Показники еластичності клубово-поперекового м`язу у пацієнтів з болем в нижній частині спини в залежності від наявності синдрому доброякісної гіпермобільності суглобів

Abstract

Pain in the lower back is a highly urgent problem that leads to a decrease in the quality of life of a large number of patients in the modern world. At the same time, the causes of pain in the lower back are different and their combination has not been sufficiently studied to date. It is known that the presence of benign joint hypermobility syndrome in a patient significantly worsens the course and manifestations of pain in the lower back. One of the components of pain in the lower back is changes in the iliopsoas muscle. This is psoas syndrome. At the same time, the diagnosis of psoas syndrome in practical medicine is complicated by the lack of specific laboratory tests and imaging techniques. The purpose of this work was to study the possibilities of determining the tension of the iliopsoas muscle using shear wave elastometry in patients with pain syndrome in the lower back and the difference between their tensions depending on the presence of benign hypermobility syndrome in patients. Material and methods. We examined 83 patients with lower back pain aged 42.31±1.54 years, 41 were female and 42 were male. To participate in the study, all patients underwent X-ray and ultrasound examination of the hip joints. Patients were excluded from the study in the presence of signs of osteoarthritis. To determine the presence of signs of hypermobility of the joints, we used the criteria of Baiton; the diagnosis was made on condition of obtaining more than 5 points. Among the patients examined by the Bayton criteria, 18 patients were diagnosed with benign joint hypermobility syndrome, among them 13 women and 5 men. As a control group, we selected 15 patients aged 45.6±1.74 years without complaints of pain in the lumbar region of the back and hips and without signs of benign joint hypermobility syndrome. We used shear wave elastometry to determine the stiffness of the distal parts of the lumbosacral muscle. A visual analog scale of pain (from 1 to 10) was used to determine the severity of the pain syndrome. Conclusion. We found that all patients with complaints of pain in the lower back had a significantly higher tension of the iliopsoas muscle in comparison with the group of conditionally healthy patients. The increase in tension had a strong correlation with the severity of pain syndrome according to the data of the visual analogue scale. Indicators of muscle tissue rigidity did not depend on the presence and severity of benign joint hypermobility syndrome