摘要
肌筋膜疼痛症候群是臨床診療當中相當常見的病況，它是以肌筋膜激痛點的存在為特徵。激痛點是存在於骨骼肌肉纖維裡之緊繃肌帶上的過度敏感小點。一般而言，在考量以較為侵襲性的方式(如注射或手術)來治療活動性激痛點之前，應該先以較為保守性的方式(非侵襲性的物理治療)來做治療。肌筋膜激痛點之最為重要的治療策略，是找出造成活化出激痛點的致病因子，並且治療其潛在的病理學變化。如果潛在的病因性損傷沒有被適當地予以治療，那麼肌筋膜激痛點就沒有辦法被充分地去活化，或是只能暫時性地被去活化。在這篇文獻裡，我們基於文獻的回顧與臨床的經驗，回顧了對於肌筋膜激痛點之各種不同的物理治療方式。這些治療的方式，包括：機械性的方式(如徒手治療、噴療與牽拉、按摩、鬆動術、空針穿刺、治療性運動...等)，溫熱療法，冰冷療法，電治療法，與雷射療法。臨床實務中常見到的，是同時結合使用上述兩種或是更多種的治療方式。本文對於每一種治療方式的基本原理、與其臨床上的應用，都做了討論。
並列摘要
Myofascial pain syndrome is very common in clinical practice. It is characterized by the existence of myofascial trigger points (MTrPs), which is a hypersensitive spot in a taut band of skeletal muscle fibers. In general, active MTrPs should be treated conservatively (non-invasive treatments including physical therapy) prior to the consideration of aggressive therapy (invasive treatments including injection and surgery). The most important strategy of MTrP therapy is to find out the etiological lesion that causes the activation of MTrPs and to treat the underlying pathology. If the treatment of underlying etiological lesion is not appropriate, the MTrP cannot be inactivated completely, or can only be temporarily inactivated. In this article, we reviewed various methods of physical therapy for MTrPs based on the literature and our clinical experiences. These treatments included mechanical approach (manual therapy, spray and stretch, massage, manipulation, dry needling, therapeutic exercise, etc.), thermotherapy, cryotherapy, electrotherapy, and laser therapy. Combination of two or more methods listed above is commonly used in clinical practice. The basic principle and clinical application for each treatment were also discussed.
延伸閱讀
- 洪章仁（2002）。肌激痛點之臨床現象。當代醫學，(350)，982-983。https://doi.org/10.29941/MT.200212.0007
- 洪章仁（2003）。肌激痛點之物理治療法。當代醫學，(355)，383-385。https://doi.org/10.29941/MT.200305.0012
- Kuan, T. S., Chen, S. M., Chen, J. T., & Hong, C. Z. (1998). 肌筋膜引痛點的基本單元. 中華民國復健醫學會雜誌, 26(4), 161-168. https://www.airitilibrary.com/Article/Detail?DocID=10253009-199812-26-4-161-168-a
- Hong, C. Z., Jou, E. M. F., Kuan, T. S., Chen, S. M., & Chen, J. T. (2003). 肌筋膜激痛點的診斷. 中華民國復健醫學會雜誌, 31(1), 1-12. https://www.airitilibrary.com/Article/Detail?DocID=10253009-200303-31-1-1-12-a
- 陳嘉弘、陳孟泰、林嘉敏（2014）。缺血性加壓手法治療肌筋膜激痛點之立即效益。醫學與健康期刊，3(1)，67-75。https://www.airitilibrary.com/Article/Detail?DocID=23046856-201403-201406060042-201406060042-67-75