Low back pain - from definition to diagnosis

Križobolja predstavlja bol ili nelagodnost koju bolesnik osjeća u području leđa, između rebranih lukova i donje glutealne brazde. Jedan je od najčešćih uzroka traženja liječničke pomoći, drugi je po redu uzrok izostajanja s posla, te je zbog velikih direktnih i indirektnih troškova vrlo važan socijalno-medicinski i ekonomski teret za pojedinca, obitelj i društvo. Klasificira se kao nespecifična, bez poznatog uzroka i kao specifična križobolja, za koju je poznat patomorfološki uzročni čimbenik. U postavljanju dijagnoze važna je iscrpna anamneza i klinički pregled. Proširena dijagnostička obrada potrebna je u slučajevima evidentiranja radikulopatije ili specifične ozbiljne patologije, odnosno nakon evidentiranja rizičnih faktora i simptomatologije crvenih zastava. Također, posebnu pozornost treba obratiti na psihosocijalne čimbenike ili tzv žute zastave, kao na najznačajnije prediktore kroniciteta križobolje te prediktore dugotrajne bolesnikove onesposobljenosti.Low back pain is defined as pain and discomfort, localised below the costal margin and above the inferior gluteal folds, with or without leg pain. It is one of the most commonest cause of seeking physician office visits, secound cause of sick leave, and because of high direct and indirect costs it has great medical, social and economic impact for individual, family and society. Non-specific low back pain is defined as low back pain not attributed to recognisable, known specific pathology and specific low back pain which has known pathomorfological cause. For most patients with low back pain a thorough history taking and clinical examination are suffitient. Extended diagnostic analysis are needed in the case of nerve root pain/radicular pain and serious spinal pathology, respectively after identification of red flags. Moreover, great attention has to be achieved at psychosocial factors or so called yellow flags which increase the risk of developing chronic low back pain and long term disability (including work loss associated with low back pain)