Ukubukezwa kwe-Back and neck Pain
Ngokusobala ngokwanele, ubuhlungu bezintamo nobuhlungu buyisimane nje sokuzwa okungajabulisi endaweni yentamo yakho, phakathi kwakho, kanye / noma ngemuva, noma emuva kwakho. Njengoba uzobona, ubuhlungu bezinsipho bungenziwa noma yiziphi izinombolo zezinto, kungaqondwa ngezindlela eziningi, futhi kungaletha izimpawu kwezinye izindawo zomzimba wakho.
Ubuhlungu bezinsipho buvame kakhulu, futhi ubuhlungu obukhulu be-back emuva obuthinta amaphesenti angu-80 wabantu ngesikhathi esithile empilweni yabo.
Kubuhlungu obukhulu ngokuphindaphindiwe kokuphindwe kabili njengokubuhlungu kwentamo, kanti ubuhlungu obuhlungu emuva futhi ubuhlungu bendolo bulingana.
Ubani Othola Emuva Nenhliziyo?
Ungase ube engozini enkulu yokuhlunguphazeka komgogodla uma ungowesifazane, ukhuluphele kakhulu noma ukhuluphele , ubhema , une-osteoporosis kanye / noma ungathola umzimba omningi noma awukwanele. Ezinye izimo ezingozini zibandakanya izinga lemfundo elingaphansi, lihlala emadolobheni, libe ngaphansi kweminyaka engu-50 (ubuhlungu bentamo) nangaphansi kuka-65 (ubuhlungu obuphansi emuva), amazinga aphezulu okucindezeleka, noma ubunzima obungokomzwelo (ukukhathazeka noma ukucindezeleka).
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Okubalulekile kwe-neck neck
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I-Angle Yakho Ye-Lumbosacral Yithinta Kanjani Umkhawulo Wakho Womgogodla?
Izinto ezisemsebenzini zithatha indima enkulu emngceni wezintamo nangemuva, futhi. Uma ungenelisekile ngomsebenzi wakho, awunakho ukwesekwa kwabasebenzi bakho noma abaqashi bakho, noma umsebenzi wakho uhilela ukubeka umzimba wakho ekudlideni (isibonelo, ukusebenzisa i-jackhammer) ungase ube nempilo ephakeme yomgogodla obuhlungu. Abasebenzi baseHhovisi bavame ukuzwa ubuhlungu obuningi bezintamo kunezinye izinhlobo zabasebenzi.
Okuncane kangako kwaziwa ngobuhlungu obuphakathi emaphakathi nangaphezulu kunokwentamo noma ubuhlungu obuphansi emuva. Lokhu kubangelwa ukuthi ucwaningo ngalesi sihloko lukhawulelwe. Kodwa isifundo se-2016 esashicilelwe kuyi- European Journal of Pain sikhombisa ukuthi kufana nokufana nobuhlungu bezintamo nobuhlungu.
Ngenkathi ubuhlungu bezintamo nobuhlungu bengenasisekelo, uma bekhona, besongela impilo, bangabangela ukukhathazeka futhi kwezinye izimo bangaphazamisa izinga lakho lokuphila isikhathi eside. Lokho kusho ukuthi izimo eziningi ziba iziqephu ezincane abantu abazithola ngokunciphisa umsebenzi wabo bese bevumela inkinga ukuba ithathe inkambo yayo.
Emuva Nenhliziyo Yezinwele - Ukucatshangelwa Kwezobuchwepheshe
Uma sifuna ukuthola ubuchwepheshe ngakho, intamo (futhi ngenxa yalokho ubuhlungu bentamo) ichazwa ngokuthi (ubuhlungu) kuyingxenye yomgogodla isuka kusuka ku- vertebra yakho yokuqala yomlomo wesibeletho (cishe cishe ezingeni lezansi kwendlebe yakho lobe) kuze kube sesikhombisa. I-vertebra yesibeletho yesikhombisa itholakala phezulu ehlombe lakho nangemuva.
Emaphakathi nasenhla yangemuva isilandela, ukusuka phezulu ngaphansi kwe-vertebra yesibeletho yesi-7 kuze kube phansi kwe-vertebra ye-thorasi engu-12. I-vertebra ye-thoracic engu-12 igxila cishe nge-tip of the nubhu esesithathu ukusuka phansi (okuthiwa yi-node ye-10.) Le nbambo iyona yokugcina yezintambo "zeqiniso" (ie, ifakwe emgqonyeni wesifuba ngendlela i-cartilage ngaphambili).
Ngaphansi kwembambo eyishumi kukhona ezimbili-lezi zibizwa ngokuthi "izimbambo ezinamanzi" ngoba azizungeze phambili futhi azihambelani nesifuba.
I-back back yiyona ndawo ehambelana nomgogodla we- lumbar , oqala ngaphansi kwe-vertebra ye-thorasi engu-12 futhi ibuyele phansi phezulu kwe-sacrum bone, cishe phakathi kwamabili phakathi kwamathambo amabili e-hip back. Ubuhlungu be-Sacroiliac kanye ne-coccyx nazo izinhlobo zobuhlungu bomgogodla; ikakhulukazi ubuhlungu be-sacroiliac kuthatha uhlobo lwe-sacroiliac ekusebenziseni okuhlangene. I-coccyx bone isisindo sakho. Yisithambo sokugcina somgogodla; lilenga phansi phansi kwe-sacrum.
Indlela Yokuqonda Usizi Lwe-Spine
Kunezindlela eziningi zokuchaza, ukuqonda, nokuxilonga ubuhlungu bomgogodla. Ungayibheka ngokwezikhathi ozitholile ngayo; Ubuhlungu bamuva bubizwa ngokuthi bukhulu, kanti ubuhlungu obuhlala isikhathi eside kunezinyanga ezintathu bubizwa ngokuthi ubuhlungu obungapheli noma obuqhubekayo. Isizathu esivamile kakhulu sobuhlungu obungapheli bomgogodla obuhlobene nokuguga (kanye nokulimala okude okumi isikhathi eside) yizinguquko ezishintshashintshayo ezakhiweni zomgogodla ezivela ekugqokeni nasekukhaleni isikhathi.
Ubuhlungu obukhulu futhi obuhlala njalo buphathwa ngokuhluke kakhulu komunye nomunye, ngendlela.
Noma ungaqonda ubuhlungu bomgogodla ngokwempawu zesibindi. Uma unobunzima, ubuthakathaka, ukuphazamiseka kanye / noma ukuzwa kwenhlobo kagesi ewela phansi ingalo eyodwa noma umlenze owodwa, ungase ube nesimo esibizwa ngokuthi i-radiculopathy. I-Radiculopathy iwukucasuka kwesinye sezimpande zomgogodla, noma ngokuvamile-kodwa hhayi njalo-ebangelwa ukulimala okubizwa ngokuthi i-disc herniated. Izimpande zemijovo yomgogodla yiqoqo lezinzwa eziye zaxhuma kusuka enkambeni, emgodini womgogodla ophakathi futhi zisendleleni yokuphuma kuzo zonke izindawo zomzimba. Ngamunye amathambo omgogodla unezimpande ezimbili zomgogodla (owodwa ohlangothini oluhlangothini) ophuma emthonjeni womgogodla. Uma okuthile kucindezela izimpande zomzimba, izimpande zesisindo zingase zithukuthele, ziholele ebuhlungu kanye nezinye izimpawu ezibalulwe ngenhla. Futhi, lokhu kungenziwa ngenxa ye-disc ye-herniated kodwa futhi kungase kuvele nezinguquko ze-arthritic (degenerative) emgodleni, njenge- facet joint hypertrophy , stenosis yomgogodla, i-bone spurs, nokuningi.
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Kungani Ukuhleleka Kwengqondo Kungasiza Ukukhulula Inhlungu Yakho Emuva
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Incazelo ye-Spinal Nerve Root Definition
Enye indlela yokuqonda ubuhlungu bentamo nobuhlungu ngokulandela indlela eqala ngayo. Ingabe unengozi noma enye ingozi? Ukutholakala kulezi zimo kungabandakanya i-whiplash, i-disc, i-muscle sprain noma i-ligament strain, ukuphazamiseka komgogodla, noma ukulimala komgogodla.
Kodwa uma ubuhlungu bubonakala bukhula kancane kancane, kungase kubangelwe ukuma okuncane noma ukukhubazeka komgogodla, njengokwama-scoliosis. Ubuhlungu obukhula ngokuhamba kwesikhathi kungase kube ngenxa yokuguqulwa, ukuguquka kwemigogodla ehlobene neminyaka, njengalezo okukhulunywe ngenhla, okuvame ukuholela ku-arthritis yomgogodla futhi mhlawumbe nesisu somgogodla.
Ngokungajwayelekile, ubuhlungu bentamo noma emuva bubangelwa izinkinga zesistimu ezifana nezifo, izicubu, noma ama-cysts. Umsebenzi wakho wokuxilonga uzofaka phakathi ukuhlolwa kwe " amafulegi abomvu ," okuyizibonakaliso kudokotela wakho okungamenza asole isimiso kunenkinga yokwakha. Izimbangela zesifo sofuzo kanye nesifo sofuba nazo kungenzeka. Izibonelo zezimo zesikhumba sokuzalwa ezinomzimba zihlanganisa i-spina bifida kanye ne-torticollis yokuzalwa (i-torticollis isho ukuthi "intamo esontekile"). Futhi ukukhwabanisa kukaSuermermann , ukukhubazeka okuthinta abanye abafana abasha, yisibonelo sesimo somgogodla esihlobene nezakhi zofuzo.
Ubuhlungu bomgogodla obuhlobene nalezi zimbangela ezingenhla zingenzeka kunoma yisiphi isifunda - inzalo yesibeletho, i-thoracic (phakathi nendawo / noma ngaphezulu), sacral lumbar, noma i-coccyx. Kanye nama-vertebrae, ama-disk, izinzwa, nemisipha, ubuhlungu bentamo nobuhlungu bungase buthinte noma kuthinteke izitho nama-glands endaweni kanye nemithambo yegazi.
Isimboni Sokunakekelwa Kwezimboni-Ingabe Umthengi Qaphela?
Amalungu amaningi okusungulwa kwezokwelapha okuvamile, kuhlanganise nodokotela, abacwaningi, abahlinzeka ngemithi kanye nabanye, bagxile kakhulu ekunakekeleni ubufakazi obusekelwe ebufakazini bezintamo zabo nezigulane. Lokho kusho ukuthi bafuna ukubona ubufakazi bokuthi ukwelashwa noma ukuhlinzwa kusebenza ngaphambi kokuba bayisebenzise noma bayincoma.
Futhi ngezinga elikhulu, lokhu kuhle. Ngokunakekelwa kwezempilo imboni ekhulayo, ubufakazi besayensi buyisihluthulelo sokwelashwa okuletha ukuphumula kobuhlungu kanye nekhwalithi yokuphila ethuthukisiwe. Kodwa amandla okwelapha ngokweqile anqunywa khona. Okubi nakakhulu, odokotela bavame ukunikeza ukwelashwa okungakaze kubonwe ukuthi kusebenze ngendlela ephephile futhi esebenzayo iziguli-noma ngabe kufanele, futhi nakuba iziguli zithembele kuzo ukwenza kanjalo.
Isibonelo, odokotela abaningi banikeza i-opioids njengokwelashwa kokuqala kwamakhambi ngisho nezimo ezincane zobuhlungu bomgogodla. Kodwa lokhu kungase kungadingeki ngaso sonke isikhathi. Ukubuyekezwa okuhlelekile kwe-2016 nokuhlaziywa kwe-meta kutholwe ukuthi abantu abaningi abaphatha ubuhlungu bezinambuzane behlisela ubuhlungu besikhathi emuva (okubizwa nangokuthi i-opioids) abazange bathole "ukuphumula okubalulekile emitholampilo" ebangeni lobuhlola elilinganiselwe. Ukubuyekezwa / ukuhlaziywa kwe-meta kuphetha ngokuthi abantu ababekezelela i-opioids bangathola "ukuphumula okwesikhashana isikhathi esifushane" nokuthi akukho bufakazi obukhona okumele bukhulume ngabo ngosizo lwezinhlungu zesikhathi eside.
Ngokufanayo, ukusetshenziswa kwe-opioid ubuhlungu bukhulu kakhulu, ikakhulukazi ngenxa yezifo ze-muscloskeletal. I-National Medical Expenditure Panel Survey yembula ukwanda kwamaphesenti angu-104 emigomo ye-opioid ngo-2010, kanti umcwaningi oyedwa ubika ukuthi cishe ingxenye yesigamu sabasebenzisi be-opioid banezinhlungu emuva. Uphawula ukuthi ukusetshenziswa kwama-opioids okubuhlungu okubuhlungu okubuyiselwayo kungxabano ngenxa yezinkinga zokuphepha nokusebenza kwazo.
Njengama-narcotics, lolu hlobo lwemithi luba nengozi yokulutha umlutha. Ngaphambi kokuba uvume umshwalense noma uthathe umuthi, kungcono ukukala ukuthi kungenzeka yini ukulutha umlutha kanye neminye imiphumela emibi (njengokuqunjelwa) ngokukhululeka kobuhlungu ongase ukwazi ukuthola ezinye izindlela.
Enye inkinga ye-inkinobho eshisayo ekunakekeleni umgogodla ukusetshenziselwa ngokugqamile kokucabanga kwe-diagnostic. Odokotela abaningi bacela ukuba iziguli zabo zisebenzise ngokugcwele ubuhlungu be-back-ngisho namacala amancane angase azixazulule ngokwawo.
Esifundweni sika-2009 esithi "Ukubhekana Nokucindezeleka Okubuhlungu Okubuyiselwayo: Isikhathi Sokubuyela Emuva ?," esanyatheliswa kuyi- Journal of the American Board of Family Medicine , umbhali uRick Deyo, MD, PhD., Wathola ukuthi nakuba iziqondiso odokotela ngokuqinile ukudikibala ukusebenzisa ukuhlolwa kwe-imaging uma kungadingekile (ikakhulukazi ngenxa yezindleko zezokwelapha ezingadingekile), inani le-MRIs le-lumbar spine landa ngamaphesenti angu-307 eminyakeni engu-12 eyalandela ngo-1990. Umlobi uphinde waveze ukuthi izinga lokuhlolwa kwe-imaging linikezwe umgogodla iziguli zihluka "ngokuphawulekayo" kulo lonke izwe nokuthi izinga lokuhlinzwa emuva liphakeme kunazo zonke lapho amazinga okucabanga aphezulu kakhulu.
UDeyo uphakamisa ukuthi kuze kube yizingxenye ezimbili kwezintathu zokuhlolwa kwe-imaging ezinikeziwe zingenziwa ngendlela engafanelekile.
Ucwaningo olwenziwa ngo-2016 olwanyatheliswa eMgunyeni Wokugcina lathola ukuthi abantu abanomshwalense womphakathi bafumana i-MRIs yomgogodla kaningi kunelabo abangenawo umshuwalense noma umshuwalense wangasese.
UDeyo uphinde ubhale izinto ezingase ziqhubekele lo mkhuba ophezulu ekusetshenzisweni kokucabangela ukuxilongwa kwamaphutha aphansi emuva: Ukukhula komkhakha wokucabangela wembonini yezempilo, ukwanda kwesidingo sesiguli sama-MRIs, "isimo esibucayi sobufakazi obonakalayo," njengoba uDeyo ebeka, izinsongo zokusola, nemali.
Ukuhlinzwa okubuyela emuva kungenye indawo lapho ukwelashwa okungase kube khona. Kulesi sihloko esishiwo ngenhla, uDeyo uthi izinga lokugonywa komgogodla okwenziwa ngesikhathi seminyaka engu-12 landa ngamaphesenti angu-220. Umlobi wachaza umkhuba ekuhlinzekeni okwengeziwe (futhi nakanjani izindleko eziphakeme) kulabo abagulayo abane-MRIs ekuqaleni kosuku lwabo lwezokwelapha. Inkinga iwukuthi, lezi zindlela zokuhlinza azizange, jikelele, zithuthukise amazinga ezihlungu zabaguli noma ikhono lokusebenza, uphetha.
Ngokuvamile, ucwaningo luncoma ukwelashwa ngokomzimba okuzamayo nokunye ukwelashwa okulondolozayo kwamasonto ayisithupha. Uma ukwelapha (nokuhlanganyela kwakho kuwo) kwehluleka ukukhulula ubuhlungu, ngaleso sikhathi ukuhlinzwa kungase kwenzeke. Kodwa odokotela abaningi abahlinzeki iziguli zabo zempini isiguli ku-PT. Uma kufanele kube njalo phakathi kwakho nodokotela wakho, ziphakamise ngokuzicela. Futhi uma ezama ukukuphoqelela emuva noma ukuhlinzwa kwentamo ngaphambi kokuba uqiniseke, kungase kube yisikhathi sokufuna umbono wesibili.
> Imithombo:
> Abdel Shaheed C. Ukuphumelela, Ukubekezelela, kanye ne-Dose-Imiphumela Ethembekile Yezingxoxo Zama-opioid for Pain Low Pain Ukubuyekezwa Okuhlelekile nokuhlaziywa kwe-Meta. I-JAMA Imithi Yangaphakathi . Julayi 2016. http://archinte.jamanetwork.com/article.aspx?articleid=2522397
> Deyo RA, Mirza SK, Turner JA. noMartin BI. (ayikho idethi) Ukudlulisa ubuhlungu obungapheli emuva: Isikhathi sokubuyela emuva? 22 (1). http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2729142/
> Igolide Gold, Esterberg E, Hollombe C, et al. (2016) Ukucabanga okuphansi emuva uma kungaboniswa: Ukuhlaziywa kwesistimu echazayo. Umagazini wePermanente. , 20 (2), iphe. 25-33. http://www.ncbi.nlm.nih.gov/pubmed/26934626
> Johansson, Stochkendahl J, Hartvigsen J, Boyle E. noCassidy J. (2016) Ukukhubazeka nokubikezela ubuhlungu obuphakathi phakathi kwabantu abaningi: Ukubuyekezwa okuhlelekile. I-European Journal of Pain (London, England). http://www.ncbi.nlm.nih.gov/pubmed/27146481
> Amasayithi B, i-Beach M, ne-Davis M. (2013) Ukwandiswa kokusetshenziswa kwezidakamizwa ze-opioid kanye nokuntuleka kokuthuthukiswa kwamamethrikhi okukhubazeka phakathi kwabasebenzisi. I-Anesthesia yesiFunda kanye neMithi Yezinhlungu. , 39 (1), iphe. 6-12. http://www.ncbi.nlm.nih.gov/pubmed/24310049