下背肌筋膜疼痛症之針刺治療

Needling Therapy for Myofascial Low Back Pain

下背痛僅是一個症狀，治療前必需要有確實的鑑別診斷，特別是必須先排除嚴重的疾病（紅旗），和因為心理社會因素導致疼痛遷延化（黃旗）的可能。下背肌筋膜疼痛症的治療方式有很多，如藥物，物理治療，姿勢調整和衛教，以及運動治療等，多學科的復健治療（multidisciplinary rehabilitation approach）和成人肌筋膜疼痛的評估及治療流程，可供臨床醫師做參考。針刺治療，則是上述的傳統保守治療效果不佳的另一種選擇。針刺治療的種類很多，包括肌激痛點注射，乾針治療，針灸，浮針治療等，但這些都只是執行治療的工具，最重要的還是要找到可能引起症狀的患肌，給予適當的治療，同時，治療後的自我牽拉運動和核心肌群的肌力訓練，更是預防下背痛再復發的不二法門。 Low back pain is just a symptom. It is very important the make exact different diagnosis before treatment, especial to find out the most severe diseases (red flags) and the psychosocial factors possible related to pain chronification (yellow flags). There are many treatments for the myofascial low back pain, including medication, physical therapy, posture correction, education, and exercise therapy. Multidisciplinary rehabilitation approach and algorithm for the evaluation and treatment of myofascial pain in an older adult are suggested for primary care specialist in this paper. Needling therapies are another choices while the traditional conservative treatments are less response for pain control. There are many needling therapies, including myofascial trigger points injection, dry needling, acupuncture, and Fu's subcutaneous needling, etc., whom are the modalities to be used for treatment. The most important thing is to figure out the tightened muscles leading to the symptoms, then giving the appropriate treatment. Besides, self-stretching exercises and muscle strengthening for core muscles might preventing recurrent of low back pain.