Escaloni James, Young Ian, Loss Justin
KORT Physical Therapy, Versailles, KY, USA.
CORA Physical Therapy, Savannah, GA, USA.
J Man Manip Ther. 2019 Feb;27(1):54-61. doi: 10.1080/10669817.2018.1514355. Epub 2018 Sep 14.
: Plantar foot pain of neural origin is a challenging diagnosis to identify and treat. The purpose of this paper is to illustrate the novel way in which cupping was utilized in conjunction with neural glides to better diagnose and manage a patient who presented with symptoms of peripheral neuropathic plantar foot pain. : A 65-year-old male presented to physical therapy with the diagnosis of plantar fasciitis by an orthopedic surgeon. The presentation included a diffuse area of pain toward the medial border of the foot with a peripheral neuropathic pain description. Cupping was used to identify pain in the saphenous nerve distribution and aided in resolving symptoms with the concomitant use of lower quarter neural glides. : At discharge and 1-year follow-up, the patient had a full resolution of symptoms and a return to prior level of function. Self-report outcomes included the numeric pain rating scale and the lower extremity functional scale. : This case is the first to describe the use of cupping combined with neural glides in the diagnosis and management of peripheral neuropathic pain from the saphenous nerve that was previously diagnosed as plantar fasciitis. The proposed mechanisms behind this treatment are also reviewed. : In patients that present with symptoms of plantar fasciitis, testing neural glides combined with cupping may be warranted to confirm or refute the presence of a peripheral neuropathic pain source. Further studies are necessary to determine the mechanisms and further utility of the combined interventions in well controlled trials. : Level IV.
神经源性足底疼痛的诊断和治疗颇具挑战性。本文旨在阐述一种新颖的方法,即拔罐结合神经松动术,以更好地诊断和管理一名表现为周围神经性足底疼痛症状的患者。
一名65岁男性因骨科医生诊断为足底筋膜炎而前来接受物理治疗。其症状包括足部内侧缘弥漫性疼痛,并伴有周围神经性疼痛的描述。通过拔罐来确定隐神经分布区域的疼痛,并在同时进行下肢神经松动术时辅助缓解症状。
在出院时和1年随访时,患者症状完全缓解,功能恢复到先前水平。自我报告的结果包括数字疼痛评分量表和下肢功能量表。
该病例首次描述了拔罐结合神经松动术在诊断和管理先前被诊断为足底筋膜炎的隐神经周围神经性疼痛中的应用。同时还对这种治疗背后的潜在机制进行了综述。
对于出现足底筋膜炎症状的患者,可能有必要进行神经松动术结合拔罐测试,以确认或排除周围神经性疼痛源的存在。需要进一步的研究来确定联合干预措施在严格对照试验中的机制和进一步的实用性。
四级。