Vol. 2 Núm. 1 (2020): Junio
Movimiento y dolor

Manejo fisioterápico de dolor neuropático sin correlación anatómica nerviosa: informe de caso

Juan José Fernández-Pérez
Centro de rehabilitación neurológica FOREN, Tres Cantos, Madrid, España.
Alberto Pérez-González
Instituto de rehabilitación funcional (IRF) La Salle, Madrid, España.
Publicado junio 1, 2020

 Palabras clave

  • Atrapamiento neural,
  • Fisioterapia,
  • Terapia manual,
  • Movilización neural

  Cómo citar

1.
Fernández-Pérez JJ, Pérez-González A. Manejo fisioterápico de dolor neuropático sin correlación anatómica nerviosa: informe de caso. MOVE [Internet]. 1 de junio de 2020 [citado 30 de noviembre de 2020];2(1). Disponible en: https://jomts.com/index.php/MOVE/article/view/19

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Resumen

El dolor neuropático periférico por atrapamiento es una patología muy descrita en la literatura desde el punto de vista anatomo-patológico. No obstante, la literatura solo nos presenta un manejo quirúrgico, con técnicas poco conservadoras y es por ello que presentamos este caso. Paciente LG, varón de 46 años que acude a consulta con 1) alodinia en la cara medial del brazo y dolor eléctrico con pinchazos hasta la muñeca (EVA 84); 2) molestias en epicóndilo lateral tras fondos en el gimnasio (EVA 30). La resonancia magnética nuclear no muestra hallazgos relevantes. Presentaba limitación de 10º en la extensión de codo y una flexión glenohumeral de 45º, con endfeel doloroso y los test neurodinámicos ULNT2b para radial y modificación para musculocutáneo positivos. Los cuestionarios Quick Dash (86,7%) y Tampa Scale of Kinesiophobia (29/44) con valores muy altos. Tratamiento conservador: se realizó una intervención de fisioterapia, combinando ejercicio cardiovascular, fuerza resistencia y control motor, combinado con terapia manual. Los síntomas neurales y el ROM se recuperaron por completo. El cuestionario Quick Dash (2,27%), TSK (16) y fuerza de prensión (de 20 a 59kg) mostraron una mejora clínicamente relevante. La fisioterapia, mediante un tratamiento que promueva el ejercicio y estrategias de afrontamiento activas son de gran utilidad en pacientes con signos/síntomas neurales.


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