{"id":31412,"date":"2019-03-20T17:08:20","date_gmt":"2019-03-20T16:08:20","guid":{"rendered":"http:\/\/www.invarena.cz\/?p=31412"},"modified":"2019-06-04T14:24:15","modified_gmt":"2019-06-04T12:24:15","slug":"boli-me-loket-a-zapesti-co-mam-delat","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=31412","title":{"rendered":"Bol\u00ed m\u011b loket a z\u00e1p\u011bst\u00ed, co m\u00e1m d\u011blat?"},"content":{"rendered":"<p><strong>Dotaz: Ji\u017e asi 5 let m\u011b bol\u00ed loket, p\u00edch\u00e1, vyst\u0159eluje do z\u00e1p\u011bst\u00ed, u\u017e i prsty m\u011b bol\u00ed, d\u011bl\u00e1m t\u011b\u017ekou pr\u00e1ci manu\u00e1ln\u011b 15 let, ale dnes u\u017e pomalu neuzvednu paletu, a kdy\u017e ano, tak je to hor\u0161\u00ed. Brn\u011bn\u00ed, te\u010f u\u017e bol\u00ed i rameno, ale to je\u0161t\u011b nen\u00ed takov\u00e1 bolest jako u lokte a z\u00e1p\u011bst\u00ed \u2026<\/strong><\/p>\n<p><!--more--><\/p>\n<p><strong>Odpov\u011b\u010f:<\/strong><\/p>\n<p>K proveden\u00ed diagn\u00f3zy je t\u0159eba pe\u010dliv\u00e9 vy\u0161et\u0159en\u00ed horn\u00ed kon\u010detiny a odebr\u00e1n\u00ed anamn\u00e9zy, kdy se l\u00e9ka\u0159 m\u016f\u017ee zaj\u00edmat i o dal\u0161\u00ed okolnosti, nap\u0159. zda bolesti b\u00fdvaj\u00ed hor\u0161\u00ed v noci, zda posti\u017een\u00fd mus\u00ed ruce tzv. &#8222;prot\u0159epat&#8220; k dosa\u017een\u00ed \u00falevy, zda jsou prsty otekl\u00e9, apod.<\/p>\n<div class=\"top-gap2\">\n<div class=\"o-answer\">\n<p class=\"o-answer__text\">Velmi \u010dasto se v podobn\u00fdch p\u0159\u00edpadech, jak\u00fd popisujete ve sv\u00e9m dotazu, jedn\u00e1 o p\u0159et\u00ed\u017een\u00ed z\u00e1p\u011bst\u00ed a p\u0159edlokt\u00ed. Dlouhodob\u00e9 p\u0159et\u011b\u017eov\u00e1n\u00ed sval\u016f a\u00a0\u0161lach rukou (uv\u00e1d\u00edte t\u011b\u017ekou manu\u00e1ln\u00ed pr\u00e1ci a\u017e 13 let), kter\u00e9 je d\u016fsledkem \u010dasto opakovan\u00fdch pohyb\u016f p\u0159i nam\u00e1hav\u00e9 \u010dinnosti nebo p\u0159etrv\u00e1vaj\u00edc\u00edho svalov\u00e9ho nap\u011bt\u00ed, m\u016f\u017ee v\u00e9st k\u00a0velmi nep\u0159\u00edjemn\u00e9mu, bolestiv\u00e9mu onemocn\u011bn\u00ed svalov\u00fdch \u00fapon\u016f. Jde o z\u00e1n\u011bt v\u00a0m\u00edst\u011b \u00faponu sval\u016f a\u00a0\u0161lach na\u00a0kost, kter\u00fd ov\u0161em nen\u00ed infek\u010dn\u00ed (nen\u00ed zp\u016fsoben bakteriemi nebo viry). V m\u00edst\u011b, kde se up\u00edn\u00e1 \u0161lacha nebo vaz na kost, doch\u00e1z\u00ed k z\u00e1n\u011btliv\u00e9 infiltraci a na ni organismus reaguje bolest\u00ed. Diagn\u00f3zou tedy m\u016f\u017ee b\u00fdt z\u00e1n\u011bt \u0161lach ruky.<\/p>\n<div class=\"top-gap2\">\n<div class=\"o-answer\">\n<p class=\"o-answer__text\">P\u0159edpokl\u00e1d\u00e1m, \u017ee tyto pot\u00ed\u017ee jste probrala s praktickou l\u00e9ka\u0159kou, m\u00e1te ov\u0161em tak\u00e9 mo\u017enost nav\u0161t\u00edvit ortopeda, m\u016f\u017ee b\u00fdt p\u0159\u00ednosn\u00e9 i vy\u0161et\u0159en\u00ed EMG, kter\u00e9 prov\u00e1d\u00ed tak\u00e9 neurologick\u00e9 ambulance.<\/p>\n<\/div>\n<\/div>\n<div class=\"top-gap2\">\n<div class=\"o-answer\">\n<p class=\"o-answer__text\">Zti\u0161en\u00ed bolest\u00ed se nej\u010dast\u011bji dostav\u00ed po vynech\u00e1n\u00ed fyzick\u00e9ho p\u0159et\u00ed\u017een\u00ed, po p\u0159echodn\u00e9m znehybn\u011bn\u00ed a po kr\u00e1tkodob\u00e9m u\u017e\u00edv\u00e1n\u00ed nesteroidn\u00edch antirevmatik typu Ibalgin, n\u011bkdy l\u00e9ka\u0159 m\u016f\u017ee doporu\u010dit i ort\u00e9zu.<\/p>\n<\/div>\n<\/div>\n<p>Nejprve se v\u011bt\u0161inou doporu\u010duje l\u00e9\u010dba rehabilitac\u00ed, proto\u017ee se\u00a0 jedn\u00e1 o nejm\u00e9n\u011b agresivn\u00ed l\u00e9\u010dbu. Napjat\u00e9 svaly se daj\u00ed vhodn\u00fdmi cvi\u010debn\u00edmi technikami uvolnit. P\u0159i p\u0159etrv\u00e1vaj\u00edc\u00edch pot\u00ed\u017e\u00edch m\u016f\u017ee v\u00a0 \u00favahu p\u0159ij\u00edt elektrol\u00e9\u010dba, ultrazvuk, laser a\u00a0dal\u0161\u00ed metody. Rehabilitace je zam\u011b\u0159eno na\u00a0uvoln\u011bn\u00ed \u00faponu a\u00a0potla\u010den\u00ed z\u00e1n\u011btliv\u00e9 reakce. Pokud se stav nad\u00e1le nelep\u0161\u00ed, mohou se aplikovat obst\u0159iky, kter\u00e9 sice okam\u017eit\u011b zaberou, ale vhodn\u00e9 jsou pouze v\u00a0krajn\u00edch p\u0159\u00edpadech.<\/p>\n<p>N\u011bkdy je definitivn\u00edm \u0159e\u0161en\u00edm \u00faponov\u00fdch bolest\u00ed a\u017e operace, p\u0159i kter\u00e9 se sval upne na\u00a0jin\u00e9 m\u00edsto a\u00a0bolestiv\u00e9 m\u00edsto se tak uvoln\u00ed. Pro doporu\u010den\u00ed l\u00e9ka\u0159e k operaci hraje roli typ pacienta, jeho reakce na\u00a0l\u00e9\u010dbu a\u00a0m\u00edra zat\u011b\u017eov\u00e1n\u00ed kon\u010detiny.<\/p>\n<p>Zn\u00e1my jsou i alternativn\u00ed a\u00a0dopl\u0148kov\u00e9 metody l\u00e9\u010dby jako akupunktura, akupresura nebo enzymatick\u00e1 terapie, a je mo\u017en\u00e9 jich vyu\u017e\u00edt, i\u00a0kdy\u017e v\u00fdsledky nejsou podle l\u00e9ka\u0159\u016f v\u011bt\u0161inou nijak p\u0159esv\u011bd\u010div\u00e9. Svoji roli p\u0159i t\u011bchto alternativn\u00edch technik\u00e1ch hraje i\u00a0psychologick\u00fd \u00fa\u010dinek. Pokud m\u00e1 pacient pocit, \u017ee mu to pom\u00e1h\u00e1, nen\u00ed rozumn\u00e9 mu to rozmlouvat, a to i z toho d\u016fvodu, \u017ee alternativn\u00ed l\u00e9\u010dba obvykle nem\u00e1 ne\u017e\u00e1douc\u00ed vedlej\u0161\u00ed \u00fa\u010dinky, nepo\u0161kod\u00ed pacienta.<\/p>\n<p>MUDr. Jan \u010cin\u010dura<\/p>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<div class=\"mh-excerpt\"><p>Dotaz: Ji\u017e asi 5 let m\u011b bol\u00ed loket, p\u00edch\u00e1, vyst\u0159eluje do z\u00e1p\u011bst\u00ed, u\u017e i prsty m\u011b bol\u00ed, d\u011bl\u00e1m t\u011b\u017ekou pr\u00e1ci manu\u00e1ln\u011b 15 let, ale dnes <a class=\"mh-excerpt-more\" href=\"https:\/\/www.invarena.cz\/?p=31412\" title=\"Bol\u00ed m\u011b loket a z\u00e1p\u011bst\u00ed, co m\u00e1m d\u011blat?\">[&#8230;]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":31413,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[18,11],"tags":[],"class_list":["post-31412","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-poradna","category-zdravi"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/31412","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=31412"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/31412\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/31413"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=31412"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=31412"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=31412"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}