Jefferson-Falardeau Justin, Houle Sébastien
Practice of Chiropractic, Clinique Expression Santé, Rosemere, Québec, Canada.
Practice of Chiropractic, Magog, Québec, Canada.
J Chiropr Med. 2019 Dec;18(4):327-334. doi: 10.1016/j.jcm.2019.07.003. Epub 2020 Jul 29.
This report describes the case of a patient with chronic radial nerve entrapment symptoms managed with chiropractic care. We propose a complementary functional neurologic assessment of muscle function in different positions that could reveal muscle dysfunctions absent with standard test position.
A 45-year-old man presented to a private chiropractic clinic with a throbbing pain 5 cm above the right lateral elbow epicondyle radiating onto the back of the lower arm and increasing after using a mouse when working on a computer. A Mill test and a Cozen test created pain near the lateral epicondylitis. The use of complementary functional neurologic assessment for radial nerve entrapment showed changes in manual muscle testing after tests were done in different positions to increase the compression on the nerve.
Chiropractic management was performed, including myofascial therapy, spinal and proximal radioulnar joint adjustments, neural mobilization, and the use of a splint. After 7 days (2 treatments), the patient showed no elbow pain even if he worked on his computer using a mouse. After a 2-year follow-up, no recurrence was reported.
In this case of radial nerve entrapment symptoms, the patient benefited from chiropractic management using standard chiropractic, applied kinesiology, and neural mobilization techniques. The complementary functional neurologic assessment of radial nerve entrapment proposed revealed muscles dysfunctions absent with the standard test position. These changes in manual muscle testing were useful to determine the possible sites of entrapment in order to direct the therapeutic efforts to these locations.
本报告描述了一名患有慢性桡神经卡压症状的患者接受整脊治疗的病例。我们提出一种对不同体位肌肉功能进行补充性的功能神经学评估,这可能会揭示在标准测试体位下未出现的肌肉功能障碍。
一名45岁男性前往一家私人整脊诊所就诊,其右外侧肘上髁上方5厘米处有搏动性疼痛,向下臂背部放射,在使用电脑鼠标工作后加重。米氏试验和科曾试验在外侧肱骨髁炎附近引发疼痛。对桡神经卡压进行补充性的功能神经学评估显示,在不同体位进行测试以增加对神经的压迫后,徒手肌力测试出现了变化。
进行了整脊治疗,包括肌筋膜治疗、脊柱及近端桡尺关节调整、神经松动术以及使用夹板。7天后(2次治疗),即使患者使用鼠标在电脑上工作,肘部也不再疼痛。经过2年随访,未报告复发情况。
在这个桡神经卡压症状的病例中,患者受益于使用标准整脊、应用运动学和神经松动术的整脊治疗。所提出的对桡神经卡压进行补充性的功能神经学评估揭示了在标准测试体位下未出现的肌肉功能障碍。徒手肌力测试中的这些变化有助于确定可能的卡压部位,以便将治疗措施针对这些部位。