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11 Jun 2019
坐骨神經痛症可大可小
脊骨神經科醫生 汪家智
早前某個周日,為新家園協會的基層新移民人士做義診服務。我和一班脊醫及推拿師義工團用了三個半小時時間,接見了大約150名痛症人士。當中大部分也是坐骨神經痛及腳痛。因為他們在香港大部分都是從事勞動工作,包括酒樓、搬運、地盤等,常常受到勞損。
他們告訴我們義工,起初只是一般腰痛,有一點酸酸感覺。但慢慢地腰痛就開始伸展到腳走路時,腳會有一點拉著,只可以走一、兩分鐘便要坐下休息。有一些發病時,腳會感覺麻痺無力,但因為收入問題,他們不能放假休息,只好服用止痛藥或看看跌打醫師來止一止痛。我們為一位坐骨神經痛的患者做了腰骨矯正。為腰肌肉做推拿按摩,還教授一些伸展運動來減輕病情。做完後,他感覺腰的壓力少了,走路也可以舒服點。但因為病情已有一段時間,所以不能一次便可治療好。但我相信如果繼續做治療,情況一定有好轉。
對於一般患腰痛人士,我常常建議他們一定要照一次X光,來看看腰椎第四、五節 (L4, L5)有沒有退化或移位。如果有就一定要及早治療,免得後患無窮。大多數在X光裡,脊醫會留意腰骨是否有骨刺,這是代表腰骨出現了勞損,令到軟骨包括椎間盤、韌帶有磨損。
另外,腰骨正面是否直,側面是否有正常生理弧度,也是非常重要。因為若果正面的腰骨有一點側彎,偏向一邊就會影響腰椎神經線的位置,造成腰椎神經線受壓,嚴重可以導致坐骨神經痛。如果側面的腰骨欠缺正常生理弧度,可以產生腰椎過份受壓,盤骨出現移位。
坐骨神經痛的一個共通點是臀部肌肉過緊,走路會感覺痛楚,因此每一天要定時伸展腿肌肉,不要久坐及走路不能超過半小時。一些對坐骨神經痛有幫助的運動,如游泳,可讓身體放鬆,也可以伸展腿肌。坐骨神經痛人士切勿向前彎腰,因為這樣會加大椎間盤壓力,導致突出。最後,若果腰痛問題長達半年也沒好轉,就應找脊醫做一次脊骨檢查及評估了!
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