背景/目的:神经源性足底疼痛是一种具有挑战性的诊断和治疗方法。本文的目的是说明将拔罐与神经滑翔结合使用的新颖方法,以更好地诊断和管理出现周围神经性足底疼痛症状的患者。病例描述:一名65岁的男性接受物理治疗,骨科医生诊断为足底筋膜炎。介绍包括向足部内侧边界扩散的疼痛区域,并描述了周围神经性疼痛。拔罐用于识别隐神经分布中的疼痛,并通过同时使用下四分之一神经滑翔来帮助解决症状。结果:出院时和1年随访,患者症状完全缓解,功能恢复至之前水平.自我报告结果包括数字疼痛评定量表和下肢功能量表。讨论:这是第一个描述拔罐联合神经滑翔在诊断和治疗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。还回顾了这种治疗背后的拟议机制。结论:在出现足底筋膜炎症状的患者中,结合拔罐测试神经滑翔可能有必要确认或反驳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良好对照试验中的机制和进一步效用。证据级别:IV级。
Background/purpose: 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. Case description: 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. Outcome: 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. Discussion: 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. Conclusion: 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 of Evidence: Level IV.