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搬东西姿势学对了，腰就不疼了吗

2 条依据 · 约 650 字 · 出处逐条列出

先算搬的量：一次搬多重、一天搬几趟，能拆就拆、能推车就推；把护腰课和护腰带停掉，别再为搬东西时腰弯没弯较劲。上过搬运姿势培训的工人，后来腰痛的并不比没上过的少；和腰痛有关的是搬得重、搬得多，每次多搬10公斤或每天多搬10次，风险高约一成，平时规律锻炼的人发作少三成多到四成多。

这里不保证什么

手法照做没坏处，但这几处都只是关联证据，还说不成定论；膝盖退化疼也一样，先练腿和减重，别急着上关节镜。

展开看依据2 条 · 点标题进原条目

不要指望学会「正确搬运姿势」、上搬运培训就能防腰痛，要减的是搬的重量和次数，平时多锻炼

上过搬运姿势培训的工人，后来腰痛的并不比没上过的少。搬东西时腰弯得多的人，也没看出更容易腰痛。和腰痛有关的是搬得重、搬得多，每次多搬 10 公斤或每天多搬 10 次，风险高约一成。平时规律锻炼的人，腰痛发作少三成多到四成多。

  • 先算搬的量：一次搬多重的、一天搬几趟，能拆就拆、能推车就推
  • 把护腰课和护腰带停掉，别再为搬东西时腰弯没弯较劲
  • 每周排几次锻炼，力量加走路，先排进日历再练

坑培训那篇的可信范围很宽，「少搬重物」也只有关联证据；手法照做没坏处，但这几处都还说不成定论。

成本：不花钱。不用再为搬东西时腰弯没弯较劲，也不用为护腰课和护腰带花钱。要做的是两件事。重的东西拆开搬、用推车或找人一起搬，这只多花几分钟。每周抽几次时间锻炼，这要长期坚持。第 6 节 · 反面清单

出处

Verbeek JH, Martimo KP, Karppinen J, Kuijer PP, Viikari-Juntura E, Takala EP. (2011). Manual material handling advice and assistive devices for preventing and treating back pain in workers. Cochrane Database of Systematic Reviews, CD005958. <https://doi.org/10.1002/14651858.CD005958.pub3>；Saraceni N, Kent P, Ng L, Campbell A, Straker L, O'Sullivan P. (2020). To Flex or Not to Flex? Is There a Relationship Between Lumbar Spine Flexion During Lifting and Low Back Pain? A Systematic Review With Meta-analysis. Journal of Orthopaedic & Sports Physical Therapy, 50(3), 121–130. <https://doi.org/10.2519/jospt.2020.9218>；Coenen P, Gouttebarge V, van der Burght AS, et al. (2014). The effect of lifting during work on low back pain: a health impact assessment based on a meta-analysis. Occupational and Environmental Medicine, 71(12), 871–877. <https://doi.org/10.1136/oemed-2014-102346>；Steffens D, Maher CG, Pereira LS, et al. (2016). Prevention of Low Back Pain: A Systematic Review and Meta-analysis. JAMA Internal Medicine, 176(2), 199–208. <https://doi.org/10.1001/jamainternmed.2015.7431>；Health and Safety Executive. Manual handling at work: Training; Good handling technique. <https://www.hse.gov.uk/msd/manual-handling/training.htm>；<https://www.hse.gov.uk/msd/manual-handling/good-handling-technique.htm>；反方：Wai EK, Roffey DM, Bishop P, Kwon BK, Dagenais S. (2010). Causal assessment of occupational lifting and low back pain: results of a systematic review. The Spine Journal, 10(6), 554–566. <https://doi.org/10.1016/j.spinee.2010.03.033>

不要因为中老年人膝盖慢慢疼起来（骨关节炎、退化性半月板撕裂）就做关节镜清理或切半月板，先减重、练大腿肌肉

膝盖退化疼的中老年人，做关节镜清理或切掉一块半月板，并不比假手术强。假手术只在皮肤上划几个口子，做完的人疼痛和走路却和真手术差不多。好处最多撑几个月，还可能招来腿上的血栓。坚持练腿能让膝盖少疼，超重的人再减重，疼得更少。

  • 先问医生一句：不做手术，先练腿和减重，可以观察多久
  • 每周安排几次练大腿和臀部，最好先请康复科或理疗师教一套
  • 超重的把体重减下来，两三个月复评一次疼和走路

坑国内 2018 版指南说法不同，认为带游离碎骨、半月板移位这类机械症状的人清理效果较好；这处分歧还没结。

成本：不花手术钱，也省下术后 2 到 6 周的恢复期。要做的是长期练大腿和臀部的肌肉，每周几次，最好先请康复科医生或理疗师教一套。超重的人还要少吃多动、把体重减下来。难在练和减重都见效慢，手术听起来一次就能解决。第 6 节 · 反面清单

出处

Moseley JB, O'Malley K, Petersen NJ, et al. (2002). A controlled trial of arthroscopic surgery for osteoarthritis of the knee. New England Journal of Medicine, 347(2), 81–88. <https://doi.org/10.1056/NEJMoa013259>；Kirkley A, Birmingham TB, Litchfield RB, et al. (2008). A randomized trial of arthroscopic surgery for osteoarthritis of the knee. New England Journal of Medicine, 359(11), 1097–1107. <https://doi.org/10.1056/NEJMoa0708333>；Sihvonen R, Paavola M, Malmivaara A, et al. (2013). Arthroscopic partial meniscectomy versus sham surgery for a degenerative meniscal tear. New England Journal of Medicine, 369(26), 2515–2524. <https://doi.org/10.1056/NEJMoa1305189>；Thorlund JB, Juhl CB, Roos EM, Lohmander LS. (2015). Arthroscopic surgery for degenerative knee: systematic review and meta-analysis of benefits and harms. BMJ, 350, h2747. <https://doi.org/10.1136/bmj.h2747>；Siemieniuk RAC, Harris IA, Agoritsas T, et al. (2017). Arthroscopic surgery for degenerative knee arthritis and meniscal tears: a clinical practice guideline. BMJ, 357, j1982. <https://doi.org/10.1136/bmj.j1982>；Kise NJ, Risberg MA, Stensrud S, et al. (2016). Exercise therapy versus arthroscopic partial meniscectomy for degenerative meniscal tear in middle aged patients: randomised controlled trial with two year follow-up. BMJ, 354, i3740. <https://doi.org/10.1136/bmj.i3740>；Fransen M, McConnell S, Harmer AR, et al. (2015). Exercise for osteoarthritis of the knee. Cochrane Database of Systematic Reviews, CD004376. <https://doi.org/10.1002/14651858.CD004376.pub3>；Messier SP, Mihalko SL, Legault C, et al. (2013). Effects of intensive diet and exercise on knee joint loads, inflammation, and clinical outcomes among overweight and obese adults with knee osteoarthritis: the IDEA randomized clinical trial. JAMA, 310(12), 1263–1273. <https://doi.org/10.1001/jama.2013.277669>；反方：中华医学会骨科学分会关节外科学组 (2018). 骨关节炎诊疗指南（2018年版）（四、治疗 （三）手术治疗 2．关节镜清理术）. 中华骨科杂志, 38(12), 705–715. <https://doi.org/10.3760/cma.j.issn.0253-2352.2018.12.001>（全文 <https://cmab.yiigle.com/uploads/guide_html/%E9%AA%A8%E5%85%B3%E8%8A%82%E7%82%8E%E8%AF%8A%E7%96%97%E6%8C%87%E5%8D%97%EF%BC%882018%E5%B9%B4%E7%89%88%EF%BC%89.html>）

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