下腰疼的臨床實踐治療指南

健康 09-26

作者： Dr.wong

來源：運動醫學部落，已獲授權

關於下腰痛的臨床實踐治療指南發表在2012年4月美國JOSPT雜誌上（骨科和運動物理治療雜誌）。該指南介紹了基於最佳循證的治療腰背部疼痛的方法。

下腰疼的臨床實踐治療指南

Early treatment seems to be key todecreasing your pain and getting back to full activity. Treatments that focuson exercise and staying active limit the amount of time your back pain lastsand reduce the chance that it will reoccur.

早期治療的關鍵是減少患者的疼痛和重返完全的活動。治療的重點是運動和保持有限的活動，減少疼痛複發的機會。

訓練時機的選擇

Based on your examination, the besttreatment for acute low back pain may be manual therapy (mobilization /manipulation) or exercises that restore motion anddecrease pain in the leg thatis linked to your low back pain. Exercises that improve coordination, strength,and endurance are best added to treatment once the pain lessens. However, ifyour pain becomes chronic, moderate- to high-intensity exercises andprogressive exercises that focus on finess and endurance are helpful in painmanagement.

下腰疼的臨床實踐治療指南

· 急性下腰痛最佳治療可能是手法治療，或恢復性運動訓練和減少腿部疼痛。

· 一旦疼痛減輕，最好加入協調，力量和耐力訓練。

· 如果疼痛變成慢性的，中~高強度的訓練（體適能和耐力）有助於疼痛管理。

訓練方案

Back Stretches For Lower Back Pain

§ Standing hamstring stretch腘繩肌牽伸（站立）

Do 10 to 25 repetitions, then relax. Donot attempt this exercise if the pain is too severe. This exercise buildsstrength in the lower back area.

10~25次，如果太疼痛，不要嘗試這個練習

§ Quadruped arm/leg raise四點跪位（伸上肢/腿）

Keeping your knees bent, squeeze thebuttocks and hold for a second or two,then relax. Do 10 repetitions. This isanother strength-buildingexercise.

保持1~2秒，重複10次

Pull one knee toward your chest and holda second. Extend the otherleg out atthe same time. Stretch the back muscle onone side, then repeat withthe otherleg. Repeat 10 times. Discontinue theexercise if pain is overbearing.

§ Gluteal stretch臀肌牽伸

Pull one knee toward your chest and holda second. Extend the other leg out at the same time. Stretch the back muscle onone side, then repeat with the other leg. Repeat 10 times. Discontinue theexercise if pain is overbearing.

將一側膝關節拉向胸前，保持1s，重複10次。如果痛苦持續，停止運動。

§ Cat and camel

A helpful starting exercise iscontrolled,gentle spine movement with the Cat & Camel. First arch your backup towardthe ceiling, like an angry cat. Increase the movement with a deepinhale. Thenexhale, tighten (or brace) your abdominals, drop your chest towardthe floorand lift your head slightly as shown. Repeat this exercise 10 times.

首先向上弓起你的背，就像一個憤怒的貓。運動時加強深吸氣，然後呼氣，收緊腹部，放平軀幹，抬起頭，如圖所示。重複動作10次。調整脊柱運動協調。

§ Pelvic tilt骨盆前傾

Staying in the same position, bring bothknees up together and holdthatposition for a second or two. Drop your feet tothe floor and repeat again.Do this 10 times.

每次1~2秒，重複動作10次。

§ Partial curl軀幹旋轉

Hold the position for 5 to 7seconds,release and relax for 2~3 seconds before repeating.

保持5~7秒，之間休息2~3秒，重複10次

§ Extension exerise軀幹伸展訓練

Hold the position for 5 to 7seconds,release and relax for 2~3 seconds before repeating.

保持5~7秒，之間休息2~3秒，重複10次

§ Side Plank側向支撐

Hold the position for 5 to 7seconds,release and relax for 2~3 seconds before repeating.

保持5~7秒，之間休息2~3秒，重複5次

下腰疼的臨床實踐治療指南