Kameda Masahiro, Tanimae Hideyuki
Senshunkai Hospital: 2-14-26 Kaiden, Nagaokakyo, Kyoto 617-0826, Japan.
Kichijoji Taishido Manual Medicine Office, Japan.
J Phys Ther Sci. 2019 Feb;31(2):141-148. doi: 10.1589/jpts.31.141. Epub 2019 Feb 7.
[Purpose] Ineffective and prolonged treatment of low back pain is a major social problem resulting in a huge economic burden. The effectiveness of back pain and/or leg pain treatment using active soft tissue release alone or in combination with a trigger point block was examined. [Participants and Methods] Among 115 patients who underwent medical examination at Senshunkai Hospital during the study period, information on treatment outcomes using active soft tissue release alone or in combination with a trigger point block, location of myofascial trigger points, and duration of treatment were extracted for patients with low back pain, leg pain, or low back pain with leg pain. [Results] Myofascial pain syndrome was diagnosed in 73.4% (36/49) in the low back pain group, 50% (16/32) in the leg pain group, and 85.3% (29/34) in the low back pain with leg pain group. Symptom improvement was noted in all three groups with active soft tissue release alone (90.9%, 20/22; 90.0%, 9/10; and 100%, 14/14, respectively) and active soft tissue release + a trigger point block (90.9%, 10/11; 100%, 1/1; and 92.9%, 13/14, respectively). The gluteus medius was the major myofascial trigger point in all groups. [Conclusion] Manual therapy with active soft tissue release and a trigger point block constitutes an effective treatment combination for low back pain and leg pain, but prolonged treatment is required in chronic cases.
[目的] 下腰痛的无效和长期治疗是一个重大的社会问题,会带来巨大的经济负担。本研究探讨单独使用主动软组织松解术或联合触发点阻滞治疗背痛和/或腿痛的有效性。[参与者与方法] 在研究期间于千春会医院接受医学检查的115例患者中,提取了单独使用主动软组织松解术或联合触发点阻滞的治疗结果、肌筋膜触发点位置以及治疗时间等信息,这些患者患有下腰痛、腿痛或下腰痛伴腿痛。[结果] 下腰痛组中73.4%(36/49)被诊断为肌筋膜疼痛综合征,腿痛组为50%(16/32),下腰痛伴腿痛组为85.3%(29/34)。单独使用主动软组织松解术时,三组均有症状改善(分别为90.9%,20/22;90.0%,9/10;100%,14/14),联合主动软组织松解术 + 触发点阻滞时也有症状改善(分别为90.9%,10/11;100%,1/1;92.9%,13/14)。臀中肌是所有组中的主要肌筋膜触发点。[结论] 主动软组织松解术和触发点阻滞的手法治疗对下腰痛和腿痛构成有效的治疗组合,但慢性病例需要长期治疗。