[E-BOOK] A little gift to the pain therapists (Acupuncturist, tuina therapist, physiotherapist, chiropracts, occupational therapist and pain management)

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[E-BOOK] A little gift to the pain therapists (Acupuncturist, tuina therapist, physiotherapist, chiropractor, occupational therapist, and  pain management)

对于一般的疼痛，像关节扭伤，肌肉拉伤等，治疗师都会应对自如，大都以痊愈告终。如果遇到一些几个月，甚至几年，而疼痛迁延不愈，一定是一个疑难疼痛了，除了已经知道的一些难治的全身性疾病，像类风湿，脊髓空洞症等，治疗师不能徒手解决，但一些神经卡压，像枕大神经痛，四边口腋神经卡压等，还有一些深处小肌肉的损伤，如肩胛下肌肉损伤，肱肌损伤等，如果诊断正确，治疗到位，也会很快解决，甚至是立竿见影。因此，对于治疗师来说，掌握了神经卡压和深处小肌肉损伤，将是如虎添翼，您的临床将会是不一样的景象。2024年，我要用大部分业余时间写完这部电子书，希望能给你带来临床治疗的一点启示，有所收获。也是我2024年送给疼痛治疗师的一份小礼物。

【Preface】  For general pain problems, such as sprained joints, muscles, etc., therapists can deal with it easily, and most cases will be cured. if therapists meet some cases that do not improve in several months or even several years, they have difficult cases, and intractable pain. in addition, there are some systemic diseases we all know and no way to recover from completely, such as rheumatoid disease, and syringomyelia, therapists can not solve them with natural treatments, but some nerve entrapment, such as great accipitral neuralgia, axillary nerve entrapment, there also are some small deep muscles injury, such as Subscapular muscle injury, brachialis muscle injury, they will be resulted quickly, even immediate results,  if diagnosed correctly, and treated suitably. therefore, for the therapists,  understanding and using the knowledge of nerve entrapment and small deep muscle injury will be added to the wings of the tiger, and even more powerful, there will be a different situation in clinical practice. I will finish the E-book with most of my spare free time in 2024, I hope it can bring a little bit of enlightenment and benefits in therapist’s clinical practice. it is also a little gift to the clinical pain therapists in 2024.

【概述】电子书由两部分组成。第一部分是关于神经卡压，将介绍几十种常见的神经卡压，第二部分是深部小肌肉损伤，很容易被忽视，但在临床中却很常见。每种疾病都有解剖重点、临床表现难点、诊断和鉴别诊断的重要特点、我的临床经验和看法、以及我常用的治疗方法，或者是从网上和书本上收集的一些治疗方法。

【Overview】 The e-book will be composed of two parts. the first part is about nerve entrapment, which will introduce dozens of common nerve entrapments, the second part is about deep small muscle injury, which is easy to neglect, but it is very common in clinical practice. each disease has an anatomy focus, the clinical manifestations difficulties, the important features of the diagnosis and differential diagnosis, my clinical experience and opinions, and my commonly used treatment methods, or some treatment methods from the collected internet and books.

第一部分 神经卡压

神经卡压一般特点：

特点一，疼痛性质是刺痛，麻痛，窜痛，烧灼样痛,放电样麻痛感或蚁走感；

特点二，按压或敲打疼痛点以外区域，可诱发远处疼痛, 即Tinel征，就是指叩击神经损伤(仅指机械力损伤)或神经损害的部位或其远侧，而出现其支配皮区的放电样麻痛感或蚁走感，代表神经再生的水平或神经损害的部位。

特点三，用针检查受累区域，可发现有痛觉的敏感或迟钝；

特点四，夜里及休息时疼痛加重，而白天或工作时疼痛减轻；

特点五，一些特殊试验，可以诊断神经卡压。如颈椎神经根卡压，做压颈试验可引发肩背痛，四边口腋神经卡压，做投球动作可引发肩背痛。

特点六，封闭卡压点（压痛点），或针灸神经松解，或手法卡压点松解，疼痛立即缓解。

【注：当遇到疼痛常年不愈，夜间疼痛或休息痛， 以刺痛，麻痛，放射痛为特征，按压或敲打远处可诱发疼痛，检查有感觉敏感或迟钝，就要想到神经痛，要做进一步检查，进而确诊，制定治疗方案】

Part 1 Nerve entrapment

The nerve entrapment general tips:

Tip 1, the pain caused by nerve entrapment is a pinprick, tingling, burning, shooting, or ant-crawling sensation on the skin.

Tip 2, Tinel’s sign is a tingling or “pins and needles” feeling you get when your healthcare provider taps your skin over a nerve. Tinel’s sign may be an indicator that you have nerve compression or damage where they’re tapping.

Tip 3, when checking the area the nerve controlled, find the sensitivity or dullness to pain.

Tip 4, aggravated by rest or at night, relieved by activity or daytime.

Tip 5, some special tests can help to sure of nerve entrapment, such as pressure on the neck to confirm the cervical nerve root entrapment; when doing the posture throwing the ball out, then causes shoulder and back pain, we will think of axillary nerve entrapment.

Tip 6, the pain will immediately disappear when we put pressure on the trigger points, loosen the nerve with an acupuncture needle, or inject medicine into the trigger points.

【Attended: when you think it is neuralgia, you should do more examination, such as MRI, EMG， and conformed diagnosis, then choose the appropriate treatment.】