{"id":4805,"date":"2025-05-15T17:51:25","date_gmt":"2025-05-15T15:51:25","guid":{"rendered":"https:\/\/kineaphp.fr\/?p=4805"},"modified":"2026-01-01T23:17:11","modified_gmt":"2026-01-01T22:17:11","slug":"les-lombalgies","status":"publish","type":"post","link":"https:\/\/kineaphp.fr\/?p=4805","title":{"rendered":"Les lombalgies"},"content":{"rendered":"\n<h2 class=\"wp-block-heading\">Les cat\u00e9gories de lombalgie<\/h2>\n\n\n\n<h3 class=\"wp-block-heading\">Cat\u00e9gorie patho-anatomique<\/h3>\n\n\n\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>Primaire<\/td><td>Secondaire<\/td><\/tr><tr><td>Facettaire : clinical diagnostic tool<br>Discog\u00e9nique<br>Myofascial<br>Radiculalgie<br>Radiculopathie<br>St\u00e9nose spinale<br>MODIC : comportement inflammatoire de plusieurs mois sans autres pathologies visible \u00e0 l&rsquo;imagerie<br>Sacro-iliaque<br>Spondylolisth\u00e9sis<\/td><td>Arthropathie de hanche (douleur r\u00e9f\u00e9r\u00e9es)<br>Ost\u00e9oporose<br>Infection (hanche, projet\u00e9, discale)<br>N\u00e9oplasique (cancer)<br>Syst\u00e9mique : spondyloarthrite, rhumatisme psoriasique, polyarthrite rhumato\u00efde, lupus, vascularite,<br>Cardio-vasculaire<br>Endom\u00e9triose<br>N\u00e9phrologique<br>My\u00e9lopathie<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<p><\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Cat\u00e9gorie idiopathique<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Sans cause ou non secondaire \u00e0 une pathologie particuli\u00e8re<\/li>\n\n\n\n<li>A risque de chronicit\u00e9<\/li>\n\n\n\n<li>Avec douleur r\u00e9f\u00e9r\u00e9e somatique : pas de trajet sp\u00e9cifique<\/li>\n<\/ul>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h2 class=\"wp-block-heading\">Recommandation th\u00e9rapeutique<\/h2>\n\n\n\n<h3 class=\"wp-block-heading\">Les drapeaux<\/h3>\n\n\n\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"847\" height=\"554\" src=\"https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/05\/image-9.avif\" alt=\"\" class=\"wp-image-4808\" srcset=\"https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/05\/image-9.avif 847w, https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/05\/image-9-300x196.avif 300w, https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/05\/image-9-768x502.avif 768w\" sizes=\"auto, (max-width: 847px) 100vw, 847px\" \/><\/figure>\n\n\n\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"822\" height=\"400\" src=\"https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/05\/image-10.avif\" alt=\"\" class=\"wp-image-4809\" srcset=\"https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/05\/image-10.avif 822w, https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/05\/image-10-300x146.avif 300w, https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/05\/image-10-768x374.avif 768w\" sizes=\"auto, (max-width: 822px) 100vw, 822px\" \/><\/figure>\n\n\n\n<h3 class=\"wp-block-heading\">PEC non m\u00e9dicamenteuse<\/h3>\n\n\n\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"866\" height=\"569\" src=\"https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/05\/image-11.avif\" alt=\"\" class=\"wp-image-4810\" srcset=\"https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/05\/image-11.avif 866w, https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/05\/image-11-300x197.avif 300w, https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/05\/image-11-768x505.avif 768w\" sizes=\"auto, (max-width: 866px) 100vw, 866px\" \/><\/figure>\n\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-9d6595d7 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<p>Non recommand\u00e9<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Semelles<\/li>\n\n\n\n<li>Ultrasons<\/li>\n\n\n\n<li>Traction lombaire<\/li>\n<\/ul>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<p>Pas de donn\u00e9es pour savoir si on recommande ou pas<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Dry needling<\/li>\n\n\n\n<li>M\u00e9ditation<\/li>\n\n\n\n<li>Acupuncture<\/li>\n\n\n\n<li>Hypnose<\/li>\n\n\n\n<li>Corset<\/li>\n<\/ul>\n<\/div>\n<\/div>\n\n\n\n<h3 class=\"wp-block-heading\">PEC m\u00e9dicamenteuse<\/h3>\n\n\n\n<p>Court terme en rouge \/ long terme en vert<br>-Antid\u00e9presseur (prescrit par MK) particuli\u00e8rement int\u00e9ressant pour des douleurs neuros (pas d&rsquo;accoutumance)<\/p>\n\n\n\n<p>Opio\u00efde : accoutumance<\/p>\n\n\n\n<p>Non recommand\u00e9s : myo-relaxant, antibiotique, vitamine D, patch lidoca\u00efne et anti-TNF alpha<\/p>\n\n\n\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"866\" height=\"492\" src=\"https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/05\/image-12.avif\" alt=\"\" class=\"wp-image-4811\" srcset=\"https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/05\/image-12.avif 866w, https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/05\/image-12-300x170.avif 300w, https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/05\/image-12-768x436.avif 768w\" sizes=\"auto, (max-width: 866px) 100vw, 866px\" \/><\/figure>\n\n\n\n<h3 class=\"wp-block-heading\">L&rsquo;infiltration<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Non recommand\u00e9 en l&rsquo;absence de signes \u00e9vocateurs d&rsquo;une radiculalgie<\/li>\n\n\n\n<li>Indiqu\u00e9e si radiculalgie persistante s\u00e9v\u00e8re et r\u00e9sistante aux traitements<\/li>\n\n\n\n<li>Si chirurgie du rachis, l&rsquo;infiltration doit \u00eatre \u00e0 distance de l&rsquo;\u00e9tage op\u00e9r\u00e9<\/li>\n\n\n\n<li>Voie foraminale contre-indiqu\u00e9e<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\">Traitement des lombalgie<\/h3>\n\n\n\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>Lombalgie aigu\u00eb<\/td><td>Lombalgie chronique<\/td><\/tr><tr><td>Consensus global :<br>Rester actif<br>Exercice thr\u00e9peutique<br>AINS<br>Opio\u00efde<\/td><td>Approche multidisciplinaire<br>Rester actif<br>Exercice th\u00e9rapeutique<br>AINS<br><a>CBT<\/a> (Cognitive Behavioral Therapy)<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<h3 class=\"wp-block-heading\">Auto-gestion du patient<\/h3>\n\n\n\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"657\" height=\"438\" src=\"https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/05\/image-13.avif\" alt=\"\" class=\"wp-image-4815\" srcset=\"https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/05\/image-13.avif 657w, https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/05\/image-13-300x200.avif 300w\" sizes=\"auto, (max-width: 657px) 100vw, 657px\" \/><\/figure>\n\n\n\n<h3 class=\"wp-block-heading\">Approche personne centr\u00e9e<\/h3>\n\n\n\n<p>PDDM : indication pour adapter la PEC<\/p>\n\n\n\n<p>Voir le <a href=\"https:\/\/pddmmodelfr.wordpress.com\/\">site <\/a><\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Transition vers APA<\/h3>\n\n\n\n<p>Pr\u00e9vention : hygi\u00e8ne de vie (effets b\u00e9n\u00e9fiques \u00e0 long terme)<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>R\u00e9gularit\u00e9 : pas d&rsquo;interruption > 3 semaines<\/li>\n\n\n\n<li>R\u00e9currence : 4 \u00e0 6 fois\/semaine<\/li>\n\n\n\n<li>R\u00e9chauffement : 30mn de l\u00e9g\u00e8re transpiration ou acc\u00e9l\u00e9ration FC<\/li>\n\n\n\n<li>R\u00e9compense : format plaisir<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Les cat\u00e9gories de lombalgie Cat\u00e9gorie patho-anatomique Primaire Secondaire Facettaire : clinical diagnostic toolDiscog\u00e9niqueMyofascialRadiculalgieRadiculopathieSt\u00e9nose spinaleMODIC : comportement inflammatoire de plusieurs mois sans autres pathologies visible \u00e0 l&rsquo;imagerieSacro-iliaqueSpondylolisth\u00e9sis Arthropathie de hanche (douleur r\u00e9f\u00e9r\u00e9es)Ost\u00e9oporoseInfection (hanche, projet\u00e9, discale)N\u00e9oplasique (cancer)Syst\u00e9mique&hellip;<\/p>\n<p class=\"more-link-wrapper\"><a href=\"https:\/\/kineaphp.fr\/?p=4805\" class=\"more-link\">Continue Reading<span class=\"screen-reader-text\"> \u00ab\u00a0Les lombalgies\u00a0\u00bb<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[464],"tags":[],"class_list":["post-4805","post","type-post","status-publish","format-standard","hentry","category-pathologies-des-lombaires"],"_links":{"self":[{"href":"https:\/\/kineaphp.fr\/index.php?rest_route=\/wp\/v2\/posts\/4805","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kineaphp.fr\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kineaphp.fr\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kineaphp.fr\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kineaphp.fr\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=4805"}],"version-history":[{"count":8,"href":"https:\/\/kineaphp.fr\/index.php?rest_route=\/wp\/v2\/posts\/4805\/revisions"}],"predecessor-version":[{"id":4823,"href":"https:\/\/kineaphp.fr\/index.php?rest_route=\/wp\/v2\/posts\/4805\/revisions\/4823"}],"wp:attachment":[{"href":"https:\/\/kineaphp.fr\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=4805"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kineaphp.fr\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=4805"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kineaphp.fr\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=4805"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}