Σύνδρομο του De Quervain
Οι τένοντες του μακρού απαγωγού και του βραχέος εκτείνοντα του αντίχειρα μοιράζονται ένα κοινό έλυτρο.
Είναι δυνατό μέσα στο κοινό αυτό έλυτρο οι προστριβόμενοι συνεχώς τένοντες να υφίστανται χρονίως πίεση, η οποία οδηγεί σε ερεθισμό τους (στενωτική τενοντοελυτρίτιδα) και στην εμφάνιση πόνου στην περιοχή αυτή και ελαττωμένης λειτουργικότητας του αντίχειρα. Η αντιμετώπιση είναι κατ’ αρχήν συντηρητική (τοπική έγχυση κορτικοστεροειδών) και όταν τα ενοχλήματα επιμένουν χειρουργική, που αποσκοπεί στην αποσυμπίεση των πιεζόμενων στοιχείων με την κατάλληλη διάνοιξη του ελύτρου τους.
Ανάλογα σύνδρομα μπορεί να εμφανισθούν από πίεση του ωλενίου νεύρου καθώς διέρχεται ανάμεσα στο ωλέκρανο και την παρατροχίλια απόφυση, και από πίεση του οπίσθιου κνημιαίου νεύρου (σύνδρομο ταρσιαίου σωλήνα).
Φυσικοθεραπευτική αντιμετώπιση
- SIS
Μηχανισμός Δράσης:
Το πρωτόκολλο έχει ως αποτέλεσμα την ανακούφιση από τον πόνο (ενδογενής οπιοειδή θεωρία). Το πρωτόκολλο βασίζεται στην ενεργοποίηση του ενδογενούς οπιοειδούς συστήματος. Πρόσθετο αποτέλεσμα είναι η βελτίωση της τροφικότητας ( ενεργοποίηση της μυικής αντλίας). Επιπλέον οδηγεί σε μείωση του οιδήματος, βελτίωση της κυκλοφορίας και της τροφικότητας. Το πρωτόκολλο βασίζεται στην ενεργοποίηση της μυικής αντλίας.
- Laser MLS
- TENS
- Διατατικές ασκήσεις, ενδυνάμωση και λειτουργική επανεκπαίδευση με stretching.
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