不痛就沒事? 錯!僵直性脊椎炎不只讓你痛!

運動筆記   udn聯合新聞網 發表於2017/08/21

 

2017-08-21 10:00:00 聯合線上企劃 諮詢專家:馬偕紀念醫院過敏風濕免疫科主任李修身醫師

僵直性脊椎炎不只帶來疼痛長期發炎還會造成脊椎骨沾黏、僵硬、行動不便等後果(圖片來源:123RF)

 

「反正這病也治不好,只要不痛就行了,一直吃藥會有副作用!」

 

隨著健保實施、藥物進步及衛教宣導,提升了僵直性脊椎炎的治療成效,但門診中還是會遇到誤以為「反正治不好」、「不痛就算了」,導致病情控制不佳的病友。

 

馬偕紀念醫院過敏風濕免疫科主任李修身醫師強調,僵直性脊椎炎不只帶來疼痛,有些病人自我感覺「並不是很痛,不用吃藥,去做做復健就好。」其實長期發炎還會造成脊椎骨沾黏、僵硬、行動不便等後果。李修身醫師強調,「痛」絕不是僵直性脊椎炎唯一的治療指標,據研究顯示,持續性的藥物治療可降低產生沾黏等現象,因此當症狀改善時可以在醫師指導下調整藥量,但絕不可隨意停藥。

 

「僵直性脊椎炎多是年輕病人,我遇過才 19 歲就坐著輪椅來看診的男孩,發炎指數高,膝蓋、下背、腳踝關節都腫起來。」而在接受治療 3 個月後,男孩就能恢復正常生活了。李修身強調,免疫風濕疾病的治療在近年來有來突破性的治療成果,但很多病人仍害怕長期使用藥物會有副作用,事實上與僵直性脊椎炎不好好治療所帶來的病痛相比,藥物產生副作用的機率相對較輕,而且不是每個人都會發生,怕副作用而拒絕用藥,可說是因噎廢食,只會讓病情變得更嚴重。

 

值得注意的是,僵直性脊椎炎並不容易確診。李修身有位病人輾轉求醫 5 年才找到答案,「可惜在門診時發現他的症狀已經從腰椎蔓延到頸椎,脖子都感覺僵硬,不太能動了。」雖然治療可以大幅改善疼痛、僵硬、活動不便等症狀,但若骨頭已發生沾黏是無法消失、軟化的;李修身提醒,僵直性脊椎炎最大的特色是症狀愈不動愈嚴重,所以在睡到半夜和早晨起床時特別痛苦,身體僵硬、起不了床,動一動反而比較舒服;和一般拉傷、扭傷愈動愈痛正好相反。

 

也有些病人沒有腰痠背痛,或是疼痛在可忍受範圍內而忽略了,而是非典型的腳跟腫痛、足底筋膜炎、虹彩炎等症狀;除了有賴醫師的診斷,病人若有僵直性脊椎炎家族史,建議諮詢免疫風濕專科醫師,以便早期診斷、治療。

 

 

 

資料來源:udn聯合新聞網

*健康知識 盡在運動筆記*


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