Baastrup's disease

Introduction / definition

Baastrup's disease (Baastrup syndrome, Baastrup sign) is described after Christian Ingerslev Baastrup Pain syndrome in the field of Lumbar spine.

This becomes through touching Spinous processes (Spinous process) and the irritation of the surrounding ligaments and Muscles evoked. In the English-speaking world, Baastrup's disease is also known askissing spine disease" called.

root cause

In the case of the highly educated Thorns and too much convex bending of the Lumbar spine (Hyperlordosis) the spinous processes may come into contact.

This also explains why very hard-working men are piled up by one Baastrup-syndrome are affected. A long-term shoveling activity, for example in road construction, seems to be particularly predisposing.
In combination with degenerative changes in the Spine with height reductions of the movement segments, especially the one to the front (ventral) lying Spinal column, Baastrup's disease can develop.

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clinic

Of the Baastrup's disease is one of the causes of the chronic Lumbar syndrome. The spinous processes are particularly strong

• pressure and
• sensitive to knocking.

The stretching (Extension) of the Spine leads to a further strengthening of the Lordosis and is therefore particularly painful.

Diagnosis

The touching spinous processes are called "kissing spine“And are on the X-ray image good to see from the side. Often seen are also:

• bony neoplasms (Osteophytes),
• Calcifications and
• connective tissue indurations (sclerosis) in the attachment area of ​​the muscles running along the spine (paravertebral muscles).

In addition, the increased convex curvature of the lumbar spine (hyperlordosis) and the degenerative changes in the spine can be visible in the X-ray image.

On the physical examination, there is a sensitivity to pressure and knocking over the lumbar spine, as well as an increased one Hollow back formation on. For further diagnosis, a Local anesthetic injected into the affected area. If there is then no pain, this is another indication for the diagnosis. Other imaging procedures such as Computed Tomography (CT) or Magnetic resonance imaging (MRI) are usually not necessary.

Therapy for Baastrup's disease

The therapy of Baastrup's disease is primarily carried out conservative. The physiotherapeutic Treatment is mainly aimed at the curvature improve the spine and thus prevent contact with the spinous processes.
The therapy of Baastrup's disease serves above all

• Reduction of the Hollow back through muscle strengthening exercises and the
• Pain reduction through muscle-relaxing measures.

In addition, through Heat application and Electrotherapy, a symptomatic improvement of the symptoms of Baastrup's disease can be achieved and is therefore very pleasant for many patients. In the case of very acute complaints, a

• Local anesthetic in combination with a
• Corticosteroid between the vertebral bodies (interspinal) can be injected.

These numb the pain and also have an anti-inflammatory effect. Baastrup's disease is surgically treated only in exceptional cases, such as massive pain that is refractory to therapy. The spinous processes are reduced in size in a wedge shape, whereby the contact between the spinous processes is initially removed. Nevertheless, this is not a causal therapy, since the degenerative changes in the spine in particular cannot be surgically corrected. In most cases, this leaves residual symptoms.

Sport - which one is good?

Baastrup's disease is also known as "Kissing spines" designated. This refers to the excessive approach of the spinous processes (Processi Spinosi) the vertebral body. The result is hyperlordosis of the spine. Stretching exercises are therefore very important to protect the ligaments of the spine from being excessively shortened.

Particular emphasis should be placed on stretching the hip flexors and back extensors. Every patient should find a sport that does not cause them additional pain. Because exercise itself is an important positive factor for a successful therapy. Many sufferers report that swimming training and physical therapy have a relieving effect on symptoms, whereas long periods of standing or jogging cause pain.

Basically, it should be ensured that the postural muscles are trained. In addition to the back muscles, the abdominal muscles and the glutes are particularly important for stability that works against a hollow back. Yoga and Pilates are sports that specifically train these muscles.

Exercises

Some exercises to counteract the sequelae of Baastrup's disease are easy to do in everyday life. However, it is always advisable to consult a physiotherapist to make sure that you are doing the exercises correctly and that all muscle groups are trained in a balanced manner. For example, you stand with your back against a wall and press your lower back against the wall for 15 seconds, alternating with 10-second pauses.

In addition, the plank exercise in the prone, supine or side position is a good workout. Also, stretching your hip flexors while standing with your leg bent and gripping your buttocks around your foot is a good exercise.

physical therapy

Physiotherapy is one of the main factors in the therapy of Baastrup's disease. Not only does targeted strength training prevent worse sequelae, manual therapy can also provide relief in painful areas. Muscle tissue can also be loosened up manually therapeutically and counteract any further immobility.

In the case of illnesses that affect posture, there is a fine line between maximum benefit from correctly performed exercises and damage caused by improper stress caused by incorrectly performed training. This is why good physiotherapeutic care cannot be dispensed with in any case with Baastrup's disease.

Summary

Baastrup's disease is a Pain syndrome of the Lumbar spinecaused by the combination

• physically heavily stressful activities,
• greater Spinous processes,
• a strong one Hollow back and one
• degenerative height reduction of the Vertebral bodies.

These causes can lead to the touch of the spinous processes and the associated pain, especially when the spine is stretched. In addition, the affected area is sensitive to pressure and knocking.

The diagnosis can be based on the

• Symptoms of complaint,
• of the clinical examination and one
• X-ray be asked.

Since Baastrup's disease is also caused by degenerative changes, an operation cannot achieve a cure. For this reason, conservative therapy with physiotherapeutic improvement of the curvature of the spine and symptom-oriented physiotherapy is in the foreground.