5 Things You Should Know About Back Pain | Body Stuff with Dr. Jen Gunter | TED

Back pain is one of the biggest reasons we seek medical care,

翻译人员: Yip Yan Yeung 校对人员: Jacky He

背部疼痛是我们去见医生的 最主要原因之一，

and low back pain is listed as a leading cause of disability worldwide.

而腰痛被列为了世界上 导致残疾的主要因素之一。

But there's a lot of misinformation out there,

但是流传着许多 有关的不实信息，

and along with it, a lot of bad treatments.

产生了许多欠佳的治疗方式。

(Music)

（音乐）

[Body Stuff with Dr. Jen Gunter]

[珍·冈特（Jen Gunter）医生的 身体秘密（Body Stuff）节目]

So today, I want to bring up five things you should know about back pain.

那么今天，我想分享 关于背痛你该知道的五件事。

One:

第一：

Back pain isn't just limited to the spine.

背痛不局限于脊柱。

Our back is made of bones called vertebrae

我们的背部由“椎骨” 这类骨头支撑着。

that run from your neck to your tailbone.

它从你的脖子延伸到尾骨。

These vertebrae form the spinal column, which houses the spinal cord.

椎骨组成了脊柱， 里面是脊髓。

Each vertebrae is also connected to the others by ligaments.

每块椎骨之间由韧带相连。

Between each vertebrae are discs

椎骨间是椎间盘，

which provide cushion and help absorb and distribute pressure.

起到缓冲， 吸收和分散压力的作用。

Within this structure of connections

在这种相连结构中，

are also joints, muscles, tendons and nerves.

还存在关节、肌肉、肌腱和神经。

But our back isn't held up by just the spine.

但是我们的背部不只由脊柱撑起来。

In fact, a lot of that work is done by our core,

事实上，这很大程度 依靠着我们的核心肌群，

which includes our abdominal muscles,

包括腹部肌肉、

low back muscles, hips and glutes and pelvic floor.

腰部肌肉、臀部肌群和骨盆肌群。

The muscles in our core take pressure off the rest of the spine.

我们的核心肌群分散了 脊柱其余部分的压力。

Every day, we put all kinds of pressure on our backs

每天，我们都在给背部 施加各种各样的压力，

when we walk, stand, carry our groceries, lift boxes,

包括我们走路、站立、 抱着杂货、抬起箱子，

and even when we sit.

以及静坐的时候。

So it’s not only spinal pressure

所以不仅是脊柱的压力，

but torn muscles or slipped discs that could be contributing to back pain.

肌肉撕裂或者 椎间盘突出也会导致背疼。

But pain itself is even more complex.

但是痛感本身更加复杂。

Often, it's how pain signals are processed in the nerves,

通常来讲，是疼痛信号

经神经或大脑里的处理方式

or in the brain

that perpetuates the pain.

让疼痛持续良久。

Other factors, like stress and anxiety, can amplify pain.

其他因素，如压力和焦虑， 会使疼痛加剧。

This complexity is why treating back pain can be so frustrating,

这些复杂因素使得 治疗背痛令人崩溃，

and why it's enticing to seek out all sorts of medically suspect care.

也让人们去欣然尝试 各种未被证实的治疗方法。

Which leads me to two:

这就要谈到第二点：

Chiropractic treatment is not backed by science.

脊椎推拿没有任何科学依据。

Going to chiropractors for spinal manipulation is very popular,

去脊椎推拿师那儿“整脊”很流行，

especially in the United States.

尤其是在美国。

But a study that looked at 45 systematic reviews

但是有一项分析了 45 份全面性综述的研究

found no evidence supporting chiropractic treatment

发现脊椎推拿没有

对于任何身体病症有效的迹象。

as effective for any medical condition.

I'm not denying that people who visit chiropractors

我不否认去做脊椎推拿的人

sometimes feel better after a session,

每次结束后感觉更好，

but studies suggest that the comfort and relief from being touched

但是研究表明体肤触碰 带来的安宁和舒缓

is most likely a placebo effect.

很可能是潜在原因。

This is also a reminder

这里还要提醒，

that chiropractic treatment can sometimes be dangerous.

脊椎推拿有些时候是危险的。

There are people who have suffered vascular strokes after neck adjustments.

有人在颈部“正骨”之后 出现了脑卒中状况。

Three:

第三：

Imaging techniques like MRI or X-ray

像核磁共振 和 X 光这样的造影技术

don't always help with diagnosing back pain.

有时候无法诊断背痛。

For instance, you can be in a lot of pain

比如，你痛得要死，

and get an MRI showing a pristine spine with nothing out of the ordinary.

但核磁共振显示 你的脊柱没有任何毛病。

Or you could have no pain whatsoever,

或者你根本不痛，

and an MRI could turn up abnormalities, like a bulging disc.

然后核磁共振发现异常， 说你有椎间盘突出。

What’s more, sometimes, when you do have pain,

还有些时候， 你确实感到疼痛，

and abnormality on MRI may have nothing to do with it.

但是核磁共振找到的 异常毫无关联。

Additionally, an MRI doesn't always capture what's happening with your muscles

此外，核磁共振不会经常 捕捉到肌肉的状态，

or tell us how pain is being processed in the brain.

或者显示大脑是如何传达疼痛的。

There are instances when imaging helps to rule out a serious problem,

有案例表明影像确实 可以排除严重问题的可能，

especially after trauma or an accident,

尤其是在受到创伤或事故之后；

or if there are red flags,

或者确定是否有危险预兆，

meaning warning signs for cancer or troubling neurological symptoms.

即癌症信号或者不妙的精神症状。

But for the majority of people with back pain,

而对于大多数背痛患者而言，

imaging has actually been associated with worse patient outcomes

通常与造影相关的是 更差的治疗效果

and unnecessary surgeries.

和不必要的手术。

Speaking of surgeries, four:

说到手术，第四点：

Back surgeries can sometimes do more harm than good.

脊背手术有些时候弊大于利。

Researchers analyzed studies on two types of spine surgery,

研究人员分析了 关于两类脊椎手术，

腰椎融合术和腰椎减压术的研究。

lumbar spine fusion and lumbar spine decompression.

They found that neither of these surgeries

他们发现这两类手术都没有

was more effective than nonsurgical treatment,

非手术疗法来得有效。

which I'll get into in a bit.

这我会后续展开。

Finally, five:

最后第五点：

Physical therapy is a really good option for back pain.

物理疗法对背痛来说 是个很不错的选择。

A well-designed physical therapy program

一项精心设计的物理疗法计划

can often be very effective at treating acute and chronic back pain.

通常会在治疗急性 和慢性背痛上有奇效，

But it does take work.

只不过需要下点功夫。

Good physical therapy involves not just assessments,

好的物理疗法不仅涵盖评估，

but also a structured home exercise program,

还包括合理安排的 居家锻炼计划；

which you need to do regularly.

这你也得定期完成。

There are also multidisciplinary clinics that can offer multimodal therapy,

市面上也有综合诊所 提供多种形式的治疗，

like medications, physical therapy, and, sometimes, injections.

如药物治疗、物理治疗， 以及注射治疗。

What I'm saying is there isn't always an easy fix for back pain.

我是说背部疼痛 很少会有简单的治法。

The solutions take time

治疗需要时间，

and sometimes need a multipronged approach.

有些时候需要多角度配合。

For now, you can show your back some love by staying active

至于现在，关爱 你的背部吧，动起来，

and doing exercises that strengthen your muscles,

多多锻炼，强健肌肉，

including your core.

也别忘了核心肌群。