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得了落枕怎么治療,落枕是什么原因引起的

中(zhong)醫世家 2023-07-31 08:50:20

一、怎么治療落枕

1.中醫療法

中醫治療落(luo)枕的方法(fa)很多,手(shou)法(fa)理(li)筋、針(zhen)灸(jiu)、藥物、熱敷等均(jun)有良(liang)好的效果,尤以(yi)按(an)摩理(li)筋法(fa)為佳。

(1)按(an)(an)(an)摩(mo)(mo)理筋一般(ban)落枕(zhen)經1~2次治(zhi)療即(ji)(ji)可(ke)緩(huan)(huan)解,輕(qing)者(zhe)(zhe)即(ji)(ji)可(ke)治(zhi)愈。但(dan)部(bu)(bu)分患(huan)者(zhe)(zhe)實(shi)際上(shang)(shang)(shang)是在(zai)(zai)頸(jing)(jing)部(bu)(bu)長(chang)期病(bing)(bing)變(bian)(bian)的基礎(chu)上(shang)(shang)(shang)發病(bing)(bing),如(ru)頸(jing)(jing)部(bu)(bu)肌(ji)肉長(chang)期勞損(sun)或(huo)(huo)頸(jing)(jing)椎有(you)退行(xing)性病(bing)(bing)變(bian)(bian)等,在(zai)(zai)一定(ding)條(tiao)件下(xia)誘發本病(bing)(bing),即(ji)(ji)使通過治(zhi)療使紊亂的關節(jie)復(fu)位(wei),但(dan)頸(jing)(jing)部(bu)(bu)軟組織的充(chong)血、水腫、增厚(hou)等炎性變(bian)(bian)化(hua)也會(hui)繼(ji)續造(zao)成(cheng)頸(jing)(jing)部(bu)(bu)不(bu)適,需要2周甚至(zhi)1個月以上(shang)(shang)(shang)的治(zhi)療、休息才能痊愈。按(an)(an)(an)摩(mo)(mo)理筋有(you)以下(xia)幾(ji)種(zhong)方(fang)法(fa):①按(an)(an)(an)摩(mo)(mo)者(zhe)(zhe)立于落枕(zhen)者(zhe)(zhe)身后(hou)(hou),用(yong)一指輕(qing)按(an)(an)(an)頸(jing)(jing)部(bu)(bu),找出最(zui)痛(tong)點(dian),然(ran)(ran)后(hou)(hou)用(yong)拇(mu)指從該側(ce)(ce)頸(jing)(jing)上(shang)(shang)(shang)方(fang)開始,直(zhi)到(dao)(dao)肩背部(bu)(bu)為止(zhi),依(yi)次按(an)(an)(an)摩(mo)(mo),對最(zui)痛(tong)點(dian)用(yong)力按(an)(an)(an)摩(mo)(mo),直(zhi)至(zhi)感明顯酸(suan)脹(zhang)即(ji)(ji)表(biao)示力量已夠,如(ru)此反復(fu)按(an)(an)(an)摩(mo)(mo)2~3遍(bian),再(zai)以空心(xin)拳輕(qing)叩按(an)(an)(an)摩(mo)(mo)過的部(bu)(bu)位(wei),重(zhong)復(fu)2~3遍(bian)。重(zhong)復(fu)上(shang)(shang)(shang)述按(an)(an)(an)摩(mo)(mo)與輕(qing)叩,可(ke)迅速使痙攣的頸(jing)(jing)肌(ji)松(song)弛而止(zhi)痛(tong);②將(jiang)左(zuo)手(shou)(shou)或(huo)(huo)右(you)(you)手(shou)(shou)中(zhong)、食(shi)、無名指并攏(long),在(zai)(zai)頸(jing)(jing)部(bu)(bu)疼痛(tong)處尋找壓(ya)痛(tong)點(dian)(多在(zai)(zai)胸鎖乳突肌(ji)、斜方(fang)肌(ji)等處),由輕(qing)到(dao)(dao)重(zhong)按(an)(an)(an)揉5分鐘(zhong)(zhong)左(zuo)右(you)(you)。可(ke)左(zuo)右(you)(you)手(shou)(shou)交替進行(xing);用(yong)小魚際由肩頸(jing)(jing)部(bu)(bu)從上(shang)(shang)(shang)到(dao)(dao)下(xia),從下(xia)到(dao)(dao)上(shang)(shang)(shang)輕(qing)快迅速擊打兩(liang)分鐘(zhong)(zhong)左(zuo)右(you)(you);用(yong)拇(mu)指和食(shi)指拿捏(nie)左(zuo)右(you)(you)風池穴(xue)(xue)、肩井穴(xue)(xue)1-2分鐘(zhong)(zhong);以拇(mu)指或(huo)(huo)食(shi)指點(dian)按(an)(an)(an)落枕(zhen)穴(xue)(xue)(手(shou)(shou)背第2、3掌(zhang)(zhang)骨間,指掌(zhang)(zhang)關節(jie)后(hou)(hou)5分處),待有(you)酸(suan)張感覺(jue)時再(zai)持續2-3分鐘(zhong)(zhong);最(zui)后(hou)(hou)進行(xing)頭頸(jing)(jing)部(bu)(bu)前屈、后(hou)(hou)仰(yang)、左(zuo)右(you)(you)側(ce)(ce)偏及(ji)旋轉(zhuan)(zhuan)等活(huo)動(dong)(dong)(dong),此動(dong)(dong)(dong)作應緩(huan)(huan)慢(man)進行(xing),切(qie)不(bu)可(ke)用(yong)力過猛;③兩(liang)手(shou)(shou)同(tong)時點(dian)揉承漿、風府穴(xue)(xue)約1分鐘(zhong)(zhong),手(shou)(shou)法(fa)輕(qing)柔,然(ran)(ran)后(hou)(hou)雙手(shou)(shou)點(dian)揉患(huan)部(bu)(bu)對側(ce)(ce)之合谷、后(hou)(hou)溪穴(xue)(xue),強刺激(以病(bing)(bing)人(ren)耐受為度),同(tong)時令患(huan)者(zhe)(zhe)輕(qing)緩(huan)(huan)左(zuo)右(you)(you)扭(niu)頸(jing)(jing),盡量扭(niu)轉(zhuan)(zhuan)至(zhi)最(zui)大(da)限度,約1分鐘(zhong)(zhong),然(ran)(ran)后(hou)(hou)低頭,仰(yang)頭,活(huo)動(dong)(dong)(dong)頸(jing)(jing)部(bu)(bu)。若落枕(zhen)癥狀較輕(qing),此手(shou)(shou)法(fa)即(ji)(ji)可(ke)獲(huo)效(xiao)。頭痛(tong)嚴重(zhong)、頸(jing)(jing)部(bu)(bu)不(bu)能轉(zhuan)(zhuan)動(dong)(dong)(dong)者(zhe)(zhe),可(ke)先按(an)(an)(an)揉患(huan)側(ce)(ce)肩井穴(xue)(xue)2~3分鐘(zhong)(zhong),并囑患(huan)者(zhe)(zhe)緩(huan)(huan)緩(huan)(huan)轉(zhuan)(zhuan)動(dong)(dong)(dong)頸(jing)(jing)項(xiang),當(dang)疼痛(tong)稍減后(hou)(hou),再(zai)行(xing)治(zhi)療,效(xiao)果更佳;④自我按(an)(an)(an)摩(mo)(mo):用(yong)兩(liang)手(shou)(shou)掌(zhang)(zhang)在(zai)(zai)枕(zhen)部(bu)(bu)用(yong)力按(an)(an)(an)摩(mo)(mo),直(zhi)到(dao)(dao)局部(bu)(bu)發熱為止(zhi)。

此(ci)外,對于頸椎棘突有(you)偏歪者,還可以(yi)應用(yong)扳(ban)法,通常對于外傷型(xing)落(luo)枕更為有(you)效(xiao)。操作時用(yong)力(li)(li)要(yao)(yao)求(qiu)穩而(er)有(you)突發性(xing),以(yi)聽到有(you)彈(dan)(dan)響聲為佳,但切不可強求(qiu)有(you)彈(dan)(dan)響聲,要(yao)(yao)適可而(er)止(zhi),不能粗暴(bao)用(yong)力(li)(li)。行(xing)扳(ban)法前要(yao)(yao)明(ming)確診(zhen)斷(duan),排除骨折、脫位(wei)或(huo)腫瘤等疾病,以(yi)免造成不必(bi)要(yao)(yao)的(de)傷害。

(2)針(zhen)(zhen)灸療(liao)法(fa)針(zhen)(zhen)灸治(zhi)(zhi)療(liao)本病方(fang)法(fa)頗多,如針(zhen)(zhen)刺(ci)(ci)(ci)(ci)、指(zhi)針(zhen)(zhen)、電(dian)針(zhen)(zhen)、耳(er)穴(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)壓丸等(deng)。①針(zhen)(zhen)刺(ci)(ci)(ci)(ci)主(zhu)穴(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue):懸(xuan)鐘(zhong)、養老(lao)、后(hou)(hou)(hou)溪。配(pei)穴(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue):內(nei)關(guan)(guan)(guan)、外(wai)(wai)(wai)關(guan)(guan)(guan)、中渚、陽陵泉。治(zhi)(zhi)法(fa):以(yi)主(zhu)穴(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)為(wei)主(zhu),每(mei)(mei)次(ci)(ci)(ci)僅(jin)取(qu)一(yi)穴(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue),效欠佳(jia)時(shi),加(jia)用(yong)(yong)(yong)或(huo)(huo)改用(yong)(yong)(yong)配(pei)穴(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)。懸(xuan)鐘(zhong)穴(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue),直刺(ci)(ci)(ci)(ci)1、5~1、8寸(cun)(cun)(cun)(cun)深,用(yong)(yong)(yong)強或(huo)(huo)中等(deng)刺(ci)(ci)(ci)(ci)激(ji),得氣(qi)后(hou)(hou)(hou)留(liu)針(zhen)(zhen)15~20分(fen)(fen)(fen)(fen)(fen)鐘(zhong);養老(lao)穴(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue),針(zhen)(zhen)尖(jian)向上(shang)(shang)斜刺(ci)(ci)(ci)(ci)1、5寸(cun)(cun)(cun)(cun),使(shi)針(zhen)(zhen)感(gan)傳(chuan)至肩部(bu)(bu);后(hou)(hou)(hou)溪,直刺(ci)(ci)(ci)(ci)0、5~0、8寸(cun)(cun)(cun)(cun),得氣(qi)后(hou)(hou)(hou)捻(nian)轉運針(zhen)(zhen)1~3分(fen)(fen)(fen)(fen)(fen)鐘(zhong),亦可加(jia)電(dian)針(zhen)(zhen)刺(ci)(ci)(ci)(ci)激(ji),頻(pin)率40~50次(ci)(ci)(ci)/分(fen)(fen)(fen)(fen)(fen),連續(xu)波(bo)。配(pei)穴(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue),用(yong)(yong)(yong)常規針(zhen)(zhen)法(fa),深刺(ci)(ci)(ci)(ci),務求(qiu)得氣(qi)感(gan)強烈。在(zai)上(shang)(shang)述任一(yi)穴(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)位針(zhen)(zhen)刺(ci)(ci)(ci)(ci)時(shi),均須(xu)要求(qiu)患(huan)者(zhe)主(zhu)動活(huo)動頸(jing)(jing)部(bu)(bu),范(fan)圍由小漸(jian)大(da)(da)(da)。留(liu)針(zhen)(zhen)均為(wei)15分(fen)(fen)(fen)(fen)(fen)鐘(zhong),每(mei)(mei)日(ri)1次(ci)(ci)(ci)。或(huo)(huo)者(zhe)采(cai)用(yong)(yong)(yong)主(zhu)穴(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue):大(da)(da)(da)椎(zhui)。配(pei)穴(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue):肩井(jing)。治(zhi)(zhi)法(fa):令(ling)患(huan)者(zhe)端坐于(yu)椅上(shang)(shang),頭(tou)向前傾。取(qu)準穴(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)后(hou)(hou)(hou),針(zhen)(zhen)尖(jian)偏向患(huan)側(ce)進針(zhen)(zhen)深度約0、5~1寸(cun)(cun)(cun)(cun),使(shi)針(zhen)(zhen)感(gan)向患(huan)側(ce)頸(jing)(jing)、肩部(bu)(bu)傳(chuan)導,得氣(qi)后(hou)(hou)(hou),操作者(zhe)用(yong)(yong)(yong)一(yi)手(shou)(shou)按(an)(an)患(huan)側(ce)肩井(jing)穴(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue),讓患(huan)者(zhe)作最大(da)(da)(da)限度左右活(huo)動頸(jing)(jing)部(bu)(bu),同時(shi),另一(yi)手(shou)(shou)捻(nian)針(zhen)(zhen)3~4分(fen)(fen)(fen)(fen)(fen)鐘(zhong)。如效果不(bu)顯(xian)著,取(qu)艾條(tiao)長(chang)約5cm,插于(yu)針(zhen)(zhen)柄(bing)上(shang)(shang)點燃,至灸完后(hou)(hou)(hou)起針(zhen)(zhen),穴(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)區加(jia)拔罐10~15分(fen)(fen)(fen)(fen)(fen)鐘(zhong)。每(mei)(mei)日(ri)1次(ci)(ci)(ci);②指(zhi)針(zhen)(zhen)主(zhu)穴(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue):外(wai)(wai)(wai)關(guan)(guan)(guan)、內(nei)關(guan)(guan)(guan)、阿(a)是穴(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)。配(pei)穴(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue):風(feng)池、肩井(jing)、肩貞、養老(lao)、天柱(zhu)、風(feng)府、大(da)(da)(da)椎(zhui)、理想穴(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)。理想穴(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)位置:風(feng)池至肩井(jing)穴(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)之(zhi)(zhi)中點。治(zhi)(zhi)法(fa):主(zhu)穴(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)為(wei)主(zhu),效不(bu)佳(jia)時(shi)加(jia)配(pei)穴(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)。先輕(qing)拍(pai)或(huo)(huo)指(zhi)按(an)(an)疼痛處(chu)即(ji)(ji)阿(a)是穴(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)1分(fen)(fen)(fen)(fen)(fen)鐘(zhong)。術者(zhe)以(yi)拇指(zhi)掐壓患(huan)者(zhe)內(nei)關(guan)(guan)(guan)穴(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue),中指(zhi)或(huo)(huo)食指(zhi)抵于(yu)外(wai)(wai)(wai)關(guan)(guan)(guan)穴(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue),每(mei)(mei)次(ci)(ci)(ci)2~3分(fen)(fen)(fen)(fen)(fen)鐘(zhong),用(yong)(yong)(yong)力由輕(qing)而重(zhong),使(shi)壓力從(cong)內(nei)關(guan)(guan)(guan)透達外(wai)(wai)(wai)關(guan)(guan)(guan),患(huan)者(zhe)可有酸、麻、脹、熱感(gan),或(huo)(huo)有此類得氣(qi)感(gan)上(shang)(shang)傳(chuan)的(de)感(gan)覺。掐壓過(guo)程中,宜(yi)囑患(huan)者(zhe)左右旋轉頸(jing)(jing)部(bu)(bu)。配(pei)穴(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue),單手(shou)(shou)拿(na)(na)風(feng)池穴(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)20次(ci)(ci)(ci),雙手(shou)(shou)拿(na)(na)肩井(jing)穴(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)20次(ci)(ci)(ci),余穴(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)可采(cai)用(yong)(yong)(yong)指(zhi)壓法(fa),或(huo)(huo)上(shang)(shang)下(xia)左右推(tui)按(an)(an),每(mei)(mei)穴(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)1~2分(fen)(fen)(fen)(fen)(fen)鐘(zhong)。上(shang)(shang)述方(fang)法(fa)每(mei)(mei)日(ri)1次(ci)(ci)(ci),3次(ci)(ci)(ci)為(wei)一(yi)療(liao)程;③電(dian)針(zhen)(zhen)主(zhu)穴(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue):分(fen)(fen)(fen)(fen)(fen)2組(zu)。第(di)一(yi)組(zu)為(wei)養老(lao)、新(xin)設(she)、外(wai)(wai)(wai)關(guan)(guan)(guan)、肩中俞;第(di)二組(zu)為(wei)風(feng)池、肩井(jing)、大(da)(da)(da)椎(zhui)旁1寸(cun)(cun)(cun)(cun)、肩外(wai)(wai)(wai)俞。治(zhi)(zhi)法(fa)上(shang)(shang)穴(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)均取(qu)。應用(yong)(yong)(yong)直流感(gan)應電(dian)療(liao)機,取(qu)直徑為(wei)3厘米的(de)圓形(xing)手(shou)(shou)柄(bing)電(dian)極操作。其中陽極取(qu)第(di)1組(zu)穴(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue),陰極取(qu)第(di)2組(zu)穴(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)。通(tong)電(dian)前先輕(qing)揉(rou)穴(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)位片刻(ke),再通(tong)以(yi)感(gan)應電(dian),電(dian)量漸(jian)增大(da)(da)(da)至2~10V,以(yi)患(huan)者(zhe)能耐受為(wei)限,每(mei)(mei)次(ci)(ci)(ci)通(tong)電(dian)約3~5秒鐘(zhong)。當看到患(huan)側(ce)肌肉收(shou)縮,即(ji)(ji)改為(wei)直流電(dian)治(zhi)(zhi)療(liao),為(wei)20~40mA,每(mei)(mei)次(ci)(ci)(ci)亦通(tong)電(dian)3~5秒鐘(zhong),治(zhi)(zhi)療(liao)時(shi)令(ling)患(huan)者(zhe)作頸(jing)(jing)部(bu)(bu)活(huo)動。全部(bu)(bu)治(zhi)(zhi)療(liao)時(shi)間約5~10分(fen)(fen)(fen)(fen)(fen)鐘(zhong)。每(mei)(mei)日(ri)1次(ci)(ci)(ci),3次(ci)(ci)(ci)一(yi)療(liao)程;④耳(er)穴(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)壓丸主(zhu)穴(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue):頸(jing)(jing)、神門。治(zhi)(zhi)法(fa):雙側(ce)主(zhu)穴(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)均用(yong)(yong)(yong)。取(qu)綠(lv)豆1~2粒(li),置于(yu)以(yi)市(shi)售活(huo)血(xue)止(zhi)(zhi)痛膏或(huo)(huo)傷濕止(zhi)(zhi)痛肓剪成(cheng)的(de)1×1平(ping)方(fang)厘米的(de)方(fang)塊中,粘(zhan)貼(tie)(tie)于(yu)所選(xuan)耳(er)穴(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue),將邊(bian)緣壓緊。之(zhi)(zhi)后(hou)(hou)(hou),按(an)(an)壓該耳(er)穴(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)0、5~1分(fen)(fen)(fen)(fen)(fen)鐘(zhong),手(shou)(shou)法(fa)由輕(qing)到重(zhong),至有熱脹及疼感(gan)為(wei)佳(jia),并囑患(huan)活(huo)動頸(jing)(jing)部(bu)(bu)2~3分(fen)(fen)(fen)(fen)(fen)鐘(zhong)。要求(qiu)患(huan)者(zhe)每(mei)(mei)日(ri)自(zi)行(xing)按(an)(an)壓3次(ci)(ci)(ci),貼(tie)(tie)至痊愈后(hou)(hou)(hou)去掉(diao)。

(3)拔罐療法主(zhu)穴(xue)阿是(shi)穴(xue)。阿是(shi)穴(xue)位(wei)置:頸部壓(ya)痛最顯處。

配穴:風門、肩井。

治法:阿(a)是穴,用(yong)力揉按片(pian)刻,常(chang)規消毒后(hou),以(yi)三棱針(zhen)快速點刺3~5下,或用(yong)皮膚針(zhen)中等度叩(kou)(kou)打(da),叩(kou)(kou)打(da)面積(ji),可(ke)相當于罐(guan)具口徑。然后(hou),選(xuan)用(yong)適(shi)當口徑之罐(guan)具吸(xi)拔(ba)。配穴可(ke)取1~2個,針(zhen)刺得氣后(hou),留針(zhen),再于針(zhen)上(shang)拔(ba)罐(guan)。吸(xi)拔(ba)時間均為10~15分鐘(zhong)。起罐(guan)后(hou),可(ke)在阿(a)是穴用(yong)艾卷(juan)回旋灸5~7分鐘(zhong)。每(mei)日1次,不計療(liao)程。

2.藥物療法

本病多采用外用藥(yao)(yao)(yao)物(wu)治療(liao),如膏藥(yao)(yao)(yao)、藥(yao)(yao)(yao)膏等(deng)。膏藥(yao)(yao)(yao)多外貼(tie)頸(jing)部痛處(chu),每(mei)天(tian)更換一(yi)次(ci),止痛效果較理想,但病人自感(gan)貼(tie)膏后(hou)頸(jing)部活動受到一(yi)定限制,需(xu)注意,某(mou)些(xie)膏藥(yao)(yao)(yao)中含(han)有辛香走竄、動血(xue)滑胎之藥(yao)(yao)(yao),故孕(yun)婦忌用。藥(yao)(yao)(yao)膏可(ke)選用按摩乳、青(qing)鵬軟(ruan)膏等(deng),痛處(chu)擦揉,每(mei)天(tian)2~3次(ci),有一(yi)定效果。

二、落(luo)枕(zhen)的主要癥狀是什么

落(luo)枕(zhen)或稱“失枕(zhen)”,是一種(zhong)常見病,好發于青壯年,以冬春季多見。落(luo)枕(zhen)的(de)常見發病經過是入(ru)睡(shui)前并無任何癥狀,晨起后卻感到項(xiang)背部明顯酸痛,頸部活動受限(xian)。這(zhe)說明病起于睡(shui)眠之后,與睡(shui)枕(zhen)及睡(shui)眠姿(zi)勢有密切(qie)關(guan)系。

一、落枕的主要(yao)癥狀是什么?

典型癥狀: 起床后(hou)(hou)感覺頸后(hou)(hou)部,上背部疼痛(tong)不適,以一側(ce)為多,或(huo)有兩側(ce)俱(ju)痛(tong)者

急性(xing)頸部(bu)軟組織(zhi)損傷癥狀

大(da)多(duo)表(biao)現(xian)為(wei)單側(ce),男(nan)性(xing)略(lve)多(duo)于(yu)女(nv)性(xing)。主(zhu)要癥狀為(wei)頸部(bu)疼(teng)痛及活動受(shou)限,輕(qing)者為(wei)針(zhen)刺痛,重(zhong)者如刀割(ge)樣或撕裂樣疼(teng)痛。疼(teng)痛主(zhu)要在頸部(bu),也可(ke)以(yi)模(mo)糊地放射至(zhi)頭(tou)(tou)、背(bei)和上肢。任何活動均(jun)可(ke)加重(zhong)疼(teng)痛,以(yi)致轉頭(tou)(tou)時兩肩(jian)亦隨之轉動。皮(pi)膚無(wu)任何損傷,查體可(ke)在斜方肌等受(shou)損肌肉處有(you)明顯壓痛,范圍廣泛,有(you)時壓痛部(bu)位可(ke)多(duo)個,局部(bu)輕(qing)度腫脹,患者的頭(tou)(tou)常偏于(yu)一側(ce),故(gu)又(you)稱外傷性(xing)斜頸。神經系統檢查無(wu)陽性(xing)發現(xian)。

根據突然起病的病史,輕度的外傷史及局部體征,診斷可確定。

二、診斷

1.因睡眠姿(zi)勢不良或感(gan)受風(feng)寒后(hou)所致。

2.急性(xing)發病,睡(shui)眠后(hou)一側(ce)頸部出現疼(teng)痛(tong)(tong),酸脹,可向上肢或背(bei)部放射,活動不利,活動時傷側(ce)疼(teng)痛(tong)(tong)加(jia)劇,嚴重(zhong)者使頭部歪(wai)向病側(ce),有些病例進(jin)行(xing)性(xing)加(jia)重(zhong),甚至(zhi)累及(ji)肩部及(ji)胸背(bei)部。

3.患側常(chang)有頸肌(ji)(ji)(ji)痙攣,胸鎖(suo)乳突肌(ji)(ji)(ji)、斜方肌(ji)(ji)(ji)、菱(ling)形肌(ji)(ji)(ji)及肩胛(jia)提肌(ji)(ji)(ji)等處(chu)壓痛。在肌(ji)(ji)(ji)肉(rou)緊張處(chu)可(ke)觸及腫塊(kuai)和條索狀的改變。

三、落枕的(de)發(fa)病原(yuan)因是什么

主要病因: 睡(shui)枕,睡(shui)眠(mian)姿(zi)勢不正確

落枕病因主(zhu)要有兩個方面:一是肌(ji)肉扭(niu)傷,如夜間睡眠姿勢不良,頭頸(jing)長(chang)時(shi)間處于過度偏轉的位(wei)置;或(huo)(huo)因睡眠時(shi)枕頭不合適(shi),過高、過低或(huo)(huo)過硬(ying)(ying),使頭頸(jing)處于過伸(shen)或(huo)(huo)過屈狀(zhuang)態,均(jun)可引起頸(jing)部一側肌(ji)肉緊(jin)張(zhang),使頸(jing)椎小關節扭(niu)錯(cuo),時(shi)間較長(chang)即可發生(sheng)靜力性損(sun)傷,使傷處肌(ji)筋強硬(ying)(ying)不和,氣血運行不暢(chang),局(ju)部疼(teng)痛不適(shi),動(dong)作明(ming)顯(xian)受(shou)限等。二是感受(shou)風寒,如睡眠時(shi)受(shou)寒,盛夏(xia)貪涼,使頸(jing)背部氣血凝滯(zhi),筋絡痹阻,以致僵硬(ying)(ying)疼(teng)痛,動(dong)作不利。

著名中醫褚建飛先(xian)生(sheng)認為落(luo)枕是(shi)指(zhi)人在睡覺或外傷后突感(gan)頸部(bu)肌(ji)肉疼(teng)痛,尤以頭頸部(bu)轉(zhuan)動時更甚,引起(qi)落(luo)枕的原因有:

①睡眠時頭(tou)頸姿(zi)勢不當;

②枕頭墊得(de)過高(gao)、軟硬不當或高(gao)低不平(ping);

③頸部外傷;

④頸部受風著涼;

⑤如為(wei)頸椎病引起(qi),可反復(fu)“落(luo)枕(zhen)”。

四、預防落(luo)枕的措施是(shi)什(shen)么

1.保養

(1)用(yong)枕(zhen)(zhen)(zhen)(zhen)適當人生(sheng)的(de)(de)(de)三分之一(yi)是在床上度(du)(du)過的(de)(de)(de),枕(zhen)(zhen)(zhen)(zhen)頭的(de)(de)(de)高低軟(ruan)硬對頸(jing)(jing)(jing)椎(zhui)(zhui)(zhui)有(you)直(zhi)接影響,最佳的(de)(de)(de)枕(zhen)(zhen)(zhen)(zhen)頭應(ying)該(gai)是能(neng)支(zhi)撐(cheng)頸(jing)(jing)(jing)椎(zhui)(zhui)(zhui)的(de)(de)(de)生(sheng)理曲線(xian),并保(bao)持頸(jing)(jing)(jing)椎(zhui)(zhui)(zhui)的(de)(de)(de)平直(zhi)。枕(zhen)(zhen)(zhen)(zhen)頭要(yao)有(you)彈性穩定,枕(zhen)(zhen)(zhen)(zhen)芯(xin)(xin)以熱壓縮海綿枕(zhen)(zhen)(zhen)(zhen)芯(xin)(xin)為(wei)宜。喜歡仰臥的(de)(de)(de),枕(zhen)(zhen)(zhen)(zhen)頭的(de)(de)(de)高度(du)(du)為(wei)8厘米左右(you);喜歡側臥的(de)(de)(de),高度(du)(du)為(wei)10厘米左右(you)。仰臥位時(shi),枕(zhen)(zhen)(zhen)(zhen)頭的(de)(de)(de)下緣(yuan)最好(hao)墊在肩胛骨(gu)的(de)(de)(de)上緣(yuan),不(bu)(bu)能(neng)使頸(jing)(jing)(jing)部脫空(kong)。其實,枕(zhen)(zhen)(zhen)(zhen)頭的(de)(de)(de)真(zhen)正(zheng)名字應(ying)該(gai)叫”枕(zhen)(zhen)(zhen)(zhen)頸(jing)(jing)(jing)“。枕(zhen)(zhen)(zhen)(zhen)頭不(bu)(bu)合適,常造成落枕(zhen)(zhen)(zhen)(zhen),反復落枕(zhen)(zhen)(zhen)(zhen)往往是頸(jing)(jing)(jing)椎(zhui)(zhui)(zhui)病的(de)(de)(de)先兆,要(yao)及時(shi)診治;另外要(yao)注意的(de)(de)(de)是枕(zhen)(zhen)(zhen)(zhen)席(xi)(xi),枕(zhen)(zhen)(zhen)(zhen)席(xi)(xi)以草編為(wei)佳,竹席(xi)(xi)一(yi)則太(tai)涼,二則太(tai)硬,最好(hao)不(bu)(bu)用(yong)。

(2)頸(jing)(jing)部(bu)保暖頸(jing)(jing)部(bu)受寒冷刺激會使肌肉血管痙攣,加重(zhong)頸(jing)(jing)部(bu)板滯疼痛。在秋冬(dong)季(ji)節(jie),最好穿高領衣服;天氣稍熱,夜間睡眠時(shi)應注意防止頸(jing)(jing)肩部(bu)受涼;炎熱季(ji)節(jie),空調溫度不能太低。

(3)姿勢正(zheng)確頸(jing)椎病的主要誘因(yin)是(shi)工作(zuo)學習的姿勢不正(zheng)確,良(liang)好的姿勢能減少(shao)勞累,避免損傷。低頭(tou)時間過長,使肌(ji)肉(rou)疲勞,頸(jing)椎間盤出(chu)(chu)現(xian)老化(hua),并出(chu)(chu)現(xian)慢(man)性勞損,會繼發(fa)一系列(lie)癥狀。最佳的伏案(an)工作(zuo)姿勢是(shi)頸(jing)部保持正(zheng)直,微(wei)微(wei)地(di)前傾,不要扭(niu)轉、傾斜;工作(zuo)時間超(chao)過1小時,應該休息(xi)幾分鐘(zhong),做些頸(jing)部運(yun)動(dong)或按摩;不宜頭(tou)靠(kao)在床(chuang)頭(tou)或沙發(fa)扶手上(shang)看(kan)書、看(kan)電(dian)視。

(4)避免損(sun)傷頸(jing)(jing)部(bu)的(de)損(sun)傷也會(hui)誘發(fa)本(ben)病,除了(le)注意姿勢以外(wai),乘坐(zuo)快速(su)的(de)交通工具,遇(yu)到急剎車,頭部(bu)向(xiang)前沖(chong)去,會(hui)發(fa)生”揮鞭樣(yang)”損(sun)傷,因此,要(yao)(yao)注意保護自己,不要(yao)(yao)在車上(shang)打瞌睡,坐(zuo)座位時(shi)(shi)可(ke)適當地扭轉(zhuan)身(shen)體,側面向(xiang)前;體育比(bi)賽(sai)時(shi)(shi)更要(yao)(yao)避免頸(jing)(jing)椎(zhui)損(sun)傷;頸(jing)(jing)椎(zhui)病急性(xing)發(fa)作時(shi)(shi),頸(jing)(jing)椎(zhui)要(yao)(yao)減(jian)少活動,尤其要(yao)(yao)避免快速(su)的(de)轉(zhuan)頭,必(bi)要(yao)(yao)時(shi)(shi)用(yong)頸(jing)(jing)托(tuo)保護。

2.頸部功能鍛煉

頸(jing)椎(zhui)的(de)(de)(de)鍛煉應該慎重,要避(bi)免(mian)無目的(de)(de)(de)的(de)(de)(de)快速(su)旋轉或搖擺,尤其是頸(jing)椎(zhui)病(bing)急性期、椎(zhui)動脈型頸(jing)椎(zhui)病(bing)或脊髓型頸(jing)椎(zhui)病(bing)。我們(men)推薦的(de)(de)(de)方法簡(jian)單易行,但要達到防病(bing)治(zhi)病(bing)的(de)(de)(de)目的(de)(de)(de),必須持(chi)之以恒。

(1)頭中(zhong)(zhong)立(li)(li)(li)(li)位(wei)前屈至(zhi)(zhi)(zhi)(zhi)(zhi)極(ji)(ji)限(xian),回(hui)復(fu)(fu)到(dao)(dao)(dao)中(zhong)(zhong)立(li)(li)(li)(li)位(wei);后伸至(zhi)(zhi)(zhi)(zhi)(zhi)極(ji)(ji)限(xian),回(hui)復(fu)(fu)到(dao)(dao)(dao)中(zhong)(zhong)立(li)(li)(li)(li)位(wei);左旋至(zhi)(zhi)(zhi)(zhi)(zhi)極(ji)(ji)限(xian),回(hui)復(fu)(fu)到(dao)(dao)(dao)中(zhong)(zhong)立(li)(li)(li)(li)位(wei);右旋至(zhi)(zhi)(zhi)(zhi)(zhi)極(ji)(ji)限(xian),回(hui)復(fu)(fu)到(dao)(dao)(dao)中(zhong)(zhong)立(li)(li)(li)(li)位(wei);左側(ce)屈至(zhi)(zhi)(zhi)(zhi)(zhi)極(ji)(ji)限(xian),回(hui)復(fu)(fu)到(dao)(dao)(dao)中(zhong)(zhong)立(li)(li)(li)(li)位(wei);右側(ce)屈至(zhi)(zhi)(zhi)(zhi)(zhi)極(ji)(ji)限(xian),回(hui)復(fu)(fu)到(dao)(dao)(dao)中(zhong)(zhong)立(li)(li)(li)(li)位(wei)。動作宜(yi)緩慢(man),稍稍用力。鍛煉時,有(you)的(de)病人頸部可(ke)感覺到(dao)(dao)(dao)響聲,如(ru)果(guo)伴有(you)疼(teng)痛,應減(jian)少鍛煉的(de)次數或(huo)停止鍛煉;如(ru)果(guo)沒有(you)疼(teng)痛,則可(ke)以繼續鍛煉。

(2)頭中立位雙手十(shi)指相(xiang)叉(cha)抱在頸后,頭做緩慢的(de)前(qian)屈和后伸運(yun)動(dong),與(yu)此同(tong)時,雙手用(yong)力(li)對抗頭的(de)運(yun)動(dong),以鍛煉(lian)頸椎后側的(de)肌(ji)肉(rou)力(li)量。

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