Der Internist

, Volume 58, Issue 1, pp 39–46 | Cite as

Muskuloskeletal bedingter Thoraxschmerz

Schwerpunkt: Thoraxschmerz

Zusammenfassung

Hintergrund

Etwa 10–50 % der Thoraxschmerzen sind Folge muskuloskeletaler Erkrankungen. In der Primärversorgung besteht dieser Zusammenhang doppelt so häufig wie in der Notaufnahme.

Ziel der Arbeit

Der Beitrag soll eine Übersicht der wichtigsten muskuloskeletalen Ursachen von Thoraxschmerzen bieten. Dabei wird auch auf die Diagnostik und Therapie eingegangen.

Methoden

Dem Beitrag liegen eine selektive Literaturrecherche und -aufarbeitung zum Thema der muskuloskeletalen Thoraxschmerzen zugrunde.

Ergebnisse und Diskussion

Nichtentzündliche Erkrankungen wie Kostochondritis und Fibromyalgie sind häufige Ursachen von Thoraxschmerzen. Entzündliche Erkrankungen wie Spondyloarthritis und rheumatoide Arthritis oder systemischer Lupus erythematodes sind deutlich seltener, aber schwerwiegender und sollten daher erkannt und behandelt werden. Oft erfordern die Diagnostik und Therapie einen interdisziplinären Ansatz. Thoraxschmerzen im Rahmen von muskuloskeletalen Erkrankungen stellen immer Ausschlussdiagnosen von anderen schweren Erkrankungen an Herz, Lunge und Magen dar. Vor allem bei funktionellen myofaszialen Störungen kommt physiotherapeutischen und physikalischen Therapiemaßnahmen eine besondere Bedeutung zu, unter anderem der manuellen Therapie, der transkutanen elektrischen Nervenstimulation und dem stabilisierenden Training.

Schlüsselwörter

Kostochondritis Fibromyalgie Rheumatoide Arthritis Spondyloarthritis Systemischer Lupus erythematodes 

Musculoskeletal-related chest pain

Abstract

Background

Approximately 10–50% of chest pains are caused by musculoskeletal disorders. The association is twice as frequent in primary care as in emergency admissions.

Aim

This article provides an overview of the most important musculoskeletal causes of chest pain and on the diagnostics and therapy.

Methods

A selective search and analysis of the literature related to the topic of musculoskeletal causes of chest pain were carried out.

Results and conclusion

Non-inflammatory diseases, such as costochondritis and fibromyalgia are frequent causes of chest pain. Inflammatory diseases, such as rheumatoid arthritis, spondyloarthritis and systemic lupus erythematosus are much less common but are more severe conditions and therefore have to be diagnosed and treated. The diagnostics and treatment often necessitate interdisciplinary approaches. Chest pain caused by musculoskeletal diseases always represents a diagnosis by exclusion of other severe diseases of the heart, lungs and stomach. Physiotherapeutic and physical treatment measures are particularly important, including manual therapy, transcutaneous electrical stimulation and stabilization exercises, especially for functional myofascial disorders.

Keywords

Costal chondritis Fibromyalgia Arthritis, rheumatoid Spondyloarthritis Lupus erythematosus, systemic 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

C. Sturm und T. Witte geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Copyright information

© Springer Medizin Verlag Berlin 2016

Authors and Affiliations

  1. 1.Klinik für RehabilitationsmedizinMedizinische Hochschule HannoverHannoverDeutschland
  2. 2.Klinik für Immunologie und RheumatologieMedizinische Hochschule HannoverHannoverDeutschland

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