腰痛
楊惟婷整理
日本德島大學醫院整形外科教授西良浩一表示，約有15%的腰痛是出自於神經、骨骼問題，但另外85%的腰痛，連醫師都很難診斷出病因，他認為其中一部分恐是大腿僵硬造成腰痛。
西良浩一指出人在活動時，大腿肌肉失去彈性、伸展困難的話，相連的骨盆會被向前拉扯、變得傾斜，連帶地人也向前倒，此時身體會無意識地讓腰部後彎、保持平衡，久了造成腰背部的豎脊肌過度緊繃，恐漸漸形成腰痛。
另外，日本知名運動訓練專家清水忍也說，大腿肌太僵硬與腰痛有密不可分的關係。
想知道自己的腿僵不僵硬，可以趴在地上，試著用腳後跟碰屁股。如果碰不到，就表示腰痛恐與大腿僵硬有關，即使現在沒事，未來也可能會因此腰痛。
同時清水忍分享了伸展大腿，預防改善腰痛的方法﹕
■首先橫躺，用手抓著腳背，讓腳後跟靠著屁股。
■接著，大腿出力往身體後方慢慢地伸展，左右腿各10次為一回，一天練3回就可改善大腿僵硬。
有時，腰痛連醫師都很難診斷出病因。
有一個熱愛攝影的阿伯，30年來飽受腰痛，四處求醫，被診斷罹患輕微椎間盤突出，長年接受藥物與復健治療不見效果，連走路都疼痛不已。
後來，經菁英診所復健科尤稚凱醫師仔細檢查，測試找尋壓痛點後，在按壓到薦椎結節韌帶時，患者的症狀完全顯現，包括下背痛、傳導痛、坐著起身的瞬間劇痛、走路痛到跛行、大腿前側酸痛…等。尤稚凱醫師仔細檢查，發現問題與坐骨神經痛無關，原來只是一條韌帶作祟，經精準治療後，解除30年疼痛。
尤稚凱醫師表示，真假坐骨神經痛要仔細明辨。
他說，坐骨神經痛症狀，包括腰痛、屁股後方的不舒服，甚至到大腿、小腿及腳的下方會麻、痛等，一般人認知大部份是來自於﹕
■腰椎如有椎間盤突出，
■屁股後方的關節有退化性關節炎，去壓迫到坐骨神經的神經叢；
■是梨狀肌症候群﹕
其肌肉腫脹時會刺激它下方的坐骨神經導致疼痛，
■假性的坐骨神經痛﹕
如上臀神經炎、薦髂關節炎、薦髂韌帶撕裂傷及本案的薦椎結節韌帶撕裂傷等，這些就是所謂的假性坐骨神經痛，必須加以鑑別診斷才能確診。
他強調，這位阿伯照過核磁共振顯示輕微椎間盤突出，加上症狀合併有左側腰痛與傳導痛，容易被診斷為坐骨神經痛，但經他透過理學檢查排除坐骨神經痛，為了確診，他更給予診斷性麻醉，即借助超音波導引將麻藥施打在該處韌帶，結果所有症狀消失，行走無礙，終於揪出罪魁禍首為薦椎結節韌帶撕裂傷。
他將增生劑(如自體血小板生長因子、高濃度葡萄糖水等)直接注射在阿伯韌帶撕裂處，刺激韌帶重新修復，進而回復強韌，穩定腰椎，改善了阿伯因腰椎不穩定而造成腰痛，及韌帶損傷造成韌帶傳導痛。阿伯在完成三次治療後，已可活動自如，幾近痊癒。
參考資料﹕2019年02月18日 中時電子報
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