黄强民-腰背肌筋膜触发点治疗讲稿课件.pptVIP

臀大肌牵张法：①平卧，单腿屈膝屈髋，对侧手握住另一侧膝，并向另一侧反复牵拉。②也可以高坐位，做上述动作。 臀中，小肌牵张法：单腿直腿站立，将站立侧手抓住患侧踝部向上拉到站腿膝上，患侧手向下压患侧膝部。 梨状肌牵张法：①平卧，单腿屈膝屈髋，对侧手握住另一侧膝，并向另一侧反复牵拉。②也可以高坐位，做上述动作。 多裂肌牵张法：①平卧，单腿屈膝屈髋，对侧手握住另一侧膝，并向另一侧反复牵拉。②也可以高坐位，做上述动作。 精品 肌膜疼痛基本治疗原则BASIC PRINCIPLE of MYOFASCIAL PAIN THERAPY 1). 找出並治疗引起活动性肌疼痛触发点的病因 To treat Underlying Etiological Lesion. 2).控制疼痛 To provide Pain Control (inactivation of MTrPs). 3). 去除持续因子 To correct Perpetuating Factors. 4).病人教育 To perform Patient Education. 5).自我疗法 To demonstrate Home Program. 精品 找出並治疗引起活动性肌疼痛触发点的病因 Identification of Underlying Pathological Lesion: 活动触发点 Active MTrP 潜在触发点 Latent MTrP 什么原因使触发点活化？ Central sensitization 2nd to: Soft tissue lesions, Neurogenic lesions, Endocrine disorders (Fibromyalgia), Other factors 精品 抑制 活性肌疼痛触发点 Inactivation of MTrPs General Consideration - 1:保守治疗还是侵入性治疗 Conservative VS Aggressive Treatment: 保守疗法：物理疗法 Conservative Treatment: physical medicine Any MTrPs with pain or discomfort. 针刺疗法 MTrP Injection: Poor response to conservative therapy Deeply seated MTrPs, Chronic recurrent MTrPs, Very active MTrPs, etc. 精品 抑制 活性肌筋膜触发点的常用疗法Commonly Applied Techniques to inactivate (immediately release) MTrPs: 1.物理疗法 Physical Therapy 2.整脊 Chiropractic Therapy 3.針灸治疗 Acupuncture 4.针刺疗法 Myofascial Trigger Point Injection 5. SET技术 Sling Exercise Therapy 6. 其它疗法 Others. 精品 干针和针灸Dry Needling and Acupuncture 1). 基础原理 Basic Principle: a. 脊髓机制 Spinal Cord Mechanism -Effect of dry needling: LTRs = 得气 b. 内源性镇痛系统 Endogenous opioid system: Neurotransmitters: 5HT, etc. c. 其它 Others. Acupuncture point Vs Trigger Point. 2）临床应用 Clinical Application: 干针－局部颤搐 Dry Needling – Local twitch responses. b.传统针灸－得气 Traditional acupuncture -Deqi. 精品 湿针基础原理BASIC PRINCIPLES OF Wet needling 适应症： 保守治疗无效、发病原因解除后触发点仍存、 疼痛位置固定、发现关键和源发触发点 Before considering MTrP injection: 1. Previous conservative treatment. 2. Previous treatment for etiological lesions. 3. Pain recognition. 4. Key Trigg