Lyme-Borreliose als Ursache für chronische HWS-Beschwerden mit Ausstrahlung in die obere Extremität

Zusammenfassung

Physiotherapeutisches Management nimmt eine zentrale Rolle in der konservativen Behandlung von akuten und chronischen Beschwerden am Bewegungsapparat ein. Allerdings eignen sich nicht alle vom Arzt zur Physiotherapie überwiesenen Patienten für physiotherapeutische Interventionen. Eine Vielzahl systemischer Erkrankungen kann eine neuromuskuloskeletale Ursache vortäuschen.

Eine 45-jährige Patientin kam mit der Diagnose „Zervikobrachialsyndrom“ zur Physiotherapie. Da die Therapie keine Wirkung zeigte, wurde sie für weitere Untersuchungen zum Arzt zurückgeschickt. Kurz darauf konnte die Diagnose „chronische Lyme-Borreliose“ als Ursache der Beschwerden gestellt werden.

Auch bei Patienten mit typischen Beschwerden einer Nervenwurzelkompression müssen die ursprünglichen diagnostischen und Interventionshypothesen immer wieder kritisch hinterfragt werden. Trotz vorheriger ärztlicher Abklärung sollten Physiotherapeuten wachsam sein und bei Auffälligkeiten unbedingt Rücksprache mit dem überweisenden Arzt halten.

Abstract

Physiotherapy plays a key role in the conservative management of acute and chronic musculoskeletal disorders. Not all patients referred to physiotherapy are, however, suitable for physiotherapeutic interventions. Many systemic diseases may fake a neuromusculoskeletal source.

A 45-year female patient with the diagnosis “cervicobrachial syndrome” came to physiotherapy. As the therapy did not have any effect on the problem she was sent back to the practitioner for further assessment. Shortly afterwards the diagnosis “chronic lyme disease” was established as source of the complaints.

Even when patients present with complaints typical of a nerve root compression the original diagnostic and intervention hypotheses must be continuously critically reanalysed. Despite previous medical assessment physiotherapists should be alert and consult the referring practitioner in the case of abnormalities.

Schlüsselwörter

Lyme-Borreliose - HWS-Beschwerden - Nervenwurzelkompression - Differenzialdiagnose - Physiotherapie

Keywords

lyme disease - cervical complaints - nerve root compression - differential diagnosis - physiotherapy

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