盆骨是位於下腹的環狀結構,並由3塊骨構成,功能包括連接大腿與腰脊,以及保護內臟等。盆骨給人的印象是牢固不能運動,但其實在孕婦臨產時受激素刺激下,韌帶鬆軟盆腔打開;而一般人盆骨內的關節亦能容許幾毫米幅度的運動,這協同了腰椎及下肢在步行或跑步的力學機能。
盆骨痛的原因
盆骨關節的受傷可以因為跌仆挫損、運動創傷、不正確負重姿勢、不良坐立姿勢,或久坐缺乏承托的梳化等引致。受傷機制因與腰痛相似,症狀位置亦相近,所以往往容易與腰痛混淆,但兩者又可同時發生,或互為因果。盆骨痛亦可因為一側下肢傷患,使腰負荷增加繼而誘發盆骨症狀。盆骨痛的位置較一般腰痛為低,病人常能指出疼痛位置位於褲頭帶下的腰臀範圍,疼痛常於久坐後站立時加劇,但在運動後又突然消失。治療人員會診斷痛症來源是腰還是盆骨,及髂或髂關節的主次問題。
盆骨痛的治療原則
治療方法在急性發作期主要以止痛為主,患者可以接受針灸,或物理治療等;當疼痛減退時,則會施行手法或手力治療,回復髂關節的正常位置及動作。此外,要減少盆骨痛的復發,患者應注意平日坐立姿勢,戒除靠一側的坐立姿勢,及不作蹺腳坐的習慣。平常多作髖部拉筋運動,尤其梨狀肌拉筋運動。如果患者本身有長短腳或扁平足問題,則應考慮使用鞋墊,矯正下肢力學問題。
盆骨疼痛算是比較常被忽視的症狀,這可能由於常與腰痛或梨狀肌綜合症混淆。此外,盆骨問題亦可導致腰高低,繼而影響脊柱各個生理弧度,誘發各種與脊椎骨相關的痛症。所以,若是不幸患上腰背痛,還是要清楚是腰痛還是腰盆骨痛,治療才能針對真正的患處。
原文刊登於2018年4月21日《香港經濟日報》理療感悟,標題為"舉足輕重說盆骨"
作者:盧文健 註冊中醫師 註冊物理治療師

閱讀更多:盆骨痛骶髂關節錯位
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