Siddiq Md Abu Bakar, Jahan Israt, Masihuzzaman Sam
Physical Medicine and Rheumatology, Brahmanbaria Medical College, Brahmanbaria, Bangladesh.
Department of Biochemistry and Biotechnology, University of Science and Technology, Chittagong, Bangladesh.
Curr Rheumatol Rev. 2018;14(3):279-283. doi: 10.2174/1573397113666170310100851.
Wallet neuritis is an example of extra-spinal tunnel neuropathy concerning sciatic nerve. Its clinical appearance often gets confused with sciatica of lumbar spine origin. Wallet- induced chronic sciatic nerve constriction produces gluteal and ipsilateral lower extremity pain, tingling, and burning sensation. It was Lutz, first describing credit-card wallet sciatica in an Attorney, surfaced on Journal of American Medical Association (JAMA), 1978; however, the condition has not been well-studied in various other occupations.
In this write-up, we take the privilege of demonstrating wallet neuritis as an example of peripheral sensitization in three different professionals' namely specialist doctor, driver, and banker first time in Bangladesh. All the three patients' demonstrated aggravated gluteal pain with radiation on the homo-lateral lower extremity while remained seated on heavy wallet for a while, fortunately improved discontinuing such stuff with. Alongside radical wallectomy, piriformis stretching exercise on the affected side had also been recommended and found worthy in terms of pain relief.
long-standing use of rear pocket wallet may compress and sensitize ipsilateral sciatic nerve, generating features resembling lumbago sciatica; thereby, remains a source of patients' misery and diagnostic illusion for pain physicians as well.
钱包神经炎是坐骨神经的椎管外隧道神经病变的一个例子。其临床表现常与腰椎源性坐骨神经痛相混淆。钱包引起的慢性坐骨神经受压会导致臀部和同侧下肢疼痛、刺痛和烧灼感。1978年,卢茨首次在美国医学会杂志(JAMA)上描述了信用卡钱包导致的坐骨神经痛;然而,这种情况在其他各种职业中尚未得到充分研究。
在本报告中,我们有幸首次在孟加拉国展示了钱包神经炎作为三种不同职业(专科医生、司机和银行家)外周敏化的一个例子。所有三名患者在长时间坐在厚重钱包上时,均表现出臀部疼痛加剧并向同侧下肢放射,幸运的是,停止使用此类物品后疼痛有所改善。除了彻底切除钱包外,还建议对患侧进行梨状肌伸展运动,并且发现这在缓解疼痛方面是有价值的。
长期使用后袋钱包可能会压迫并使同侧坐骨神经致敏,产生类似腰腿痛的症状;因此,这仍然是患者痛苦的根源,也是疼痛科医生诊断错觉的来源。