婦女疾病
即時提問 ?[ 會員#15335 ] Manus
手腕痛醫唔好
醫生你好，2014年因打羽毛球右手手腕手受傷，感到關節有聲但沒有疼痛，至2015年4月右手手腕開始痛，痛的情況是24小時都痛，甚至半夜會痛醒，經多次中醫針灸、物理治療仍未康復。最後於8月照MRI(附件一)，結果顯示只是普通的手腕軟組織受傷。醫生開咗1個多月NSAIDs消炎藥及注射類固醇，並轉介以聚焦式衝擊波治療(最新一代)，但經20次仍未好，每天都十分痛，並且要停薪留職去休息，但仍未康復~~
最後，在2016年2月4日去看肌骼科醫生，醫生以超聲波作檢討，認為我橈神經被纏住，並有數個關節鬆弛(附件二)。醫生首先幫我進行Perineural injection therapy (Neural prolotherapy)，即以PRP 鬆開被纏住的神經，並在鬆弛的關節注射PRP，並要求每月注射一次，共三次。
注射後手腕腫脹了約三天，而這三天內我的手腕完全唔痛，情況十分理想。但隨著手腕三天後消腫，可怕的痛覺又回來，而且好像比之前更強烈。我想詢問︰
1. 神經痛的情況係點﹖我而家24小時都痛係咪神經痛﹖
2. 假如神經被纏住或發炎，MRI可唔可以檢查到﹖係咪要做神經電子測試，定係超聲波都可以睇到?
3. 假如我再做多2次PRP都冇效，有咩方法可以處理神經痛?有冇手術可以做?
十萬分感謝，感激醫生的回應~~
附件一︰
「there are some soft tissue swelling and oedema seen on the ventral aspect and the distal radius compatible with soft tissue injury. in addition, bone oedema with increased signal on STIR images is seen in the ventral aspect of the distal radius, scaphoid and trapezium. No fracture is seen.
No significant fluid is seen in the intercarpal rows.」
附件二
「Physical examination and dynamic ultrasound showed dorsal branch of the radial nerve swelling, and both the distal radio-ulnar joint and scaphoid lunate joint laxity. He is advised to have ultrasound guided nerve block of the right dorsal branch of the radial nerve and ultrasound guided injection of the distal radio-ulnar joint and the scaphoid lunate joint.」
最後，在2016年2月4日去看肌骼科醫生，醫生以超聲波作檢討，認為我橈神經被纏住，並有數個關節鬆弛(附件二)。醫生首先幫我進行Perineural injection therapy (Neural prolotherapy)，即以PRP 鬆開被纏住的神經，並在鬆弛的關節注射PRP，並要求每月注射一次，共三次。
注射後手腕腫脹了約三天，而這三天內我的手腕完全唔痛，情況十分理想。但隨著手腕三天後消腫，可怕的痛覺又回來，而且好像比之前更強烈。我想詢問︰
1. 神經痛的情況係點﹖我而家24小時都痛係咪神經痛﹖
2. 假如神經被纏住或發炎，MRI可唔可以檢查到﹖係咪要做神經電子測試，定係超聲波都可以睇到?
3. 假如我再做多2次PRP都冇效，有咩方法可以處理神經痛?有冇手術可以做?
十萬分感謝，感激醫生的回應~~
附件一︰
「there are some soft tissue swelling and oedema seen on the ventral aspect and the distal radius compatible with soft tissue injury. in addition, bone oedema with increased signal on STIR images is seen in the ventral aspect of the distal radius, scaphoid and trapezium. No fracture is seen.
No significant fluid is seen in the intercarpal rows.」
附件二
「Physical examination and dynamic ultrasound showed dorsal branch of the radial nerve swelling, and both the distal radio-ulnar joint and scaphoid lunate joint laxity. He is advised to have ultrasound guided nerve block of the right dorsal branch of the radial nerve and ultrasound guided injection of the distal radio-ulnar joint and the scaphoid lunate joint.」
