerverodspåvirkning med svære og funktionshæmmende smerter, bør du vurderes af en rygkirurg inden for 12 uger</li> </ul> </li> <li>Henvisning til ortopædkirurg <ul> <li>Ved udtalte skævheder i ryggen</li> </ul> </li> <li>Henvisning til reumatolog <ul> <li>Ved mistanke om Bechterews sygdom eller anden betændelsessygdom</li> </ul> </li> </ul> <h2>Illustrationer</h2> <h3>Animationer</h3> <ul> <li> <a href="~/link.aspx?_id=03F15453C5C447CE9E552B7C3054D503&_z=z">Ryggens anatomi</a> </li> <li> <a href="~/link.aspx?_id=982CBF34ED1541DABCEF40DF31E0F463&_z=z">Lave rygsmerter</a> </li> <li> <a href="~/link.aspx?_id=D56779B5E56B4A1AB0DDA0CEB2F4419A&_z=z"> </a> <a href="~/link.aspx?_id=D56779B5E56B4A1AB0DDA0CEB2F4419A&_z=z">Slidte bruskskiver i ryggen</a> </li> <li> <a href="~/link.aspx?_id=1AA22C59CBAE48F185F1EE0B592651FE&_z=z">Spinalstenose</a> </li> <li> <a href="~/link.aspx?_id=44EFCDBD78AF46F39D15C98A7981DB6C&_z=z">Ryg, tværsnit</a></li> </ul> <p> </p> <h2>Vil du vide mere</h2> <ul> <li> <a href="~/link.aspx?_id=928F8FF0A32E4C8E8E22E4FAAAAB8878&_z=z">Rygsmerter </a>- for sundhedsfaglige </li> <li> <a href="~/link.aspx?_id=74E03C59199940A0B4E188E5C2758423&_z=z">Lændesmerter, lave rygsmerter</a> - for sundhedsfaglige</li> </ul> <h3>Træningsfilm for lænderyggen</h3> <ul> <li><a href="~/link.aspx?_id=E6907ACE746044D89F2AB5C1757CB471&_z=z">Øvelsesprogram, 3 øvelser</a><br> <br> <a href="~/link.aspx?_id=3F37EE5C2C4C4078896641E521E6506D&_z=z"><img alt="Træningsfilm for lænderyggen" 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&_z=z">Øvelsesprogram, 3 øvelser med arabisk tale - فيديوهات تمارين رياضية باللغة العربية</a><br> <br> <a href="~/link.aspx?_id=475FEDB6C4FC460DBE85104E216E5B65&_z=z"><img alt="Træningsfilm for lænderyggen på arabisk" src="737E9F0FEE87480FBBB49E2FF87F2196-135-84" title="Klik for at se introduktionsvideoen" style="height: 84px; width: 135px;" height="84" width="135"></a></li> </ul>]]></HtmlField> <TextField Name="DoctorsHandbookID">13815</TextField> <TextField Name="PageTitle">Lændesmerter</TextField> <TextField Name="NavigationTitle">Lændesmerter, lumbago</TextField> <CheckBoxField Name="ShowInMenu">true</CheckBoxField> <CheckBoxField Name="ShowInContentField">true</CheckBoxField> <DateTimeField Name="RevisedDate">2023-02-28T08:08:00</DateTimeField> <LinkListField Name="Authors"> <LinkField linktype="internal">{CE2BA99D-50C9-4893-9B3A-504CFF36BD80}</LinkField> <LinkField linktype="internal">{9240F87A-FE81-40E5-A079-F715F683A0B5}</LinkField> </LinkListField> <LinkListField Name="Organization"> <LinkField linktype="internal">{DBBC5F07-FEB9-4FAC-8DCA-1C8C28C4F5B5}</LinkField> </LinkListField> <LinkListField Name="SearchAreaID"> <LinkField linktype="internal">1</LinkField> </LinkListField> <TextField Name="Description">Smerter i lænden er en folkesygdom. 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