跌一下，屁股痛很久 (by 王凱平醫師)
你有沒有過這個經驗？一個失足落地撞到尾椎，之後屁股就痛很久，想坐也坐不好，躺也躺得不舒服，久站久走也常常腰和屁股還有大腿都疼痛。這有可能是今天要討論的主題：「薦髂關節疼痛症候群」。
薦髂關節疼痛症候群又稱做薦髂關節功能障礙 (SI Joint Dysfunction)。遇到這個問題很衰，因為症狀會很像椎間盤突出、坐骨神經痛，常常復健做了好很久都沒有效果，MRI核磁共振也不一定找得到原因。
其實薦髂關節疼痛症候群並不是什麼神秘的東西，之所以難治療，是因為薦髂關節被很多韌帶包覆、連接著，通常相當穩定，所以容易被被忽略它其實是個「可以小幅度活動的微動關節」！
因為可以小幅度活動，所以如果撞擊到薦髂關節時，除了可能讓關節本身和周圍的韌帶受傷之外，也可能有些微的錯位。當應該要穩定的薦髂關節變得不穩定時，走路、坐、站都很容易拉扯到關節，讓它復原緩慢，甚至演變成長期疼痛。
薦髂關節疼痛症候群和坐骨神經痛等問題分辨的方法也很簡單，那就是去擠壓薦髂關節時會痛。其實常常還沒檢查，患者自己說「一坐下或躺下，一碰到這裡就會痛！」那就有很高的機率是薦髂關節疼痛症候群了。
屁股痛的治療
瞭解原因後，治療的方法可以三管齊下，分別是「止痛」、「加速傷害修復」、「增加關節穩定性」這三管。止痛無法治本，但是可以讓患者比較舒服、肌肉比較放鬆不警戒。針灸、局部止痛注射、物理治療的儀器治療都是不錯的方法。
要如何加速薦髂關節附近韌帶的修復呢？因為韌帶血液經過比較少，所以復原通常較慢一些。這邊建議可以用葡萄糖增生注射，或是使用PRP自體血小板注射，經驗上來說都有不錯的效果。
修復之後要增加關節的穩定性，建議可以做一些臀部的訓練、搭配一些肌內效貼布貼紮。大部分來說2到3週就會有治療效果，通常1到2個月內可以康復。
合作撰寫：
好痛痛(粉絲頁) 、 王凱平醫師 (專欄頁面) (粉絲頁) (部落格)
好痛痛的運動傷害書籍，集結 2 位醫師、6 位物理治療師、2 位運動教練一起教你如何預防/處理運動傷害 (博客來連結) (誠品連結)
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She is our beloved family dog and this is her 1st litter.
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They will have their vet check, 1st vaccinations and microchip.
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