Coppieters Michel W, Bartholomeeusen Katrien E, Stappaerts Karel H
Department of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Australia.
J Manipulative Physiol Ther. 2004 Nov-Dec;27(9):560-8. doi: 10.1016/j.jmpt.2004.10.006.
To discuss the diagnosis and treatment of a patient with cubital tunnel syndrome and to illustrate novel treatment modalities for the ulnar nerve and its surrounding structures and target tissues. The rationale for the addition of nerve-gliding techniques will be highlighted.
Two months after onset, a 17-year-old female nursing student who had a traumatic onset of cubital tunnel syndrome still experienced pain around the elbow and paresthesia in the ulnar nerve distribution. Electrodiagnostic tests were negative. Segmental cervicothoracic motion dysfunctions were present which were regarded as contributing factors hindering natural recovery.
After 6 sessions consisting of nerve-gliding techniques and segmental joint manipulation and a home exercise program consisting of nerve gliding and light free-weight exercises, a substantial improvement was recorded on both the impairment and functional level (pain scales, clinical tests, and Northwick Park Questionnaire). Symptoms did not recur within a 10-month follow-up period, and pain and disability had completely resolved.
Movement-based management may be beneficial in the conservative management of cubital tunnel syndrome. As this intervention is in contrast with the traditional recommendation of immobilization, comparing the effects of both interventions in a systematic way is an essential next step to determine the optimal treatment of patients with cubital tunnel syndrome.
探讨一名肘管综合征患者的诊断与治疗，并阐述针对尺神经及其周围结构和靶组织的新型治疗方式。将重点强调增加神经滑动技术的基本原理。
一名17岁女性护理专业学生，创伤性肘管综合征发病两个月后，肘部周围仍有疼痛，尺神经分布区有感觉异常。电诊断测试为阴性。存在节段性颈胸运动功能障碍，被认为是阻碍自然恢复的因素。
经过6次由神经滑动技术和节段性关节手法治疗组成的治疗，以及一个由神经滑动和轻度自由重量练习组成的家庭锻炼计划后，在损伤和功能水平（疼痛量表、临床检查和诺斯威克公园问卷）上均有显著改善。在10个月的随访期内症状未复发，疼痛和功能障碍已完全消除。
基于运动的管理方法可能对肘管综合征的保守治疗有益。由于这种干预与传统的固定建议相反，以系统的方式比较两种干预措施的效果是确定肘管综合征患者最佳治疗方法的关键下一步。
