Department of Physical Medicine and Rehabilitation, Mayo Clinic Sports Medicine Center, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Clin Sports Med. 2010 Jul;29(3):437-57. doi: 10.1016/j.csm.2010.03.002.
Nerve entrapment represents an uncommon but important cause of lower limb pain among runners. This article reviews the diagnosis and management of several nerve entrapment syndromes that may be encountered among runners, but clinicians must be aware that any peripheral nerve may be affected. Successful diagnosis and management are predicated on several underlying principles: (1) maintain a high index of suspicion for neurologic syndromes, (2) recognize common presentations of neuropathic pain, (3) perform a meticulous physical examination, including postexercise examination when necessary, (4) consider a broad differential diagnosis (neurologic and nonneurologic), (5) use diagnostic testing appropriately, and (6) make rational clinical decisions, including referral for second opinion when indicated. A thorough knowledge of neuroanatomy and running biomechanics allows the clinician to successfully apply these principles to almost all clinical scenarios.
神经卡压是跑步者下肢疼痛的一种不常见但重要的原因。本文回顾了几种可能发生在跑步者身上的神经卡压综合征的诊断和治疗，但临床医生必须意识到任何外周神经都可能受到影响。成功的诊断和治疗基于以下几个基本原则：（1）对神经综合征保持高度怀疑，（2）认识到神经性疼痛的常见表现，（3）进行细致的体格检查，包括必要时的运动后检查，（4）考虑广泛的鉴别诊断（神经和非神经），（5）适当使用诊断测试，（6）做出合理的临床决策，包括在必要时转介以获得第二意见。对神经解剖学和跑步生物力学的透彻了解使临床医生能够成功地将这些原则应用于几乎所有临床情况。
