Dirençli de Quervain tenosinovitinin lokal anestezik ile tedavisi (nöralterapi): Olgu sunumu

Öz

De Quervain tenosinoviti lateral el bilek ağrısının en sık nedenidir. Tenosinovitin tedavisinde splintleme, non-steroid anti inflamatuar ilaçlar ve kortikosteroid enjeksiyonları kullanılır. Nöralterapi (NT), lokal anestezikler kullanılarak yapılan bir tanı ve tedavi yöntemidir. Kas iskelet sistemi bozuklukları NT yaklaşımıyla tedavi edilebilir. Bu vaka sunumunda dirençli de Quervain tenosinovitinin nöralterapi yaklaşımıyla yönetimi sunulmuştur.45 yaşında masabaşı işe sahip erkek hasta polikliniğimize 2 yıldan uzun süredir devam eden sağ el bilek ağrısı şikayetiyle başvurdu. Vizüel analog skalaya göre hastanın ağrısı 7/10 idi ve günden güne ağrısının arttığını ve çanta taşımada sorun yaşadığından şikayetçi idi. Hikayesinde 2 yıl önce boyun ağrısı mevcuttu. Nöralterapi programına servikal diskopati ve tenosinovit tanılarıyla alındı. 3 seans sonra hastanın fonksiyonel son durumu ve ağrısında iyileşme saptandı. Servikal diskopati ile beraber dirençli de Quervain tenosinovitinin tedavisinde nöral terapi efektif ve güvenli bir method olarak uygulanabilir.

Anahtar Kelimeler

• De Quervain tenosinoviti
• Lokal anestezik
• Nöralterapi

Management of resistant de Quervain tenosynovitis with local anesthetic (neural therapy): A case report

Abstract

De Quervain tenosynovitis is the most common reason of lateral wrist pain. Treatment consists of splinting, non-steroid anti-inflammatory drugs, and corticosteroid injections. Neural therapy (NT) is a treatment modality using injections with local anesthetics for diagnosis and treatment. Musculoskeletal disorders can be cured by NT. We herein present the management of resistant de Quervain tenosynovitis by neural therapy in a 45-year-old male patient, who was referred to our outpatient clinic with the complaint of right wrist pain lasting over 2 years. His pain was 7/10 based on visual analog scale which had gradually increased. The patient also stated that he could not lift bags and had experienced neck pain 2 years ago. He was engaged in the neural therapy program with the diagnosis of cervical discopathy and tenosynovitis. After 3 sessions he had improvement in functional outcome and pain. In the treatment of resistant de Quervain tenosynovitis accompanying cervical discopathy, neural therapy is an effective and safe method.

Keywords

• de Querivain tenosynovitis
• Local anesthtetic
• Neuraltherapy

References

1. 1. Ippolito JA, Hauser S, Patel J, Vosbikian M, Ahmed I. Nonsurgical Treatment of De Quervain Tenosynovitis: A Prospective Randomized Trial. Hand (N Y). 2018:30:1558944718791187.
2. 2. Pensak MJ, Bayron J, Wolf JM. Current treatment of de Quervain tendinopathy. J Hand Surg Am. 2013;38:2247-9.
3. 3. Nazlikul H. Nöralterapi Ders Kitabı. Nobel Kitabevi, Istanbul, 2010.
4. 4. Weinschenk S. Neural therapy—A review of the therapeutic use of local anesthetics. Acupuncture and Related Therapies 2012;1:5–9.
5. 5. Egli S, Pfister M, Ludin SM, Puente de la Vega K, Busato A, Fischer L. Long-term results of therapeutic local anesthesia (neural therapy) in 280 referred refractory chronic pain patients. BMC Complement Altern Med. 2015;15:200.
6. 6. Mermod J, Fischer L, Staub L, Busato A. Patient satisfaction of primary care for musculoskeletal diseases: a comparison between Neural Therapy and
7. 7. conventional medicine. BMC Complement Altern Med. 2008;8:33.
8. 8. Fischer L. [Pathophysiology of pain and neural therapy]. Praxis (Bern 1994). 2003;92:2051–59.

9. 9. Mermod J, Fischer L, Staub L, Busato A. Patient satisfaction of primary care for musculoskeletal diseases: a comparison between Neural Therapy and conventional medicine. BMC Complement Altern Med. 2008;8:33.
10. 10. Kuo YL, Hsu CC, Kuo LC, Wu PT, Shao CJ, Wu KC, et al. Inflammation is present in De Quervain’s disease – Correlation study between biochemical and histopathological evaluation. Ann Plast Surg 2015;74:146-51.
11. 11. Karakan M, Hasanoğlu Erbaşer GN, Torun B, Elçi M, Tamam Y, Nazlıkul H. Etiology of cervical distonia and epilepsy molar embedded teeth an neuraltherapy treatment. Barnat. 2019;2:25-31.
12. 12. Rankin ME, Rankin EA. Injection therapy for management of stenosing tenosynovitis (de Quervain's disease) of the wrist. J Natl Med Assoc. 1998;90:474-6.