背景:下腰痛是临床上经常遇到的重要残疾问题。在文学中,研究表明,神经性疼痛在慢性腰背痛患者中相当常见。尽管上肌腱神经卡压综合征是下腰和腿部疼痛的一个未被诊断的原因,鉴别诊断在解剖学和临床上都非常重要。上肌腱神经是神经支配臀部上部皮肤的纯感觉神经。在文学中,手术等方法,神经阻滞,前列腺疗法,针灸已被用于治疗肌腱神经卡压综合征,但是没有关于锻炼的研究。在这个案例报告中,我们的目的是解释鉴别诊断的重要性,在肌腱神经卡压综合征,这是临床上下腰痛的常见原因之一,以及运动对这种疾病的影响。
方法:22岁,土耳其族裔,患有腰痛的男性患者,颈背疼痛,和虚弱没有使用酒精或香烟。在他的家族史上,母亲有糖尿病史,父亲有糖尿病和心力衰竭史。他有骨质疏松的病史,癫痫,哮喘,结节病,和心律失常。患者报告说他每月患有便秘三到四次。作为详细评估的结果,计划的运动处方被教导给病人,在确认患者正确练习了3天后,提供了运动手册,并作为家庭锻炼计划进行了8周。
结论:腰椎稳定训练,臀肌强化运动,胸腰椎筋膜动员,和伸展运动,在正确诊断后,将根据该病的临床解剖结构给出,对病人有益。然而,我们认为,大样本的随机对照研究将有助于文献。
BACKGROUND: Low back pain is an important disability problem frequently encountered in the clinic. In the literature, it has been shown that neuropathic pain in chronic low back pain is quite common in patients. Although superior cluneal nerve entrapment syndrome is an underdiagnosed cause of low back and leg pain, differential diagnosis is very important anatomically and clinically. The superior cluneal nerves are pure sensory nerves that innervate the skin of the upper part of the buttocks. In the literature, methods such as surgery, nerve blockade, prolotherapy, and acupuncture have been used in the treatment of cluneal nerve entrapment syndrome, but there are no studies on exercise. In this case report, our aim is to explain the importance of differential diagnosis in cluneal nerve entrapment syndrome, which is one of the common causes of low back pain in the clinic, and the effects of exercise in this disease.
METHODS: A 22-year-old, Turkish-ethnicity, male patient with complaints of low back pain, neck-back pain, and weakness did not use alcohol or cigarettes. In his family history, there was a history of diabetes in the mother and diabetes and heart failure in the father. He had a history of osteoporosis, epilepsy, asthma, sarcoidosis, and cardiac arrhythmia. The patient reported that he suffered from constipation three to four times a month. As a result of the detailed evaluation, the planned exercise prescription was taught to the patient, and after it was confirmed that the patient did the exercises correctly for 3 days, the exercise brochure was given and followed as a home exercise program for 8 weeks.
CONCLUSIONS: Lumbar stabilization exercises, gluteal muscle strengthening exercises, thoracolumbar fascia mobilization, and stretching exercises, which will be given in accordance with the clinical anatomy of the disease after the correct diagnosis in cluneal nerve entrapment syndrome, have been beneficial for the patient. However, we think that randomized controlled studies with a large sample will contribute to the literature.