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,

譯者: Lilian Chiu 審譯者: Helen Chang

背痛是我們尋求醫療 照護服務的主因之一，

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

而下背痛也是全球的 殘疾主要成因之一。

But there's a lot of misinformation out there,

但有很多錯誤資訊在流傳，

and along with it, a lot of bad treatments.

除此之外，還有很多 不當的治療方式。

(Music)

（音樂）

[Body Stuff with Dr. Jen Gunter]

〔關於人體〕 〔珍‧甘特博士主持〕

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

今天的主題是關於背痛 你應該要知道的五件事。

One:

第一：背痛不僅限於脊椎。

Back pain isn't just limited to the spine.

Our back is made of bones called vertebrae

我們的背是由椎骨形成， 從脖子一路延伸到你的尾骨。

that run from your neck to your tailbone.

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

這些椎骨形成脊柱，包覆著脊髓。

每個椎骨也靠著韌帶與彼此連結。

Each vertebrae is also connected to the others by ligaments.

Between each vertebrae are discs

每個椎骨之間有椎間盤，

which provide cushion and help absorb and distribute pressure.

具有緩衝功能，並能協助 將壓力吸收和分散。

Within this structure of connections

連結的結構中還包含了

are also joints, muscles, tendons and nerves.

關節、肌肉、肌腱，以及神經。

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

但我們的背並不是 只靠脊椎撐起來的。

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

事實上，

很大一部分的支撐工作 要靠我們的核心，

which includes our abdominal muscles,

包含我們腹部的肌肉、

low back muscles, hips and glutes and pelvic floor.

下背的肌肉、髖部、 臀肌，以及骨盆底。

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

我們核心的肌肉能分擔 脊椎其他部分的壓力。

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

我們的背每天承受各種壓力，

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

當我們走路、站立、提雜貨、

搬箱子，就連坐著時， 背部都要承受壓力。

and even when we sit.

So it’s not only spinal pressure

所以，不僅是脊椎的壓力，

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

肌肉拉傷或椎間盤滑脫 都有可能造成背痛。

But pain itself is even more complex.

但疼痛本身又更複雜了。

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

通常，是神經或大腦中 處理疼痛訊號的方式

or in the brain

that perpetuates the pain.

讓疼痛一直存在。

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

其他因子，如壓力和焦慮，

會放大疼痛。

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

這樣的複雜度就是治療背痛 常讓人如此灰心的原因，

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

也是為什麼人會很想尋求各種 在醫學上可議的照護方式。

Which leads me to two:

這就要談到第二點：

Chiropractic treatment is not backed by science.

整復治療背後是沒有科學支持的。

Going to chiropractors for spinal manipulation is very popular,

去找整復師做整脊是很熱門的做法，

especially in the United States.

特別是在美國。

But a study that looked at 45 systematic reviews

但有一項研究，探究了 四十五篇系統性文獻回顧，

found no evidence supporting chiropractic treatment

沒有找到證據可以證明整復治療

as effective for any medical condition.

對任何疾病有效。

I'm not denying that people who visit chiropractors

我不否認有些去找整復師的人

sometimes feel better after a session,

有時在診療之後感覺好多了，

but studies suggest that the comfort and relief from being touched

但研究指出，被觸碰的舒適緩解感

is most likely a placebo effect.

很有可能是安慰劑效果。

This is also a reminder

這也是提醒我們，

that chiropractic treatment can sometimes be dangerous.

整復治療有時是危險的。

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

有人去調整頸部之後發生中風。

Three:

第三：造影技術， 如磁振造影或 X 光，

Imaging techniques like MRI or X-ray

don't always help with diagnosing back pain.

在診斷背痛方面 不見得一定幫得上忙。

For instance, you can be in a lot of pain

比如，你有可能非常痛，

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

但磁振造影結果卻顯示 脊椎完全沒有不正常之處。

Or you could have no pain whatsoever,

或者，你也可能都不覺得痛，

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

磁振造影卻顯示有異常， 比如椎間盤突出。

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

另外，有時你真的感到疼痛，

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

磁振造影發現的異常 卻和它完全無關。

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

此外，磁振造影不見得 都能呈現出肌肉的狀況，

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

或告訴我們大腦如何處理疼痛。

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

也有例子是造影能協助

排除嚴重的問題， 特別是在創傷或意外之後，

especially after trauma or an accident,

or if there are red flags,

或者有危險信號，意即，

meaning warning signs for cancer or troubling neurological symptoms.

可能有癌症徵兆 或讓人不安的神經症狀。

But for the majority of people with back pain,

但對於大部分受背痛之苦的人來說，

imaging has actually been associated with worse patient outcomes

造影其實會被連結到 更糟糕的病人結果

and unnecessary surgeries.

以及不必要的手術。

Speaking of surgeries, four:

說到手術，第四：

Back surgeries can sometimes do more harm than good.

背部手術有時是害處多於益處。

Researchers analyzed studies on two types of spine surgery,

研究者分析了針對兩種 脊椎手術所做的研究：

lumbar spine fusion and lumbar spine decompression.

腰椎融合以及腰椎減壓。

They found that neither of these surgeries

他們發現，這兩種手術都沒有

was more effective than nonsurgical treatment,

比非手術的治療更有效，

which I'll get into in a bit.

我等下再來談這部分。

Finally, five:

最後，第五：

Physical therapy is a really good option for back pain.

對於背痛，物理治療是很好的選項。

A well-designed physical therapy program

設計良好的物理治療計畫通常可以

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

非常有效地治療急性和慢性背痛。

But it does take work.

但確實要下功夫。

Good physical therapy involves not just assessments,

好的物理治療不只涉及到評估，

but also a structured home exercise program,

還有結構化的居家運動計畫，

which you need to do regularly.

必須要有規律地去做。

There are also multidisciplinary clinics that can offer multimodal therapy,

也有多學科聯合診所，

能提供多重模式治療，

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

比如藥物、物理治療， 有時還有注射。

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

我要說的是，背痛不見得 都會有簡單的解決方法。

The solutions take time

解決需要時間，

and sometimes need a multipronged approach.

有時還需要多管齊下的方式。

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

此時，你能做的是愛護你的背，

保持活動和做運動，

and doing exercises that strengthen your muscles,

來強化你的肌肉，包括你的核心。

including your core.