The piriformis minofu (PM) amadziwika bwino muzamankhwala ngati minofu yayikulu ya m'chiuno chakumbuyo. Ndi minofu yomwe imakhala ndi gawo lowongolera kuzungulira kwa chiuno ndi kubedwa, komanso ndi minofu yomwe imatchuka chifukwa chakusintha kwake kozungulira. PM imakhalanso ndi chidwi chifukwa cha ntchito yake mu matenda a piriformis, zomwe zimakhudzidwa ngati gwero la ululu ndi kusagwira ntchito.
Matenda a Piriformis angatanthauzidwe ngati matenda omwe minofu ya piriformis, yomwe ili m'dera la matako, imapweteka ndipo imayambitsa kupweteka kwa matako. Mitsempha ya Sciatic ikhoza kukwiyitsidwa ndi kuyanjana pakati pa SN ndi PM kutulutsa ululu wam'mbuyo kumbuyo kwa ntchafu, kutsanzira 'sciatica'.
Madandaulo a ululu wa matako ndi kutumiza kwa zizindikiro sizosiyana ndi Piriformis Muscle. Zizindikiro ndizofala kwambiri ndi zizindikiro zodziwika bwino za ululu wammbuyo. Zasonyezedwa kuti matenda a piriformis amawerengera 5-6 peresenti ya milandu ya sciatica. Nthawi zambiri, zimachitika mwa anthu azaka zapakati ndipo ndizofala kwambiri mwa amayi.
Zamkatimu
Anatomy: Piriformis
PM imachokera kumtunda kwa sacrum ndipo imamangirizidwa ndi zomangira zitatu zamnofu pakati pa sacral foramina yoyamba, yachiwiri, yachitatu ndi yachinayi. Nthawi zina chiyambi chake chikhoza kukhala chotakata kwambiri kotero kuti chimagwirizanitsa kapisozi wa sacroiliac olowa pamwamba ndi sacrotuberous ndi / kapena sacrospinous ligament pansipa.
PM ndi minofu yochuluka komanso yambiri, ndipo pamene imatuluka m'chiuno kudzera muzitsulo zazikulu za sciatic foramen, imagawaniza foramen mu suprapiriform ndi infra-piriform foramina. Pamene akuyenda anterolaterally kupyolera mu sciatic foramen wamkulu, amawombera kuti apange tendon yomwe imamangiriridwa kumtunda wapamwamba wa trochanter wamkulu, womwe umagwirizanitsa ndi tendon wamba wa obturator internus ndi minofu ya Gemelli.
Mitsempha ndi mitsempha yamagazi mu suprapiriform foramen ndi mitsempha yapamwamba ya gluteal ndi zotengera, ndipo mu infra-piriform fossa ndi mitsempha yotsika kwambiri ya gluteal ndi mitsempha ndi mitsempha ya sciatic (SN). Chifukwa cha kuchuluka kwake mu sciatic foramen yayikulu, imatha kupondereza ziwiya zambiri ndi mitsempha yomwe imatuluka m'chiuno.
PM imagwirizana kwambiri ndi ma rotator ena amfupi omwe amakhala otsika monga gemellus yapamwamba, obturator internus, gemellus yapansi, ndi obturator externus. Kusiyana kwakukulu pakati pa PM ndi ma rotator ena achidule ndi ubale ndi SN. PM imadutsa kumbuyo kwa mitsempha pamene obturator ina imadutsa kutsogolo.
Chifukwa: Piriformis Syndrome
Matenda a Piriformis angayambidwe kapena okhudzana ndi zifukwa zitatu zazikulu zomwe zimayambitsa;
1. Minofu yolimba komanso yofupikitsa yomwe imayamba chifukwa chogwiritsa ntchito mopitirira muyeso monga kugwedezeka kwa squat ndi mapapu pozungulira kunja, kapena kuvulala mwachindunji. Izi zimawonjezera girth ya PM panthawi yodutsa, ndipo mwina gwero la kuponderezana / kutsekeka.
2. Kutsekeka kwa mitsempha.
3.Sacroiliac Joint Dysfunction (SI Joint Pain) yomwe imayambitsa PM spasm.
Zizindikiro: Piriformis Syndrome
Zizindikiro zodziwika bwino za matenda a piriformis ndi awa:
- Kumva kolimba kapena kukangana m'tako ndi/kapena hamstring.
- Gluteal ululu.
- Ululu wa ng'ombe.
- Kuwonjezeka kuchokera pakukhala ndi squatting, makamaka ngati thunthu likuyang'ana kutsogolo kapena mwendo wadutsa mwendo wosakhudzidwa.
- zotheka zotumphukira mitsempha zizindikiro monga kupweteka ndi paraesthesia kumbuyo, groin, matako, perineum, kumbuyo kwa ntchafu.
Chithandizo: Piriformis Syndrome
Pamene izo zikukhulupiriridwa zimenezo piriformis syndrome alipo ndipo dokotala akuwona kuti matenda apezeka, chithandizo nthawi zambiri chimadalira chomwe akukayikira. Ngati PM ili yolimba komanso yopweteka ndiye kuti poyamba chithandizo chodziletsa chidzayang'ana kutambasula ndi kupaka minofu yolimba kuchotsa PM monga gwero la ululu.
Ngati izi zikulephera, ndiye kuti zotsatirazi zaperekedwa:
- Chida chamankhwala cham'deralo chochitidwa ndi akatswiri ogonetsa omwe ali ndi ukadaulo wowongolera ululu.
- jakisoni wa steroid mu PM.
- Jekeseni wa botulinum mu PM.
- Opaleshoni Ya Mitsempha.
Zothandizira zotsogozedwa ndi achipatala monga kutambasula kwa PM ndi Direct trigger point massage zakhala zikulimbikitsidwa. Kutambasula kwa PM kumachitika m'malo a chiuno chokulirapo kuposa madigiri a 90, adduction, ndi kuzungulira kwakunja kuti agwiritse ntchito kusintha kwa zochita za PM kuti adzilekanitse kutambasula kwa minofu iyi popanda zina zozungulira kunja kwa chiuno.
Kutsiliza: Piriformis Syndrome
The piriformis minofu ndi minofu yamphamvu komanso yamphamvu yomwe imachokera ku sacrum kupita ku femur. Zimayenda pansi pa minofu ya gluteal yomwe mitsempha imayenda pansi pawo. Ngati minofuyi ilowa m'mitsempha, ndiye kuti minyewa imayambitsa kupweteka, dzanzi, kumva kuwawa, kapena kutentha kuchokera kumatako kupita ku mwendo ndi phazi. Anthu ena amakhala ndi matenda amtunduwu pamene akulimbana ndi ululu wopweteka kwambiri.
Zochita ndi zochitika zomwe zimayambitsa Minofu ya piriformis kuti ipangike kuti ipitirire kupondereza mitsempha ya sciatic, kuchititsa ululu. Minofu iyi imakoka tikangogwada, kapena kuimirira, kuyenda, kukwera masitepe. Zimakonda kumangika tikakhala pamalo aliwonse kwa mphindi zopitilira 20 mpaka 30.
Anthu omwe ali ndi mbiri ya ululu wopweteka kwambiri wa msana nthawi zambiri amaganiza kuti ululu wawo wa sciatic umawonekera m'munsi mwa msana wawo. Mbiri yawo ya disc herniations, kapena sprains, zovuta zawaphunzitsa kuganiza kuti zidzachoka ngati zachilendo komanso kuti ululuwo umachokera msana wawo. Nthawi yomweyo ululuwo ukapanda kuyankha monga mwanthawi zonse m'pamene anthu amafunafuna chithandizo, motero amachedwetsa kuchira.
Sciatica Pain
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Zomwe zili pano pa "Chithandizo cha Piriformis"Sitikufuna kuti mulowe m'malo mwa ubale wapamodzi ndi dokotala wodziwa bwino zachipatala kapena dokotala wovomerezeka ndipo siuphungu wachipatala. Tikukulimbikitsani kuti mupange zisankho zachipatala malinga ndi kafukufuku wanu ndi mgwirizano ndi katswiri wodziwa zaumoyo.
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Zambiri zathu Zimangokhala ku Chiropractic, musculoskeletal, mankhwala akuthupi, thanzi, chithandizo chamankhwala. kusokonezeka kwa viscerosomatic mkati mwazowonetsera zachipatala, zokhudzana ndi matenda a somatovisceral reflex, subluxation complexes, zovuta zaumoyo, ndi / kapena zolemba zamankhwala, mitu, ndi zokambirana.
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Timamvetsetsa kuti timafotokoza zinthu zomwe zimafunikira kufotokozedwanso momwe zingathandizire mu dongosolo la chisamaliro kapena njira yothandizira; Chifukwa chake, kuti mupitilize kukambirana pamutuwu pamwambapa, chonde lekani kufunsa Dr. Alex Jimenez, DC, Kapena tilankhule nafe 915-850-0900.
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madalitso
Dr. Alex Jimenez D.C., MSACP, RN*, CCST, Mtengo wa IFMCP*, Mtengo wa CIFM*, ATN*
imelo: makoza@elpasofunctionalmedicine.com
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