據估計，高達 84%的成年人在一生中會有下背痛的經驗。下背痛最常見的原因爲機械性下背痛（佔97%），其中腰部扭傷佔大部分70%，其他原因包含退化性椎間盤、椎間盤突出。此外，在針刀治療理論中，第三腰椎橫突綜合症是常見的病因之一。目前的治療方法主要有藥物和非藥物治療：藥物治療通常包括Acetaminophen或非類固醇類止痛藥（NSAID）；非藥物治療包含物理治療、局部封閉治療、及手術治療等。雖然大多數能即時緩解疼痛等不適症狀，但是仍存在藥物不良反應、依賴性以及停藥後病情反復、手術費用高等問題。本病例是一名74歲女性，右側腰痛症狀已10年，疼痛延伸至右側臀部，伴隨右下肢麻電感，踩地刺痛，兩腳掌麻症狀。MRI檢查顯示腰椎滑脫（Grade 1 spondylolisthesis L4/5, L5/S1）及椎間盤突出伴有神經根壓迫（L4/5、L5/S1），於112/01/09至本院中醫部門診經Activator Methods Chiropractic Technique（AMCT）診斷治療、針灸治療及兩次針刀治療鬆解第三腰椎橫突後，下背痛及下肢電麻感症狀于一個月內大幅改善（VAS由7分降至1-2分）。此爲慢性下背痛合併第三腰椎橫突綜合症，經中醫椎體偏位矯正、針灸治療搭配針刀鬆解第三腰椎橫突，分階段由骨頭、肌肉及筋膜多層次介入之治療經驗。 【關鍵詞】脊椎滑脫 ； 椎間盤突出 ； 第三腰椎綜合症 ； 針刀 ； AMCT |
According to estimates, up to 84% of adults will experience lower back pain in their lifetime. The most common cause of lower back pain is mechanical lower back pain (acing for 97%), with lumbar strain acing for the majority at 70%, degenerative disc disease at 10%, disc herniation at 4%, osteoporotic compression fractures at 4%, spinal stenosis at 3%, and spondylolisthesis at 2%. In addition, among the causes of low back pain, the transverse process syndrome of third lumbar vertebra is one of the common causes, acing for 33-50% of low back pain. The current treatment methods mainly include medication and non-medication treatments: medication treatment usually includes acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs); non-medication treatment includes physical therapy, local injection therapy, and surgical treatment. Although most treatments can relieve pain and discomfort symptoms immediately, there are still issues such as adverse drug reactions, dependence, relapse after drug withdrawal, and high surgical costs. This case involves a 74-year-old female with right-sided lower back pain for 10 years, which extended to the buttocks, accompanied by numbness and tingling sensations in the right lower limb and numbness in both feet, as well as stabbing pain when walking. MRI examination showed spondylolisthesis (Grade 1) and disc herniation with nerve root compression. After diagnosis and treatment by Activator Methods Chiropractic Technique (AMCT), acupuncture and acupotomy treatment to release the transverse process of the third lumbar vertebrae, the lower back pain and lower limb numbness and tingling symptoms significantly improved within one month (VAS dropped from 7 to 1-2). This is a case of chronic lower back pain combined with the third lumbar transverse process syndrome, treated with vertebral misalignment correction, acupuncture and acupotomy treatment to release the third lumbar transverse process, with multi-level intervention of bone, muscle and fascia in stages. 【Keywords】spondylolisthesis ； intervertebral disc herniation ； transverse process syndrome of third lumbar vertebra ； acupotomy ； Activator Methods Chiropractic Technique (AMCT) |
281.7針刀鬆解第三腰椎橫突緩解下背痛之病例報告
