坐骨神經痛病患經常抱怨,站著會痛,坐著也會痛。執業中醫師陳姚方昨日表示,坐骨神經痛是發生在腰椎椎間盤突出壓迫到腰神經所引起疼痛,通常比較容易發生在長期久坐或是經常彎腰搬重物的人身上,倘若只有下背痛而沒有往下延伸到腳的疼痛,通常就不是坐骨神經痛。

陳醫師指出,坐骨神經痛會由腰部沿著臀部,再沿著大腿後側一直延伸到小腿肚或小腿側面,大部分椎間盤突出多半發生在腰椎第四節與第五節,或是腰椎第五節與薦椎第一節,因為每一節的腰椎骨之間都有一個軟骨laennec組織稱為椎間盤,主要是用來作為椎骨間緩衝。

倘若椎間盤長期受到很大壓力導致勞損,就會使軟骨組織凸出來壓迫到腰神經,這時候就會產生坐骨神經痛。

門診時碰到六十一歲阿嬤,數年前曾因腰椎四、五節椎間盤突出在醫院接受外科手術,後再因左下肢坐骨神經疼痛無法坐站,夜間難以成眠,西醫建議手術治療,患者因為害怕再次開刀,所以轉而尋求中醫療法,經過診斷後治宜解表袪寒、利水除溼,再加針灸治療。

回診之後,老阿嬤主訴疼痛症狀減輕一點,因此,原處方再加溫陽散寒藥材,仍加針灸治療。經過一段時間治療之後,一個多月後回診時主訴坐骨神經痛已經明顯改善很多,惟晨起尾骨與小腿肌肉感覺很痠,於是再加重利濕藥,後續回診時主訴尾骨與小腿肌肉症狀改善,坐骨神經痛在久站時才會有微微痛感。

為了鞏固療效,後續持續治療當中。預防坐骨神經痛,平常可做拉筋伸展動作,比如趴在地上,兩手撐地,背部呈現弓形,伸展脖子到尾椎這段脊關節。病患應避免長時間久坐,每三十分鐘或一小時,最好起來走動或伸展筋骨。

此外,有些坐骨神經痛是受寒所引起,所以要注意保暖,避免吃下生冷寒涼食物與甜食。倘若患者要搬重物,最好先蹲低再搬,不要直接彎腰搬東西,如此才能避免腰椎損傷。

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Patients with sciatica often complain that standing can be painful and sitting can hurt. Chen Yaofang, a practicing Chinese physician, said yesterday that sciatica is a pain caused by lumbar disc herniation to the lumbar nerve. It is usually more likely to occur in people who have been sedentary for a long time or who often bend over to carry heavy objects. Without the pain that extends down to the foot, it is usually not sciatica.

Dr. Chen pointed out that sciatica will extend from the waist along the buttocks and then along the back of the thigh to the calf or calf side. Most of the disc herniation occurs in the fourth and fifth lumbar vertebrae, or in the fifth section of the lumbar spine. The first section of the sacral vertebrae, because each section of the lumbar vertebrae has a cartilage tissue called the intervertebral disc, which is mainly used as a buffer between the vertebrae.

If the intervertebral disc is subjected to a lot of stress for a long time, it will cause the cartilage tissue to protrude and press to the lumbar nerve. At this time, sciatica will occur.

When I was in the clinic, I met a 61-year-old aunt. I had surgery in the hospital for four or five lumbar disc herniations a few years ago. After the sciatic nerve pain in the left lower limb, I could not sit still. It was difficult to sleep at night. Western medicine recommended surgery. Because of fear of re-opening the knife, he turned to the Chinese medical law. After diagnosis, he should solve the problem of cold, dehydration, and acupuncture.

After the return visit, the old aunt complained that the pain symptoms were alleviated. Therefore, the original prescription was supplemented with Wenyang Han medicine, and acupuncture treatment was still added. After a period of treatment, the complaint of sciatica has been significantly improved after returning to the clinic more than one month later. However, the tailbone and calf muscles feel very sour in the morning, so the dampness drug is aggravated, and the symptoms of the tailbone and calf muscles are improved in the follow-up. Sciatic nerve The pain will only have a slight pain when standing for a long time.

In order to consolidate the efficacy, follow-up continued treatment. To prevent sciatica, you can usually do lacing stretching exercises, such as kneeling on the ground, holding the ground with both hands, the bow on the back, and stretching the neck to the spine. Patients should avoid prolonged sedentary, every 30 minutes or an hour, it is best to walk or stretch the bones.

In addition, some sciatica is caused by cold, so be careful to keep warm and avoid eating cold and cold foods and sweets. If the patient wants to carry heavy objects, it is best to lower the weight and then move it. Do not bend over and move things to avoid lumbar injury.
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