英国剑桥来的典型病例 | 右侧肩胛骨内下方疼痛

xyf4345 2020-03-06

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【编者的话】

英国巩大明医生是欧洲浮针医学会秘书长，在临床中勤于思考、认真分析，经常对于一些常见病、多发性疾病以及疑难杂症的认识不断深入，紧紧抓住浮针医学思维理念，在临床中取得了很好的疗效，今天报告的这一例，大家读后会从中学到不一样的理念和思路。谢谢巩医生！

编者

患者青年男性，因右侧肩胛骨内下剧痛2周于2020年2月24日初诊。患者外出度假中突发上述部位疼痛，痛点固定，疼痛剧烈，特殊体位疼痛明显，打哈欠、喷嚏、低头及上肢伸展时（开车）疼痛尤甚，疼痛致夜不能寐，无法工作，严重影响正常生活。看家庭医生怀疑其胸肺问题，予以X-ray检查无碍，普通止痛片效果不明显，服用吗啡也仅可缓解2-3小时（视频）。

既往有慢性腰疼史，未做检查及治疗。浮针医学查体见其右侧竖脊肌及背阔肌明显紧张肿胀（++++），前锯肌（+++）。治疗：先在右肩胛骨内侧向下进针对竖脊肌进行浮针治疗，扫散加相应再灌注，再调整针尖方向对背阔肌行扫散及再灌注活动，患者述疼痛由10降为3（见视频），

下半场自右腋前线附近向后针对前锯肌行浮针扫散加再灌注活动，患者疼痛基本消失，遂拔针留管结束治疗。第三天（2月26日）复诊患者述疼痛有所反复，但仍较前明显减轻，可进行正常活动。查体见上述患肌仍在（++），按前治疗方案施治，患者疼痛消失，嘱其约隔日后三诊。次日患者致电告知疼痛已无，取消预约，临床治愈。

【讨论】肩胛间区疼痛属临床常见病多发病，发病原因比较复杂，首先需要排除内科和一些器质性病变。多与患肌息息相关。临床常见相关肌肉有斜角肌、肩胛提肌、背阔肌、冈下肌、前锯肌、胸多裂肌、胸髂肋肌、下斜方肌、菱形肌及上后锯肌，临床上要根据浮针医学的“辨病”、“辨肌”、“辨势”来确定责任患肌加以施治，达到浮针“效如桴鼓”的效果。

治疗前后视频对比

【Case study】

Name: Mr. Wifa

Age: 30

Sex: Male

Date of record: 24/02/2020

Chief Complaint: Severe pain at Inferior Right Scapula for two weeks.

Present illness: The patient felt a severe pain at the inferior right scapula starting from two weeks ago, without clear causes. The pain stayed in one location, with a number of specific movements making the pain much worse. These include yawning, sneezing, moving the head downwards and stretching the arm (whilst driving). The patient could not fall asleep at night and was off work for two weeks. He had seen his GP and took an X-ray for the chest which came back as clear. The patient took Morphine to reduce the pain, but the pain was only alleviated for around 2-3 hours (video 1).

Past History: chronic lower back pain for many years with no diagnosis and no treatment.

FSN Examination: Right side Erector Spinae and Latissimus Dorsi were tight and swollen significantly (++++), Serratus Anterior(+++)

Elimination: Problems associated with lungs, heart or other internal organs.

Treatment: FSN needle was inserted from medial right scapula downwards, manipulating and using Reperfusion Approach for the Erector Spinae and Latissimus Dorsi. After this the pain was reduced from level 10 down to 3 according to patient feedback (video 2). The second half of the treatment involved inserting the FSN needle from the right Front Axillary Line towards the back for the Serratus Anterior. After manipulation and the Reperfusion Approach, the pain was almost gone for the patient. The needle was then removed and the tube was kept in for a few hours.

Re-visiting date: 26/02/2020

Although the patient still felt some pain, its severity was much better than before. The tight muscles were the same as before but all to lower severity after FSN examination (++). The treatment was repeated as before until the patient was pain free. The patient was booked for a third visit for 28/02/2020, but phoned the surgery one day before to say that the pain had completely gone and everything was healed up.

[Discussion] Pain between the scapulars is very common complaint, the causes can be very complicated, we found that most cases are Pathological Tight Muscle related, such as Scalene, Levator Scapulae, Erector Spinae, Infraspinatus, Serratus Anterior, Multifidus, Iliocostalis, Lower Trapezius, Rhomboid and Upper Posterior Serratus, etc. In FSN clinical practice, we should base on the principle of recognizing ‘complaint’, ‘muscle’ and ‘position’ to identify the responsible Pathological Tight Muscle, then giving treatment, to achieve the FSN quick healing effect.