Kubantu abaningi, imithi ejwayelekile ayiphumeli ngokukhululekile ukukhulula ubuhlungu. Lokhu kungaba yisinye sezizathu zokuthi ukusetshenziswa kweminye imithi yokwelashwa kanye nemithi yokwelapha eqhubekayo kuqhubeka kanjani e-United States.
AmaMelika anezinhlungu eziningi zokubuya emuva. Eqinisweni, kungenye yezizathu ezihambelayo zokuvakashela ehhovisi likadokotela futhi ezingabanjwanga izinsuku zokusebenza, kanye nenkinga evame kakhulu yokukhubazeka okuhlobene nomsebenzi, ngokusho kweNational Institute of Neurological Disorders and Stroke.
Ukwengeza, Isikhungo Sikazwelonke SokuQinisekisa NeMpilo Edidiyelwe, i-ejensi phakathi kwezikhungo zikazwelonke zezeMpilo, okuyingxenye kahulumeni wesifundazwe, ichaza ubuhlungu be-musculoskeletal kanye ne-back emuva njengokungathi ukushayela okunamandla kakhulu kokusetshenziswa kwemithi ehlukile.
I-Spine Medicine e-United States
Kodwa-ke, ingxenye enkulu yokwakhiwa kwezokwelapha igxile ekunakekelweni okuningi kwe-allopathic njengemithi.
Uhlu lwezokwelapha ezijwayelekile ngokuvamile olunikezwa odokotela ezigulini zabo ezibuhlungu luhlanganisa, phakathi kwezinye izinto, izidakamizwa ezidakayo. Uma kungenjalo eyaziwa ngokuthi i-opioids, le mithi ingase iholele endleleni yokulutha uma wena, udokotela wakho kanye nekhemisti yakho bengacabangi.
Izindaba ezinhle ukuthi ubuhlungu obuningi bokubuhlungu buya ngokwakho noma ngokulandela ngokwethembeka uhlelo lokuvivinya ikhwalithi elihle. Izindaba ezimbi (mhlawumbe) ukuthi into yokuqala engayenza udokotela wakho ojwayelekile angakunikeza i-opioid yobuhlungu bakho-noma ngabe ubukhulu bubucayi noma buncane.
Kodwa i-CDC ithi odokotela kufanele bahlole ngokucophelela izinzuzo zanoma yikuphi ukwelashwa ngokuphathelene nezinkinga zempilo ezingase ziholele. Uma kwenzeka ubuhlungu be-narcotic bukhululeka, uma udokotela wakho elindele ukuthi umuthi uzokukwenza-ngokuya kokubili ukuphumula kobuhlungu nokusebenza kwansuku zonke-kuyoba mkhulu kunengozi yokulutha umuthi, ukuqothulwa, neminye imiphumela emibi ehambisana nayo , ama-opioid kungase kudingeke ucabange.
Nokho, khumbula, ukuthi i-opioids ivele ifakaze ukuthi iyasebenza ngesikhashana, ubuhlungu obukhulu. Ngezinhlungu zesikhathi eside noma ezinomusa kuya ezilinganisweni, kunezinye izinketho ezingaveza imiphumela engcono.
Uma uthatha ama-opioid ubuhlungu, kufanele wazi ukuthi udokotela wakho kufanele aqaphe intuthuko yakho kulo lonke ukwelashwa. Amandla akho kanye nomthamo wakho wokusebenza ngokomzimba ekuphileni kwansuku zonke kufanele uthuthuke, futhi amazinga akho obuhlungu kufanele ahle. Uma kungenjalo, kungcono kakhulu ukumisa ukwelashwa kwe-opioid, i-CDC ithi.
Futhi ekugcineni, i-CDC incoma odokotela ukuthi ngaphambi nangesikhathi sokwelashwa, bakhuluma nawe ngezingozi nezinzuzo zokuthatha i-opioids.
Ezinye izindlela zokwelashwa ezinokuthi zithathelwe izidakamizwa ngokuvamile eziphakanyisiwe iziguli ezikhalazayo ngobuhlungu emuva zihlanganisa ukuhlinzwa, izinhlelo zokusiza izihlungu nobuhlungu obukhulu, kanye nokwelashwa okungokwenyama.
Ukulungiswa, ukuhlwanyelwa umgogodla we-spinal cord stimulators kuvame ukuthola izibuyekezo ezinhle ezivela ezigulini ezinezinhlungu ezingapheli ezingemuva ezibuhlungu ezibuyiselwa emuva. Futhi ngenxa yobuhlungu obunzima, inkambo yokwelashwa ngokuvamile iba usizo-kulabo abenza umsebenzi wesikole, kuyinto.
Ingabe Udokotela Wakho Uyazi Okufanele Akukhuthaze Ngendlela Yokwelapha?
Ngokuvamile, abahlinzeki bezokwelapha benza imali eningi ngalezo zonyango, kodwa izibalo zibonisa ukuthi iziguli zomgogodla azihlali kangcono njalo.
Isici semali singase sibe yilokho okulandela ijubane lomnenja lapho izikhungo zempilo ezinamandla nezempilo ziqhubeka phambili emncintiswaneni ukuze zithole ukwelashwa okuphephile, okuphumelelayo, okungenasidingo okwanelisa iziguli ezibuhlungu ngokwabo.
Ngakho odokotela banquma kanjani ukuthi yiziphi izindlela zokwelapha okufanele zincome kuwe? Esinye isinqunyiwe singase sibe ukukhethekile okuhlinzekwa ngumhlinzeki. Uma uya kwi- neurosurgeon ukuze uthole ukubonisana, isibonelo, ungase uthole ukuhlinzekwa nge-neurosurgery kuwe njengento eyophulukisa izimpawu zakho. Kodwa ezinye izinketho zingase zibe khona ongakhetha kuzo.
Ngaphezu kwalokho, lesi yisikhathi se-niche.
Udokotela wakho ohlinzayo angase abe nekhono elingavamile kolunye uhlobo lwenqubo yomgogodla, kodwa kuphela isilinganiso noma kancane ngaphezu kwamakhono ajwayelekile kwezinye ezihlobene. (Lokhu kungenzeka ukuthi udokotela ohlinzayo wenza leyo nqubo ngokuphindaphindiwe.) Lokho kusho ukuthi inqubo ethile (noma ifilosofi yokuhlinza) lapho udokotela ehamba phambili kungenzeka ukuthi akuyona into efanelekayo enikezwe ngayo iminyaka yakho, isimo, izintandokazi zakho , nohlobo lwenkinga yangemuva onayo.
Masithathe ukuthatha ukuhlinzwa kwe-disk njengesibonelo. Abanye odokotela abahlinzayo baye basebenzisa imali eningi ukuze bafunde indlela yokwenza i- dis replacement esikhundleni , okuyinto uhlobo olusha kakhulu lwenqubo. Abanye, mhlawumbe labo abaye embonini isikhathi esithile, banamathele ekuhlanganyeleni kwe-spinal test. Ayikho imfucumfucu yomgogodla noma i-disc esikhundleni sayo ephelele ngokuphepha nokusebenza, ngakho kunokuba wamukele umbono womhlinzeki oyedwa kulokho okwelashwa kwakho kufanele kube khona, kungase kusizuzise kakhulu ukucwaninga izinketho zakho ngokucophelela ngaphambi kokuba wenze.
Futhi ekugcineni, izikhungo zezokwelapha eziphezulu ziwumkhuba wokukhiqiza iziqondiso odokotela ukuze (ngokuzenzekelayo) balandele. Wena, njengesiguli, kungenzeka (noma ungahle) uzuze kulezi zincomo ngendlela ehlehlayo yefashini. Izinkombandlela zezinkinga zangemuva nangenhliziyo zinyatheliswa izinhlangano ezifana ne-American Physical Therapy Association, i-American Society of Interventional Pain Physicians, i-American College of Physicians, nabanye. Ngokuya ngenkinga yangempela yesiphambano, nokuthi ubani umshicileli, iziqondiso zikhomba kakhulu izidakamizwa, ukuhlinzwa, ukwelashwa kwejojo, kanye / noma ukwelashwa ngokomzimba njengokwelashwa. Ngokwesiko, benikeze ukuvuma okuncane emitholampilo ephelele.
Slant Holistic for Pain Ukwelashwa Kungaba Ngesikhathi Horizon
Kusukela ekuqaleni kuka-2017, ushintsho lungase luze.
Ukuzizwa okuningi nge-intanethi nakwezinhlelo zezindaba ze-TV kwenzelwe ngoFebhuwari nangoMashi ka-2017 ngenkathi i-American College of Physicians ishicilela isiqondiso, phakathi kwezinye izinto, esinconyayo izindlela zokwelapha eziningi ezinjengezobuhlungu obuhlungu emuva. Lezi zihlanganisa ukusikhipha, ukushaya umzimba, ukuxhaphaza umgogodla, i-tai chi, i-yoga, nokushisa. Lesi siqondiso sisekelwe ebufakazini, okusho ukuthi izincomo zahlanganiswa kusukela ekubuyekezweni okuhlelekile kwemiphumela evela kumgangatho ophezulu (izifundo ezingahleliwe, ezilawulwayo) ezihlola ukwelashwa. Abacwaningi babefuna ukwazi ukuthi yiziphi izidakamizwa eziveza imiphumela engcono kakhulu yezinto ezifana nokuqeda ubuhlungu emuva, ukukwazi ukusebenza ngokomzimba, ukuthuthukisa ikhwalithi yokuphila, ukunciphisa ukukhubazeka nokubuyela emsebenzini, nokuningi.
Abacwaningi babefuna nokwaziswa ngemiphumela emibi kanye namazinga okucindezeleka, kanye nokuthi iziguli ezanelisekile zinezokwelapha ngayinye.
Le mihlahlandlela ihlanganisa zonke izinhlobo zokwelashwa-hhayi nje zokwelashwa okuphelele-ukuhlukunyezwa okubuhlungu, okuyisifo sofuba nesifo esingemuva. Izincomo zaso zokwelashwa okuphelele ezihlukile zihluka ngokusho kohlobo lobuhlungu. Abalobi besikhombiso bathi babengenayo ubufakazi obanele bokukhuluma noma yiziphi izindlela ezibuhlungu ezibhekiswe emgodleni, okubizwa ngokuthi ubuhlungu obukhulu futhi ngokuvamile kubangelwa i-disc herniated.
Manje, ngaphambi kokuba ujabule (uma, ngempela ungumuntu ongathanda ukunakekelwa okuphelele ngenqubo ye-allopathic), khumbula ukuthi lokhu kuyinconywa yomphakathi owodwa kuphela. Ngamanye amazwi, ukwelashwa okuphelele njengendlela yokwelapha ubuhlungu obuvamile engakunqunywa udokotela wakho akuyona into eyenziwe.
Okungenzeka Ngemihlahlandlela Ebanzi Efakazela I-Health Holistic
Ezinye izinhlangano, ezifana ne-American Medical Association kanye ne-Joint Commission (i-ejensi yokugunyaza ebeka izindinganiso zokwelapha izibhedlela), esikhathini esidlule, yakhipha izitatimende.
Ukutholakala kwemithi yemvelo kule mibiko kanye nemibiko efanayo kungahle kwenzeke. Ngezinye izikhathi, ukwelashwa ongazijwayele ( isifo sofuba , ukubhusa umzimba, ukukhwabanisa, ukucabanga, i-yoga, isibonelo) kuthiwa ngokuqondile, kodwa umbiko unqanda ukufuna noma ukuphakamisa ngokuqinile lezi zindlela zokwelapha zokuqala . Ngezinye izikhathi, uhlu lwezinhlobo zokwelapha okuphelele luyingcosana, kepha ukusetshenziswa kwabo kukhuthazwa kakhulu.
Ulimi lukaJohn Weeks, umshicileli we- Integrator Blog News & Umbiko , uthi: "Ulimi luvame ukushintsha njengoba lezi zincwadi zinconywa zenziwa, futhi lapho uhlu lwezokwelapha oluphelele lucebile ukukhetha, lapho kuphuma khona okuncane," kusho uJohn Weeks, umshicileli we- Integrator Blog News & Umbiko .
Isibonelo, ngoNovemba 2014, i-Joint Commission yakhiphe "Ukucaciswa koMthetho Wokuphathwa Kwezinhlungu" okushiwo ngamazwi eviki, "ukuphakamisa ukubaluleka kwezinqubo ezingekho ze-pharmacologic. Ukwelashwa ngokucophelela, ukwelashwa ukusikhipha imithi, ukwelashwa kwe-chiropractic, ukwelashwa kokuziphatha kwengqondo, kanye nokwelashwa ngokweqile kwakungenye yezindlela ezibizwa ngokucacile, "usho kanje.
Kwabe sekuthi ngo-2017, i-Joint Commission yenze uhlelo olulandelayo lwe-Pain Standard yabo. Ungase ucabange ukuthi kuyoba ukuqhutshwa komqulu wokucacisa kusukela eminyakeni emithathu ngaphambili, okufaka phakathi, futhi kuqinisa uhlu lwazo lwezokwelapha ngo-2014. Esikhundleni salokho, nakuba ukutholakala okwengeziwe kulezo zonyango kunconywa, inani lezinhlanzi eziphelele elikhonjiwe empeleni lincane.
Ngenxa yalesi sizathu, amazwana amaviki, okushicilelwa kwamuva kunzima. Uthi: "Noma kunjalo, ukugcoba noma ukusikhipha imishini, kubizwa ngokuqondile." Iviki zanezela ukuthi uma ukwelashwa kungakhulunywa ngokuqondile, odokotela abambalwa bayothambekela ekutholeni umkhuba wabo noma batusa iziguli zabo.
Esinye isibonelo salesi simo selimi esishintshayo, ngokusho kwamaviki, yisiqondiso somqulu we-CDC sika-2016 somshini wezinyosi ze-opioid. (Ekugcineni sekukhululwe.) Uthi, "Umhlahlandlela uhlanganisa lolulimi oluguquguqukayo: 'Ukwelashwa okungenayo i-pharmacologic kanye nokwelashwa kwe-pharmacologic engekho opioid kukhethwa ubuhlungu obungapheli.'"
Kodwa, njengamaviki okukhulunywa ngawo kuloluhlaka, izindlela zokwelashwa ezihambisanayo kanye nokunye (isib. Ukuxhaphaza umgogodla, ukubhunga umzimba, nokugcoba umzimba) kuthiwa yizifo zokwelapha ezingathandeki, ezingekho kwemithi ezingase zivivinyelwe ubuhlungu esikhundleni se-opioids yama-narcotic. "Ukusetshenziswa kwegama elithi 'ukukhetha' kusikisela kuqala," usho kanje, "Lokhu kuwukuphela kokuguqulwa okunamandla kusuka kumkhuba wamanje."
Kodwa lapho i-CDC ishicilela inguqulo yokugcina ezinyangeni ezimbalwa kamuva, okukhulunywa ngakho okunye okuhambisanayo nokunye okunye okushiwo kwakungekho. Uhlu manje lufunda: "Ukuzivocavoca, amanzi, aerobic, psychological, cognitive therapy therapy, kanye nokuphazamiseka kwe-bio-psycho-social."
Ngamanye amazwe aseMelika aphila nobuhlungu kunesifo sikashukela, isifo senhliziyo, nomdlavuza kuhlangene (ngokusho kwe-American Academy of Pain Medicine), ukuphathwa kobuhlungu ngendlela ebiza imali, ngendlela enomthengi kubalulekile. Futhi lokhu kwenziwa kuphela ukuthi iqiniso lokuthi abantu abaningi abatholi ukusizwa abafuna kuzo odokotela babo abavamile.
> Imithombo:
> ACP. I-American College of Physicians ihlinzeka isiqondiso sokwelapha > okungavamile > ubuhlungu obuphansi emuva. I-American College of Physicians. Feb 2017. https://www.acponline.org/acp-newsroom/american-college-of-physicians-issues-guideline-for-treating-nonradicular-low-back-pain.
> Amasevisi Okulawula Nokuvimbela Izifo. Ukulimala nokufa Ukubika ngeviki. Umhlahlandlela we-CDC Wokubhala Opioids for Pain Chronic - > United States >, 2016 > Izincomo > nemibiko. NgoMashi 2016. https://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm.
> Quseem > A., MD, > PhD >, MHA, Wilt T., MD, MPH, McLean, R, MD, Forciea, M, MD IziNhlelo ezingekho emthethweni ze-Acute, Subacute, ne-Chronic Low Pain: Kusukela ku-American College of Physicians. Ama-Annal of Medicine yangaphakathi. Feb 2017. http://annals.org/aim/article/2603228/noninvasive-treatments-acute-subacute-chronic-low-back-pain-clinical-practice