Ngezinye izimo emuva, izikhundla ezithile ziyaziwa ukusiza ukuphatha izimpawu. Lezi zikhundla ziyaziwa ngokuthi yizinkanuko. Kunezinhlobo ezintathu zezinkathazo: i-flexion, isandiso kanye nokungabi nesisindo. Kuthathwa ndawonye, lezi zifiso zibizwa ngokuthi izintandokazi zeziqondiso.
Uma ingemuva yakho izwa kangcono futhi / noma izimpawu zakho zithatha uma uphonsa phambili, kungenzeka ukuthi ukulimala noma isimo osizwayo sinesibalo se-flexion.
Isibonelo, i- stenosis yomgogodla , okuyisimo esinciphisa isikhala ngaphakathi kwe-intervertebral foramen, ngokuvamile sinomqondo wokubheka. Abantu abaningi abane-stenosis yomgogodla bathola ukuthi ukugoba umgogodla wazo phambili (aka spinal ukujika) kwenza uzizwe kangcono. Isizathu sukuthi ukuguqa phambili kwenza isikhala esiningi ku- intervertebral foramen . Lokhu, futhi, kuvumela inzwa eyidlula i-foramin ukwenza kanjalo ngaphandle kokuthinteka noma ukucindezelwa eduze (futhi kaningi i-misshapen - ngenxa ye-arthritis) ithambo.
Ezinye izimo ezivame ukungena nge-flexion zihlanganisa i- spondylosis ne- spondylolisthesis .
Ngokulimala nesimo nge-diversion ye-blexion, izimpawu zivame ukwanda uma emuva kwakho kwandiswa.
I-Extension Bias
Ukuphikisana kwe-flexion bias kuyisisindo sokwandisa. Njengoba kungenzeka ucabange, ukuxhaswa kwesikhangiso kwenzeka lapho ukuhamba kwe-back back kwenza izimpawu zakho zizwe kangcono. Izibonelo zezimiso ezivame ukuba nezindleko zokwandisa ziyi-disnied ne-bulging disc.
Abantu abanesinye sezimo bavame ukuthola ukuthi uma begoba phambili (ekugqenikeni kwe-spinal) izimpawu zabo ziba zimbi nakakhulu, futhi njengoba sekushiwo kakade, lapho beqeda imhlane yabo, kubonakala kungcono.
Usizo Lokuthandwa Kwamakhombandlela Ukuhlukanisa Ubuhlungu Bakho Emuva
Ukukhishwa kwe-Flexion (kanye ne-bias extension ne-non-weight bearing) kuyingxenye ye-non-patho-anatomical system of classification for pain mechanical back back, izinkinga ze-disc ngokuqondile, ubuhlungu obuhlangene obuhlangene noma ukungasebenzi, ukungasebenzi kokuhlanganyela kwe-sacroiliac nokungazinzi komgogodla ngenxa inkinga emaphandleni (okuyiyona indawo engemuva kwe-vertebra lapho izinqubo zivela khona.
Lezi zinqubo zibe yingxenye yezihlanganisi zesici.)
Ngiyaqaphela ukuthi "okungewona i-patho-anatomical" yinto encane yomlomo ngakho-ke masikhulume leli gama.
Esikhundleni sokuthi umbukiso wakho we-MRI noma i-X-ray uveza mayelana nomgogodla wakho, uhlelo lwe-non-patho-anatomical luthatha isinqumo salo (ukuhlolwa nokukhetha ukwelashwa) kusuka ezimpawu ozibikezelayo nokuthi yini umhlinzeki wakho obhekayo ekuhambeni kwakho.
Lolu hlelo lusetshenziswa eMcKenzie nezinye izindlela zokwelapha zokwelapha.
Indlela yokwelapha ukuhlukanisa ubuhlungu obuphansi be-back back isetshenziswa kakhulu, futhi cishe nakakhulu ehhovisi likadokotela, kunokuba umtholampilo wezokwelapha. Lokhu kungashiya abanye ababelapha ngokomzimba ngokuzibophezela, njengoba indlela yabo yokusebenza ihilela ukubhekana nokuhlangana okuningi nesiguli.
Mayelana nalokhu, i-Nachemson, esihlokweni sayo, "I-diagnostic yesayensi noma i-label engavumelekile yeziguli ezibuhlungu emuva." Ukuthi ukukhubazeka kwe-Lumbar, "kusho lokhu okulandelayo:
Indlela yokuthola i-patho-anatomical yokuxilonga ubuhlungu be-back back mechanical ingabazuzisa odokotela nodokotela abahlinzayo, kodwa lezi zindlela zokutholwa kwezidakamizwa ezithinta izidakamizwa zisiza kanjani abahlinzeki bezemvelo ekuphathweni kwabo kwe-MLBP? Ingabe abahlinzeka ngokwenyama bangashintsha noma yiziphi izimo ze-patho-anatomical ngezinqubo zabo zokwelapha ezingenasidingo? Ingabe ingabe ama-discs angakwazi ukunciphisa, noma ingabe izinguquko eziguqukayo ezingxenyeni zygapophyseal kanye nama-disc intervertebral zingashintsha ngendlela elandelako izindlela zokwelashwa ezingavamile?
Eqinisweni, ukugxila ngokweqile endleleni elula yokwenza izidakamizwa zokuthola nokwelapha imbangela yezimo ezibuhlungu kuholele ekutheni uhlolwe ukuhlolwa, ukuphumula kombhede, ama-analgesics, kanye nokuhlinzwa. (Waddell 1998).
Umthombo:
I-Kinser, C., iColby, LA, Ukuzivocavoca kwezifo: Izisekelo kanye Nezobuchwepheshe. I-4th Edition. Inkampani ye-FA Davis. Philadelphia, PA. 2002.
Dunsford, A., Kumar, S., Clarke, S. Ukudidiyela ubufakazi ngokusebenza: ukusetshenziswa kwe-McKenzie-based treatment for pain mechanical back back. J Multidiscip Healthc. 2011.
I-Nachemson, A. I-diagnosis yesayensi noma ilebula engavumelekile yeziguli ezibuhlungu emuva. Ukuzimela kwe-Lumbar Segmental. Szpalski M, Gunzburg R, uPapa MH eds. Philadelphia: Lippincott William & Wilkins, 297-301.