摘要
此案例討論的20歲女性患者，因自學瑜珈及跳舞造成髖關節及腰背部反覆疼痛，行走數分鐘或久坐時自覺髖關節處有刺痛感並伴隨下背部痠痛，於西醫復健科復健一年未有明顯改善，故轉至中醫門診尋求治療。患者於西醫復健科就診檢查並未發現骨盆及髖關節處有明顯骨折或異常之處，診斷為：1.髖部扭傷(S73199A)、2.髖部關節攣縮(M24559)、3.腰椎椎間盤疾患(M5186)。一般而言，髖關節的前側肌肉（內收肌、髂腰肌、縫匠肌、股直肌及內轉肌）會因任何形式的運動而扭傷或拉傷。髖關節的疼痛可能來自於腰椎、髖關節或是薦髂關節。然而當動作發生疼痛時，較常見的情形是來自肌腱發炎或肌肉拉傷，如：股直肌肌腱炎、髂腰肌肌腱炎、縫匠肌肌腱炎。本病一般癒後良好，約二至三週可痊癒，若久治不癒，髖關節功能進行性障礙，則應注意與股骨頭骨骺炎、髖關節結核等相鑒別。然而該患者經過一年復健未癒，影像學檢查亦無明顯異常。後接受中醫治療：藥薰、熱敷、針灸，每週就診一次。髖關節刺痛感及腰部痠痛不適感於中醫針灸治療第一個月內即有明顯改善。兩個月後活動度增加，疼痛感維持第一個月的狀況。三個月後疼痛感持續減輕，活動幅度範圍持續改善。整體回復狀況及進程相當良好。
並列摘要
This is a case about a 20-year-old female, who suffered from hip joints discomfort and lower back pain because of practicing yoga and dancing. Walking for a few minutes or being sedentary would induce stabbing pain in her hip and soreness over her lower back area. There was no significant improvement in her hip pain after one year of rehabilitation, so she came to the outpatient clinic of Chinese medicine asking for help. According to the examination report of the physiatrist, there were no bone fractures or other abnormal findings in pelvic or hip region. She was diagnosed with 1. Other sprain of unspecified hip, initial encounter (S73.199A), 2. Contracture, unspecified hip (M24.559), and 3. Other intervertebral disc disorders, lumbar region (M51.86). Average speaking, sprains or strains can happen in muscles like, adductors, iliopsoas, sartorius, rectus femoris, and internal rotators, nearby the hip joint in any kind of exercise. Hip pain can be originated from lumbar spine, sacroiliac joint or hip joint. However, if pain occurs when exercising, it is commonly considered to be muscle strain or tendinitis. The prognosis of muscle strain is usually favorable. It can be fully recovered in two to three weeks. Epiphysitis of femur, and tuberculosis of hip should be ruled out, if overall function of hip keeps deteriorating. The patient had little progress after one year of rehabilitation, and there were no significant findings in imaging examination. Then she received acupuncture treatments including, herbal fumigation, hot packing, moxibustion on needle, and acupuncture with electrical stimulation, once a week. Phenomenal improvements of hip and lower back discomfort were seen in the first month of acupuncture therapy. Range of motion(ROM) increased in the second month. Pain scale and ROM of the hip joint improved consistently in the third month. The patient responded well to acupuncture therapy and had good progress in her recovery.