10,000 Miles Away Learning: 坐骨神經痛

2023.02.14

原本坐骨神經就有些不適，做了上頸椎調整後，疼痛更是劇烈，甚至讓你坐立難安。

以下資料取自《https://www.buoyhealth.com/learn/lower-back-pain#prevention》

Lower Back Pain

What is lower back pain?

Pain that is felt anywhere between the lower part of your ribs to the lower part of your backside is considered lower back pain.

There are two types: Sciatica (called lumbosacral radiculopathy) and non-sciatica. The sciatica nerve runs from your lower back through your buttocks and down your legs.

Sciatica pain is often described as a sudden, hot pain that shoots down the buttocks and leg. Sciatica can be caused by a number of conditions that put pressure on the sciatica nerve.

Non-sciatica pain is mostly in your back and not felt in the legs.

Lower back pain can also be caused by arthritis, over-exertion, and trauma.

Back pain usually improves on its own in about 4 weeks. If you are experiencing significant pain, or your pain isn’t getting better, contact your doctor.

自己有這個問題以後，才發現坐骨神經是身體最大、最長的一條神經

跟整骨師提到 lower back pain，醫師以為是腰間部位，跟醫師提了在腰以下，

懷疑是不是自己表達錯誤，腰以下不算 lower back，應該說屁股？！？

Understanding types of lower back pain

Sciatica and non-sciatica pain have somewhat different symptoms.

Sciatica symptoms

Sciatica pain typically feels like a sharp, electric-like pain that starts in your lower back and travels through the buttocks and down one leg.

Non-sciatica pain

Non-sciatica pain is felt within the lower back area. The pain can be dull, achy, sharp, or burning.

Main symptoms

Sciatica

Sharp pain in your back that moves down one leg.
The pain is usually felt behind the legs.
Sometimes there is numbness or weakness in legs.

Non-sciatica

Dull, achy, or sharp pain mostly in your back.
It’s usually worse with movement.
Usually not felt in legs. Can feel like your back is “tight.”
May be painful around your hips.

綠色是自己痛的地方！

一開始是以小腿痛為主，後轉為屁股、大腿後側都痛。

轉換姿勢時，例如從坐到站立/走路，

整條左腿都要麻痺一下才會過癮😓。

之後 lower back 也跟著會酸痛。真是令人坐立難安。

連基本的開車，疼痛起來也非常不舒服，腰部也很酸痛。

停車後，第一件事就是立刻轉動身體，

盡量讓腰部得以舒展，向前挺起舒緩疼痛。

希望不是椎間盤突出啊！

從今以後，會努力運動強化肌肉的！請給我一點時間。

Causes of low back pain

The longest nerve in the body is the sciatica. it starts in your lower spinal cord and extends through the butt, down into your legs.

Sciatica pain is caused by something irritating the sciatic nerve at its root in the spinal cord. If a disk (the cushion between bones in the spine) moves out of position (known as a disk herniation), or if the bones, disks, or ligaments wear down with age, this can pinch or irritate the sciatica nerve nearby and cause pain.

Several other conditions can mimic sciatica, including diabetic polyneuropathy, hip arthritis, and piriformis syndrome. A doctor will do an exam and may order tests to make an accurate diagnosis.

For non-sciatica lower back pain, the cause is often unknown. It may be caused by damage to the spinal disks, bones, and joints, or strains to soft tissue like muscle or ligaments.

You’re more likely to develop lower back pain if you:

Smoke cigarettes (smoking lowers bone density and may affect your spine)
Drink alcohol regularly
Are overweight or obese
Participate in sports like football or gymnastics, which put pressure on your spine
Sit for most of the day
Over-exercise (doing too much shoveling or pushing too hard)
Have certain health issues like osteoporosis or pain in other parts of your body, such as hip, knees, or wrist
Take medications like steroid pills
Have had surgery on your spine
Are older

How do I know if my back pain is serious?

Lower back pain usually gets better on its own. If you are experiencing significant pain or if the pain lasts longer than a month, see your doctor.

If you have a history of cancer, feel weakness in your legs, have urinary incontinence or loss of bowel control, fever, or other bodywide symptoms, then you may have a more serious issue such as a herniated disk or cancer. Go to the emergency room. （腳會麻，但沒有弱到不能動；大小便 OK；沒發燒。希望不是 “herniated disk 椎間盤突出症” 或 “bulging disk 突出的椎間盤”）

If you had a trauma (like a fall or motor vehicle accident), go to the emergency room.

Most lower back pain gets better after about 4 weeks of medications and/or physical therapy. If the pain continues, discuss with your doctor what to do next.

How to prevent back pain

You can help prevent back pain by leading a healthy lifestyle and following these tips:

Do aerobic exercise like swimming or walking.
Stretch and strengthen the muscles supporting your lower back. The American Academy of Orthopaedic Surgeons recommends these exercises.
If you smoke, stop.
Lose weight if you are overweight.
Avoiding extreme sports and activities that put too much stress on your back.
Avoid sitting for long periods of time.
Try to take breaks where you stand up and walk around.
Avoid heavy lifting, and lift properly, bending at the knees, not the waist

資料取自《http://www.lohas-spine.com/zh-tw/education.php?act=view&id=73》

椎間盤突出症 (Herniated Disk) 和凸出的椎間盤 (Bulging Disk) 有何區別？

所有椎間盤都會隨年齡退化，椎間盤主要是避震功能，裡面充滿著水，隨著年齡椎間盤會開始流失水分，並失去避震功能，所以椎間盤退化並不是一個問題而是一個正常的過程，只有當退化性椎間盤或凸出的椎間盤產生疼痛才是問題；所謂的椎間盤突出症就是指椎間盤退化到其外圍1/3的部分被拉長或小撕裂，這些椎間盤碎片會移動，並移動至鄰近的神經；脊椎管內會因這些椎間盤碎片的存在，造成對神經根的壓力，這就是所謂的坐骨神經痛，疼痛會延伸至小腿，通常至足部。凸出的椎間盤是所有腰椎椎間盤退化的早期步驟，當椎間盤開始失去原有的水分，它會開始逐漸變窄，並造成椎間盤失去避震的功能，逐漸失去原有高度並會導致椎間盤環往外凸出，這就好像氣墊或枕頭在洩氣後會變平又變寬，通常，此種凸出的椎間盤很少會對鄰近神經產生明顯壓力；而椎間盤突出症則是椎間盤外環破損後，造成椎間盤內較軟的物質跑出原有椎間盤外，如此物質會對鄰近神經根產生壓力；椎間盤突出症就是因為這種物質對神經根的壓迫，即產生所謂的坐骨神經痛或小腿疼痛；凸出的椎間盤則因椎間盤內物質的刺激，通常只會產生所謂機械性的疼痛問題。

脊椎構造圖