以下訪問內容是常見膝關節疼痛原因,及針灸怎樣醫治不同原因的膝關節痛。
內容:膝關節痛針灸及拔罐治療(英譯中)
日期及節目:2017/09/07 香港電台 Radio 3 “1 2 3 Show”
主持人: Noreen Mir
受訪者: 盧文健醫師
英譯中訪問內容
Q: What is the common cause of knee pain?
A: The causes are depend on the age of patients. Teenage, middle age and elderly suffer knee pain with different reasons. Teenage have knee pain may be because of sport injury, such as Anterior Cruciate Ligament (ACL), Meniscus or Medial Collateral Ligament (MCL) injuries. As for middle age and elderly, they may suffer knee pain because of degeneration, or chronic pain from sport injuries.
問: 膝關節疼痛的常見原因是什麼?
答: 原因是取決於病人的年齡。少年,中年和老年人膝關節痛的原因並不相同。少年膝關節疼痛的主因可以是運動損傷,如前交叉韌帶 (ACL),半月板或內側副韌帶 (MCL) 傷害。至於中年和老年人,他們可能會遭受的膝關節退行性變性,或慢性運動損傷急性發作。
Q: Can patient with ACL repair come for acupuncture treatment right after surgery?
A: Patient with ACL repair surgery can receive acupuncture, because they may have inflammation and swelling and acupuncture can work for it. After symptomatic control, they can also have the rehabilitation training, such as hamstring training. And we can also give them daily life advice.
問:前十字韌帶損傷修復手術後,患者能否作針灸治療?
答: 前十字韌帶修復手術患者是可以接受針灸治療,針灸能有效控制炎症和腫脹。當術後症狀減輕,病人可以接受度身設計的康復訓練,如膕繩肌訓練。此外,亦有日常生活的建議。
Q: Knee pain can be compensation result from other areas, any idea? back posture? low back?
A: Other areas can affect knee function, such as below knee region or low back region. Ankle function and foot arch status can affect knee function, causing wearing and tearing of knee and result in pain. Some people may also have knee pain because of back conditions. For example, sciatica patients can have behind side of knee pain. As a result, if patient come to clinic for knee pain, we also needs to exclude back conditions causing their knee pain.
問:膝關節疼痛是否為代償其他身體部位而產生結果?例如腰背?任何想法嗎?
答:其他身體部位是可以影響膝關節功能,如如足踝部位或腰背。踝關節功能和足弓型態可以影響膝關節功能,造成膝蓋軟骨勞損,產生疼痛。有些人也可能因為腰背問題而引致膝部位疼痛。例如,坐骨神經痛可以有膝背後側的疼痛。因此,如果病人來求診所膝關節疼痛,我們需要排除腰背問題導致的膝蓋疼痛。
Q: Apart from knee pain, how do people describe their knee discomfort?
A: Patients might also complaint knee bending and straightening stiffness. For pain nature, it is different according to the stage of knee pain. In acute stage, pain is the main symptom. Acupuncture, cupping and gentle massage can relieve pain in acute stage. As for long term condition, patients usually find their knee pain become better, and our focus should shift to help for recovery to pre-injury / pre-morbid status. For example, helps athlete back to joggling by training their agility.Different time point would have different key problems.
問: 除了膝蓋疼痛,人們是怎樣描繪他們的膝蓋不舒服?
答: 患者也可能主訴膝不能完全彎曲和伸直。疼痛性質亦會隨炎症的不同階段而改變。在急性期的主症的疼痛可以針灸,拔罐和按摩舒緩。當病人症狀改善後,治療膝關節的重點應轉移為恢復受傷前的運動狀態。例如,説明訓練運動員的靈活性。治療應該要針對不同階段的關鍵性問題。
Q: How to differentiate acute, subacute and chronic stages of pain?
A: Acute stage would have swelling, increasing body temperature and severe pain, and it usually lasts for 3-4 days. R.I.C.E principles can help in acute stage. R refers Rest, I means Ice -pack , C is compression, and E refers to elevation.
Subacute might still have swelling, and pain level become stable.
For Chronic stage, patients might still have mild swelling and most to their symptoms would subside, and patients change to have knee joint instability now. And the training exercise is depended on their knee injury conditions.
問: 如何區分急性、 亞急性和慢性階段的痛的特點?
答: 急性期的特徵是腫脹,皮膚溫度上升和嚴重的疼痛,和它通常會持續 3-4 天。 急性期可以依R.I.C.E 原則治理。R是指休息,I是冰敷,C是包紥加壓,E側是提高傷肢。亞急性期腫脹和疼痛程度變得穩定。 慢性期患仍可能有輕度腫脹。此外,若患者有膝關節失穩情況,則須加强穩定性的訓練。而訓練內容會取決於傷患所屬組織。
Q: For chronic knee pain, how can we train our knee joint?
A: we can strengthen our knee, and train knee joint agility as well. It is hope that they can go back to their favorite sport.
問: 對於慢性膝關節痛,我們如何能訓練我們的膝關節?
答: 我們可以加強我們的膝蓋,以加强膝關節的肌力及改善其靈活性。治療的最終目標是回復受傷前的運動項目。
Q: Can we use cupping for knee pain?
A: Yes, but it depends on every knee conditions. For example, not every patients needs to treat their ITB tightness, and we will use cupping to release muscle till we find the benefit of releasing muscle tightness
問: 可以用拔罐治療膝痛嗎?
答:可以,但這仍取決於個别膝關節的情況。舉例來說,是不是每個病人都需要治療繃緊的 ITB ?事實上,我們須預計放鬆肌肉的好處,才會決定用拔火罐來治療。