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1、腰背痛腰背痛的原因椎间盘源性纤维环破裂髓核压迫纤维环内的c纤维炎性因子刺激神经临床特点腰背痛的原因小关节源性小关节功能紊乱小关节退行性变小关节的神经支配脊神经背支内侧支临床表现小关节源性腰背疼痛的疼痛分布范围腰背痛的神经阻滞疗法ESI椎间盘源性腰背痛腰椎小关节注射、内侧支阻滞腰椎小关节注射、内侧支阻滞骶髂关节综合症背痛臀部大腿部疼痛偶尔有类似坐骨神经痛现象不能长时间保持某一坐姿症状复杂，诊断困难骶髂关节体格检查Gaenslen'stestisperformedwiththepatientsupine(on
2、theback).Thehipjointismaximallyflexedononesideandtheoppositehipjointisextended.Thismaneuverstressesbothsacroiliacjointssimultaneously.骶髂关节体格检查Yeoman'steststressesthesacroiliacjointbyextendingthelegandrotatingtheilium.Apositivetestproducespainoverthebackof
3、thesacroiliacjoint.骶髂关节体格检查Patrick'steststressesthehipandsacroiliacjoints.Apositivetestproducesback,buttocks,orgroinpain.骶髂关节阻滞腰腿痛的神经阻滞治疗椎间盘突出脊神经根受刺激腰神经根受压的疼痛分布腰腿痛的神经阻滞治疗ESI椎旁神经阻滞选择性神经根阻滞selectivenerverootblock选择性神经根阻滞selectivenerverootblockS1block椎管狭窄、椎间
4、孔狭窄椎体滑脱梨状肌综合症SpinalRegionReferralAreaConditionMimickedUpperCervicalSpine(neck)C1-C4Backofthehead(occiput),backoftheshoulders,angleofthejaw,faceHeadaches,migraines,jawproblems,trigeminalneuralgia,tensionintheshouldersMiddle/LowerCervicalSpine(neck)C5-C8Arm
5、s,forearms,handsandfingersTrappednerveintheneck,tenniselbow,golfer'selbow,frozenshoulderUpperThoracicSpine(abovethebra-strap)T1-T4Paininthearms,frontoftheupperchest,upperribsTrappednerveintheneck,angina,breathingdifficultiesandotherchestcomplaintsMiddleTh
6、oracicSpine(atthebra-strap)T5-T8Upperabdomen,middleribsStomachulcer,gallbladderproblems,trappedwind,indigestion,breathingdifficultiesandotherchestcomplaintsLowerThoracicSpine(belowthebra-strap)T9-T12Lowerabdomen,lowerribs,pelvisandsexualorgansIrritablebow
7、eldisorder,pelvicpain,periodpain,paininthesexualorgansUpperLumbarSpineL1-L3Groin,frontoftheupperthighTrappednerveintheback,groinandthighproblems,hipandkneeproblemsLowerLumbarSpineL4-L5Frontoftheinnerandoutershinbone,topofthefootSciatica,shinandfootproblem
8、sSacrumS1-S4Buttocks,perineumPelvicpain,coccydyniaPainTypeDiagnosisTreatmentSimpleSpinalPainSimpleSprain,MuscleSpasm,SegmentalSpinalDysfunctionAcupuncture,TENS,Exercises,ManipulationComplexSpinalPain(inadditiontotho
