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Kuvulaza Mitsempha

Back Clinic Nerve Injury Team. Mitsempha imakhala yosalimba ndipo imatha kuwonongeka chifukwa cha kupanikizika, kutambasula, kapena kudula. Kuvulala kwa mitsempha kumatha kuyimitsa zizindikiro zopita ndi kuchokera ku ubongo, zomwe zimapangitsa kuti minofu isagwire ntchito bwino komanso kutaya kumverera m'dera lovulala. Mitsempha imayang'anira ntchito zambiri za thupi, kuyambira pakuwongolera kupuma kwamunthu mpaka kuwongolera minofu yake komanso kumva kutentha ndi kuzizira. Koma, pamene kuvulala koopsa kapena vuto linalake limayambitsa kuvulala kwa mitsempha, moyo wa munthu ukhoza kukhudzidwa kwambiri. Dr. Alex Jimenez akufotokoza mfundo zosiyanasiyana kudzera m'mabuku ake osungiramo zakale ozungulira mitundu ya kuvulala ndi chikhalidwe chomwe chingayambitse kusokonezeka kwa mitsempha komanso kukambirana za mitundu yosiyanasiyana ya mankhwala ndi njira zothetsera ululu wa mitsempha ndi kubwezeretsa moyo wa munthu.

General Chodzikanira *

Zomwe zili pano sizinapangidwe kuti zilowe m'malo mwa ubale wa munthu ndi m'modzi ndi dokotala wodziwa bwino zachipatala kapena dokotala yemwe ali ndi chilolezo ndipo si malangizo azachipatala. Tikukulimbikitsani kuti mupange zisankho zanu zachipatala potengera kafukufuku wanu komanso mgwirizano ndi katswiri wodziwa zaumoyo. Kuchuluka kwathu kwachidziwitso kumangokhala chiropractic, musculoskeletal, mankhwala akuthupi, thanzi, zovuta zaumoyo, zolemba zamankhwala ogwira ntchito, mitu, ndi zokambirana. Timapereka ndikuwonetsa mgwirizano wazachipatala ndi akatswiri ochokera m'machitidwe osiyanasiyana. Katswiri aliyense amayendetsedwa ndi momwe amagwirira ntchito komanso momwe alili ndi chilolezo. Timagwiritsa ntchito ndondomeko zaumoyo ndi thanzi kuti tithandizire ndikuthandizira kuvulala kapena kusokonezeka kwa minofu ndi mafupa. Makanema athu, zolemba zathu, mitu yathu, mitu, ndi zidziwitso zimakhudza zachipatala, zovuta, ndi mitu yomwe ikukhudzana ndikuthandizira, mwachindunji kapena m'njira zina, momwe timagwirira ntchito pachipatala.* Ofesi yathu yayesetsa kupereka mawu otithandizira ndipo yazindikira. kafukufuku wofunikira kapena maphunziro othandizira ma post athu. Timapereka makope othandizira maphunziro a kafukufuku omwe amapezeka kwa oyang'anira oyang'anira ndi anthu akafunsidwa.

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 Kapena tilankhule nafe 915-850-0900.

Dr. Alex Jimenez D.C., MSACP, CCST, Mtengo wa IFMCP*, Mtengo wa CIFM*, ATN*

imelo: makoza@elpasofunctionalmedicine.com

Chilolezo mu: Texas & New Mexico*

 

Demystifying Spinal Nerve Roots ndi Impact Yawo pa Thanzi

Demystifying Spinal Nerve Roots ndi Impact Yawo pa Thanzi

by | Kuvulaza Mitsempha, Sciatica

Pamene sciatica kapena kupweteka kwina kwa mitsempha kumapereka, kodi kuphunzira kusiyanitsa pakati pa ululu wa mitsempha ndi mitundu yosiyanasiyana ya ululu kumathandiza anthu kuzindikira pamene mitsempha ya msana imakwiyitsidwa kapena kupanikizika kapena mavuto aakulu omwe amafunikira chithandizo chamankhwala?

Demystifying Spinal Nerve Roots ndi Impact Yawo pa Thanzi

Mizu ya Mitsempha ya Msana ndi Dermatomes

Matenda a msana monga ma disc a herniated ndi stenosis amatha kubweretsa ululu wowawa womwe umayenda pansi pa mkono kapena mwendo umodzi. Zizindikiro zina ndi kufooka, dzanzi, ndi/kapena kuwombera kapena kuyaka kukhudzidwa kwa magetsi. Mawu azachipatala azizindikiro za mitsempha yotsina ndi radiculopathy (National Institutes of Health: National Institute of Neurological Disorders ndi Stroke. 2020). Dermatomes ikhoza kuyambitsa kukwiya kwa msana, komwe mizu ya mitsempha imayambitsa zizindikiro kumbuyo ndi miyendo.

Anatomy

Msana uli ndi magawo 31.

  • Gawo lirilonse liri ndi mizu ya mitsempha kumanja ndi kumanzere yomwe imapereka ntchito zamagalimoto ndi zomverera ku miyendo.
  • Nthambi zolankhulana zam'mbuyo ndi zam'mbuyo zimagwirizanitsa kupanga mitsempha ya msana yomwe imatuluka mumtsinje wa vertebral.
  • Zigawo za 31 za msana zimabweretsa mitsempha ya 31 ya msana.
  • Iliyonse imatumiza kulowetsa kwa minyewa kuchokera kudera linalake la khungu kumbali imeneyo ndi gawo la thupi.
  • Madera amenewa amatchedwa dermatomes.
  • Kupatula pa mitsempha yoyamba ya msana wa khomo lachiberekero, dermatomes alipo pa mitsempha iliyonse ya msana.
  • Mitsempha ya msana ndi ma dermatome omwe amalumikizana nawo amapanga maukonde pathupi lonse.

Dermatomes Cholinga

Dermatomes ndi madera a thupi/pakhungu omwe ali ndi zomverera zomwe zimaperekedwa ku mitsempha ya msana. Mizu ya mitsempha iliyonse imakhala ndi dermatome yogwirizana, ndipo nthambi zosiyanasiyana zimapereka dermatome iliyonse kuchokera muzu umodzi wa mitsempha. Dermatomes ndi njira zomwe zidziwitso zowoneka bwino zapakhungu zimatumiza mauthenga kupita ndi kuchokera kumagulu apakati amanjenje. Zomverera zomwe zimamveka mwathupi, monga kupanikizika ndi kutentha, zimafalikira kudera lapakati lamanjenje. Pamene muzu wa mitsempha ya msana umakhala woponderezedwa kapena kukwiyitsidwa, kawirikawiri chifukwa umagwirizana ndi dongosolo lina, umayambitsa radiculopathy. (National Institutes of Health: National Institute of Neurological Disorders ndi Stroke. 2020).

Kuchuluka kwa mankhwala

Radiculopathy imatanthawuza zizindikiro zomwe zimayambitsidwa ndi minyewa yopindika pamsana. Zizindikiro ndi zomverera zimadalira komwe minyewa imatsinidwa komanso kuchuluka kwa kupsinjika.

Chiberekero

  • Ichi ndi matenda a ululu ndi / kapena zofooka za sensorimotor pamene mizu ya mitsempha pakhosi imakanizidwa.
  • Nthawi zambiri amawoneka ndi ululu womwe umatsika pa mkono umodzi.
  • Anthu amathanso kumva zomverera zamagetsi monga ma pini ndi singano, kugwedezeka, ndi kuyaka, komanso zizindikiro zamagalimoto monga kufooka ndi dzanzi.

Lumbar

  • Radiculopathy iyi imachokera ku kupsinjika, kutupa, kapena kuvulala kwa mitsempha ya msana kumunsi kumbuyo.
  • Kumva kupweteka, dzanzi, kumva kuwawa, kumveka kwamagetsi kapena kuyaka, ndi zizindikiro zamagalimoto monga kufooka kumayenda pansi pa mwendo umodzi ndizofala.

Matendawa

Gawo la kafukufuku wakuthupi wa radiculopathy ndikuyesa ma dermatomes kuti amve. Dokotala adzagwiritsa ntchito mayesero apadera amanja kuti adziwe msinkhu wa msana umene zizindikirozo zimachokera. Mayeso apamanja nthawi zambiri amatsagana ndi mayeso oyerekeza ngati MRI, omwe amatha kuwonetsa zolakwika muzu wa msana. Kufufuza kwathunthu kwa thupi kudzatsimikizira ngati mizu ya mitsempha ya msana ndiyo gwero la zizindikiro.

Kuchiza Zomwe Zimayambitsa

Matenda ambiri am'mbuyo amatha kuthandizidwa ndi njira zochiritsira zochiritsira kuti apereke mpumulo wogwira mtima. Mwachitsanzo, pa disk herniated, anthu akhoza kulangizidwa kuti apume ndi kumwa mankhwala osagwiritsidwa ntchito poletsa kutupa. Acupuncture, physiotherapy, chiropractic, kusachita opaleshoni, kapena mankhwala a decompression akhozanso kulembedwa. Kwa ululu waukulu, anthu akhoza kupatsidwa jakisoni wa epidural steroid omwe angathandize kuchepetsa ululu pochepetsa kutupa. (American Academy of Orthopedic Surgeons: OrthoInfo. 2022) Kwa stenosis ya msana, wothandizira angayambe kuyang'ana pa chithandizo chamankhwala kuti apititse patsogolo thupi lonse, kulimbikitsa mimba ndi minofu yam'mbuyo, ndi kusunga kayendedwe ka msana. Mankhwala ochepetsa ululu, kuphatikizapo NSAIDs ndi jakisoni wa corticosteroid, amatha kuchepetsa kutupa ndi kuchepetsa ululu. (American College of Rheumatology. 2023) Ochiritsa amthupi amapereka njira zosiyanasiyana zochizira kuti achepetse zizindikiro, kuphatikiza kupukutira kwapamanja ndi makina ndikukokera. Opaleshoni ikhoza kulimbikitsidwa pazochitika za radiculopathy zomwe sizimayankha chithandizo chokhazikika.

Mapulani a chisamaliro chachipatala cha Chiropractic ndi Functional Medicine Clinic ndi ntchito zachipatala ndizopadera ndipo zimayang'ana kwambiri kuvulala komanso kuchira kwathunthu. Malo athu omwe timachita ndi monga Ubwino & Chakudya, Ululu Wosatha, Kuvulala Kwawekha, Kusamalira Ngozi Yagalimoto, Kuvulala Kwa Ntchito, Kuvulala Kwambuyo, Kupweteka Kwambiri, Kupweteka kwa Pakhosi, Migraine Mutu, Kuvulala Kwa Masewera, Sciatica Kwambiri, Scoliosis, Complex Herniated Discs, Fibromyalgia, Chronic Ululu, Kuvulala Kwakukulu, Kuwongolera Kupsinjika, Chithandizo Chamankhwala Ogwira Ntchito, komanso njira zosamalira odwala. Timayang'ana kwambiri kubwezeretsa magwiridwe antchito amthupi pambuyo povulala ndi kuvulala kwa minofu yofewa pogwiritsa ntchito Specialized Chiropractic Protocols, Wellness Programs, Nutrition Yogwira Ntchito ndi Yophatikizana, Agility, ndi Mobility Fitness Training, ndi Rehabilitation Systems kwazaka zonse. Ngati munthuyo akufunikira chithandizo china, adzatumizidwa ku chipatala kapena dokotala woyenerera bwino matenda ake. Dr. Jimenez adagwirizana ndi madokotala ochita opaleshoni, akatswiri a zachipatala, ofufuza zachipatala, othandizira, ophunzitsa, ndi opereka chithandizo choyamba kuti abweretse El Paso, chithandizo chamankhwala apamwamba, kumudzi wathu.

Bweretsani Kuyenda Kwanu: Chiropractic Care For Sciatica Recovery

Zothandizira

National Institutes of Health: National Institute of Neurological Disorders ndi Stroke. (2020). Chowonadi cha ululu wammbuyo. Zabwezedwa kuchokera www.ninds.nih.gov/sites/default/files/migrate-documents/low_back_pain_20-ns-5161_march_2020_508c.pdf

American Academy of Orthopedic Surgeons: OrthoInfo. (2022). Herniated disk kumunsi kumbuyo. orthoinfo.aaos.org/en/diseases-conditions/herniated-disk-in-the-lower-back/

American College of Rheumatology. (2023). Msana stenosis. rheumatology.org/patients/spinal-stenosis

Thandizo kuchokera ku Neurogenic Claudication: Njira Zochizira

Thandizo kuchokera ku Neurogenic Claudication: Njira Zochizira

by | Chiropractic, Kuvulaza Mitsempha, Sciatica

Anthu omwe akukumana ndi kuwombera, kupweteka kwa m'munsi, ndi kupweteka kwapang'onopang'ono kwa mwendo angakhale akuvutika ndi neurogenic claudication. Kodi kudziwa zizindikiro kungathandize othandizira azaumoyo kupanga dongosolo lothandiza lamankhwala?

Thandizo kuchokera ku Neurogenic Claudication: Njira Zochizira

Neurogenic Claudication

Neurogenic claudication imachitika pamene mitsempha ya msana imapanikizidwa mu lumbar kapena kumunsi kwa msana, kuchititsa kupweteka kwapakatikati kwa mwendo. Mitsempha yoponderezedwa mu lumbar msana ingayambitse kupweteka kwa mwendo ndi kukokana. Ululu nthawi zambiri umakulirakulira ndi mayendedwe kapena zochitika zina monga kukhala, kuyimirira, kapena kugwada chakumbuyo. Amadziwikanso kuti pseudo-claudication pamene danga mkati mwa lumbar msana ukuchepa. Matenda otchedwa lumbar spinal stenosis. Komabe, neurogenic claudication ndi matenda kapena gulu la zizindikiro zomwe zimayambitsidwa ndi mitsempha ya msana, pamene stenosis ya msana imalongosola kuchepa kwa ndime za msana.

zizindikiro

Zizindikiro za Neurogenic claudication zingaphatikizepo:

  • Kupweteka kwa mwendo.
  • Kumva dzanzi, kumva kuwawa, kapena kuyaka.
  • Kutopa kwa mwendo ndi kufooka.
  • Kumva kulemera kwa mwendo/mphindi.
  • Zowawa zakuthwa, zowombera, kapena zowawa zofikira m'munsi, nthawi zambiri m'miyendo yonse.
  • Pakhoza kukhala ululu m'munsi kumbuyo kapena matako.

Neurogenic claudication ndi yosiyana ndi mitundu ina ya ululu wa mwendo, monga ululu umasinthasintha - kusiya ndi kuyamba mwachisawawa ndikuwonjezereka ndi kayendetsedwe kake kapena ntchito. Kuima, kuyenda, kutsika masitepe, kapena kutembenukira chammbuyo kungayambitse ululu, pamene kukhala, kukwera masitepe, kapena kutsamira kutsogolo kumachepetsa ululu. Komabe, nkhani iliyonse ndi yosiyana. Pakapita nthawi, claudication ya neurogenic imatha kukhudza kuyenda monga momwe anthu amayesera kupewa zinthu zomwe zimayambitsa kupweteka, kuphatikizapo kuchita masewera olimbitsa thupi, kukweza zinthu, ndi kuyenda kwanthawi yayitali. Pazovuta kwambiri, claudication ya neuroogenic imapangitsa kugona kukhala kovuta.

Neurogenic claudication ndi sciatica sizofanana. Neurogenic claudication imaphatikizapo kupsinjika kwa mitsempha pakatikati pa ngalande ya lumbar msana, kuchititsa kupweteka kwa miyendo yonse. Sciatica imaphatikizapo kupanikizana kwa mizu ya mitsempha yotuluka m'mbali mwa lumbar msana, kuchititsa kupweteka kwa mwendo umodzi. (Carlo Ammendolia, 2014)

Zimayambitsa

Ndi neurogenic claudication, mitsempha ya msana yoponderezedwa ndiyo yomwe imayambitsa kupweteka kwa mwendo. Nthawi zambiri, matabwa a msana stenosis - LSS ndi chifukwa cha pinched mitsempha. Pali mitundu iwiri ya lumbar spinal stenosis.

  • Central stenosis ndiye chifukwa chachikulu cha neurogenic claudication. Ndi mtundu uwu, ngalande yapakati ya lumbar msana, yomwe imakhala ndi msana, imachepetsera, kuchititsa kupweteka kwa miyendo yonse.
  • Lumbar spinal stenosis imatha kupezeka ndikukula pambuyo pake m'moyo chifukwa cha kuwonongeka kwa msana.
  • Congenital zikutanthauza kuti munthu amabadwa ndi vutoli.
  • Zonsezi zimatha kubweretsa neuroogenic claudication m'njira zosiyanasiyana.
  • Foramen stenosis ndi mtundu wina wa lumbar spinal stenosis umene umapangitsa kuti mipata ikhale yocheperapo mbali zonse za lumbar spine kumene mizu ya mitsempha imachokera ku msana. Ululu wogwirizana ndi wosiyana chifukwa uli mu mwendo wamanja kapena wakumanzere.
  • Ululuwu umafanana ndi mbali ya msana pamene mitsempha imapinidwa.

Anapeza Lumbar Spinal Stenosis

Lumbar spinal stenosis nthawi zambiri imapezeka chifukwa cha kuwonongeka kwa lumbar msana ndipo imakhudza anthu akuluakulu. Zifukwa za kuchepa kwa thupi zingaphatikizepo:

  • Kuvulala kwa msana, monga kugunda kwa galimoto, ntchito, kapena kuvulala pamasewera.
  • Diski herniation.
  • Osteoporosis ya msana - nyamakazi yowonongeka.
  • Ankylosing spondylitis - mtundu wa nyamakazi yotupa yomwe imakhudza msana.
  • Osteophytes - fupa spurs.
  • Zotupa za msana - zotupa zopanda khansa komanso za khansa.

Congenital Lumbar Spinal Stenosis

Congenital lumbar spinal stenosis amatanthauza kuti munthu amabadwa ndi zovuta za msana zomwe sizimawonekera pakubadwa. Chifukwa danga mkati mwa ngalande ya msana ndi yopapatiza kale, msana wa msana umakhala pachiwopsezo cha kusintha kulikonse monga zaka za munthu. Ngakhale anthu omwe ali ndi nyamakazi yofatsa amatha kukhala ndi zizindikiro za neuroogenic claudication koyambirira komanso kukhala ndi zizindikiro muzaka zawo za 30 ndi 40 m'malo mwa 60s ndi 70s.

Matendawa

Kuzindikira kwa neurogenic claudication kumatengera mbiri yachipatala ya munthu, kuyezetsa thupi, ndi kujambula. Kuwunika kwakuthupi ndikuwunikanso kumazindikira komwe ululu ukuwonekera komanso liti. Wothandizira zaumoyo angafunse kuti:

  • Kodi pali mbiri ya ululu wa m'munsi?
  • Kodi kupweteka kwa mwendo umodzi kapena zonse ziwiri?
  • Kodi ululuwo nthawi zonse?
  • Kodi ululu umabwera ndikupita?
  • Kodi ululuwo umakhala bwino kapena ukukulirakulira utayima kapena utakhala?
  • Kodi mayendedwe kapena zochitika zimayambitsa zowawa ndi zomverera?
  • Kodi pamakhala kumverera kwanthawi zonse mukamayenda?

chithandizo

Mankhwalawa amatha kukhala ndi chithandizo chamankhwala, jakisoni wa spinal steroid, ndi mankhwala opweteka. Kuchita opaleshoni ndi njira yomaliza pamene mankhwala ena onse sangathe kupereka chithandizo chogwira mtima.

Thandizo la Thupi

A dongosolo la mankhwala idzaphatikizapo physiotherapy yomwe ikuphatikizapo:

  • Kutambasula tsiku ndi tsiku
  • Kulimbikitsa
  • Zochita za aerobic
  • Izi zithandizira kukonza ndikukhazikika kwa minofu yakumbuyo ndikuwongolera zovuta za kaimidwe.
  • Thandizo la ntchito lidzalimbikitsa kusintha kwa zochitika zomwe zimayambitsa zizindikiro zowawa.
  • Izi zikuphatikizapo makina oyenerera a thupi, kusunga mphamvu, ndi kuzindikira zizindikiro za ululu.
  • Zingwe zam'mbuyo kapena malamba zithanso kulangizidwa.

Majekeseni a Spinal Steroid

Othandizira zaumoyo angalimbikitse jakisoni wa epidural steroid.

  • Izi zimapereka cortisone steroid ku gawo lakunja la msana kapena epidural space.
  • Majekeseni amatha kupereka mpumulo kwa miyezi itatu mpaka zaka zitatu. (Sunil Munakomi et al., 2024)

Mankhwala Opweteka

Mankhwala opweteka amagwiritsidwa ntchito pochiza intermittent neurogenic claudication. Izi zikuphatikizapo:

  • Ma analgesics otsika kwambiri monga acetaminophen.
  • Nonsteroidal anti-inflammatory drugs kapena NSAIDs monga ibuprofen kapena naproxen.
  • Mankhwala a NSAID amatha kuperekedwa ngati pakufunika.
  • NSAIDs amagwiritsidwa ntchito ndi ululu wosaneneka wa neurogenic ndipo uyenera kugwiritsidwa ntchito ngati pakufunika.
  • Kugwiritsa ntchito nthawi yayitali kwa NSAID kungayambitse zilonda zam'mimba, ndipo kugwiritsa ntchito kwambiri acetaminophen kungayambitse chiwopsezo cha chiwindi ndi kulephera kwa chiwindi.

Opaleshoni

Ngati mankhwala ochiritsira sangathe kupereka mpumulo wogwira mtima ndi kuyenda komanso / kapena umoyo wa moyo umakhudzidwa, opaleshoni yotchedwa laminectomy ikhoza kulangizidwa kuti iwononge lumbar msana. Ndondomeko ikhoza kuchitidwa:

  • Laparoscopically - yokhala ndi madontho ang'onoang'ono, makulidwe, ndi zida zopangira opaleshoni.
  • Opaleshoni yotsegula - ndi scalpel ndi sutures.
  • Panthawiyi, mbali za vertebra zimachotsedwa pang'ono kapena kwathunthu.
  • Kuti akhale okhazikika, nthawi zina mafupa amaphatikizana ndi zomangira, mbale, kapena ndodo.
  • Mitengo yachipambano ya onse awiri imakhala yofanana kapena yocheperapo.
  • Pakati pa 85% ndi 90% ya anthu omwe akuchitidwa opaleshoni amapeza mpumulo wokhalitsa komanso / kapena kupweteka kosatha. (Xin-Long Ma et al., 2017)

Mankhwala a Movement: Chisamaliro cha Chiropractic

Zothandizira

Ammendolia C. (2014). Degenerative lumbar spinal stenosis ndi onyenga ake: maphunziro atatu. Journal of the Canadian Chiropractic Association, 58 (3), 312-319.

Munakomi S, Foris LA, Varacallo M. (2024). Spinal Stenosis ndi Neurogenic Claudication. [Yosinthidwa 2023 Aug 13]. Mu: StatPearls [Intaneti]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Zikupezeka kuchokera: www.ncbi.nlm.nih.gov/books/NBK430872/

Ma, XL, Zhao, XW, Ma, JX, Li, F., Wang, Y., & Lu, B. (2017). Kuchita bwino kwa opaleshoni motsutsana ndi chithandizo chodziletsa cha lumbar spinal stenosis: kuwunika kwadongosolo ndi kusanthula meta-mayesero oyendetsedwa mwachisawawa. Magazini yapadziko lonse ya opaleshoni (London, England), 44, 329-338. doi.org/10.1016/j.ijsu.2017.07.032

Kumvetsetsa Mitsempha ya Mitsempha: Kuzindikira ndi Kusamalira Zopweteka Zopweteka

Kumvetsetsa Mitsempha ya Mitsempha: Kuzindikira ndi Kusamalira Zopweteka Zopweteka

by | Kuvulaza Mitsempha, Neuropathy

Kwa anthu omwe ali ndi ululu wosatha, kodi kuchitidwa opaleshoni ya mitsempha kungathandize kuchepetsa ndi kuthetsa zizindikiro?

Kumvetsetsa Mitsempha ya Mitsempha: Kuzindikira ndi Kusamalira Zopweteka Zopweteka

Mitsempha Blocks

Mitsempha ya mitsempha ndi njira yomwe imapangidwira kusokoneza / kuletsa zizindikiro za ululu chifukwa cha kusokonezeka kwa mitsempha kapena kuvulala. Zitha kugwiritsidwa ntchito pofuna kufufuza kapena kuchiza, ndipo zotsatira zake zingakhale zazifupi kapena zazitali, malingana ndi mtundu womwe ukugwiritsidwa ntchito.

  • A kwakanthawi minyewa block zingaphatikizepo kugwiritsa ntchito kapena jekeseni yomwe imayimitsa zizindikiro zowawa kuti zisafalitse kwakanthawi kochepa.
  • Mwachitsanzo, pa mimba, jakisoni wa epidural angagwiritsidwe ntchito panthawi yobereka komanso yobereka.
  • Mitsempha yokhazikika kumaphatikizapo kudula/kudula kapena kuchotsa mbali zina za minyewa kuti muyimitse zizindikiro zowawa.
  • Izi zimagwiritsidwa ntchito pazochitika zovulala kwambiri kapena zovuta zina zowawa zomwe sizinasinthe ndi njira zina zothandizira.

Kugwiritsa Ntchito Chithandizo

Othandizira azaumoyo akazindikira kuti pali vuto lopweteka lomwe limayambitsidwa ndi kuvulala kwa mitsempha kapena kusagwira bwino ntchito, amatha kugwiritsa ntchito minyewa kuti apeze malo omwe amatulutsa zizindikiro zowawa. Iwo akhoza kuchita electromyography ndi / kapena a mitsempha conduction velocity / NCV mayeso kuti adziwe chomwe chimayambitsa kupweteka kwa mitsempha yambiri. Mitsempha imathanso kuchiza ululu wosaneneka wa neuropathic, monga ululu wobwera chifukwa cha kuwonongeka kwa mitsempha kapena kupsinjika. Mitsempha ya mitsempha imagwiritsidwa ntchito nthawi zonse pofuna kuchiza kupweteka kwa msana ndi khosi chifukwa cha herniated discs kapena spinal stenosis. (Johns Hopkins Medicine. 2024)

mitundu

Mitundu itatu ili ndi:

  • Local
  • Neurolytic
  • Opaleshoni

Zonse zitatuzi zingagwiritsidwe ntchito pazinthu zomwe zimayambitsa kupweteka kosalekeza. Komabe, ma neurolytic ndi maopaleshoni opangira opaleshoni ndi okhazikika ndipo amangogwiritsidwa ntchito pa ululu waukulu womwe wakula kwambiri ndi mankhwala ena omwe sangathe kupereka mpumulo.

Zotchinga Zosakhalitsa

  • Chida chapafupi chimapangidwa ndi kubaya kapena kugwiritsa ntchito mankhwala oletsa ululu wamba, monga lidocaine, kudera linalake.
  • Epidural ndi mitsempha yam'deralo yomwe imalowetsa steroids kapena analgesics kumalo ozungulira msana.
  • Izi ndizofala pa nthawi ya mimba, yobereka, komanso yobereka.
  • Epidurals ingagwiritsidwenso ntchito pochiza kupweteka kwapakhosi kapena kupweteka kwa msana chifukwa cha mitsempha ya msana.
  • Mipiringidzo yam'deralo nthawi zambiri imakhala yochepa, koma mu ndondomeko ya chithandizo, imatha kubwerezedwa pakapita nthawi kuti athetse ululu wosatha kuchokera ku zinthu monga nyamakazi, sciatica, ndi migraines. (NYU Langone Health. 2023)

Mizinga Yokhazikika

  • Chida cha neurolytic chimagwiritsa ntchito mowa, phenol, kapena matenthedwe othandizira kuti athetse ululu wosaneneka wa mitsempha. (National Institute of Neurological Disorders ndi Stroke. 2023) Njirazi zimawononga mbali zina za minyewa mwadala kotero kuti zizindikiro zowawa sizitha kuperekedwa. Chotchinga cha neurolytic chimagwiritsidwa ntchito makamaka pazochitika zowawa kwambiri, monga kupweteka kwa khansa kapena zovuta zamtundu wa ululu / CRPS. Nthawi zina amagwiritsidwa ntchito pochiza kupweteka kosalekeza kwa kapamba komanso kupweteka pachifuwa pambuyo pa opaleshoni. (Johns Hopkins Medicine. 2024) (Alberto M. Cappellari et al., 2018)
  • Neurosurgeon amachita opaleshoni ya mitsempha yomwe imaphatikizapo kuchotsa kapena kuwononga madera ena a mitsempha. (National Institute of Neurological Disorders ndi Stroke. 2023) Mitsempha yopangira opaleshoni imagwiritsidwa ntchito pazovuta zopweteka kwambiri, monga kupweteka kwa khansa kapena trigeminal neuralgia.
  • Ngakhale kuti mitsempha ya neurolytic ndi opaleshoni ndi njira zokhazikika, zizindikiro zowawa, ndi zomverera zimatha kubwerera ngati mitsempha imatha kukula ndikudzikonza yokha. (Eun Ji Choi et al., 2016) Komabe, zizindikiro ndi zomverera sizingabwerenso patatha miyezi kapena zaka mutachita opaleshoniyo.

Madera Osiyanasiyana a Thupi

Atha kuperekedwa m'malo ambiri amthupi, kuphatikiza: (Chipatala cha Opaleshoni Yapadera. 2023) (Stanford Medicine. 2024)

  • Scalp
  • nkhope
  • Khosi
  • Collarbone
  • mapewa
  • zida
  • Back
  • Chifuwa
  • Nyumba yanthiti
  • Mimba
  • Pelvis
  • Maphwando
  • miyendo
  • kumwendo
  • mapazi

Zotsatira Zotsatira

Njirazi zimatha kukhala ndi chiopsezo cha kuwonongeka kwa minyewa kosatha. (Nyimbo ya BlueCross. 2023) Mitsempha imakhala yokhudzidwa ndipo imapanganso pang'onopang'ono, choncho cholakwika chaching'ono chingayambitse zotsatira zake. (D O'Flaherty et al., 2018) Zotsatira zoyipa zomwe zimachitika kawirikawiri ndi izi:

  • Kupuwala kwa minofu
  • Kufooka
  • Kuchita dzanzi pafupipafupi
  • Nthawi zina, chipikacho chikhoza kukwiyitsa mitsempha ndikuwonjezera ululu.
  • Madokotala aluso komanso ovomerezeka monga madokotala ochita opaleshoni, madotolo owongolera ululu, ogonetsa, ndi madokotala amano amaphunzitsidwa kuchita izi mosamala.
  • Nthawi zonse pamakhala chiwopsezo cha kuwonongeka kwa mitsempha kapena kuvulala, koma minyewa yambiri imatsekeka bwino ndikuchepetsa bwino ndikuthandizira kuthana ndi ululu wosaneneka. (Nyimbo ya BlueCross. 2023)

Zimene muyenera kuyembekezera

  • Anthu amatha kumva dzanzi kapena kumva kuwawa komanso/kapena kuona kufiyira kapena kuyabwa pafupi kapena kuzungulira dera lomwe ndi losakhalitsa.
  • Pakhoza kukhala kutupa, komwe kumapangitsa mitsempha ya mitsempha ndipo imafuna nthawi kuti ikhale yabwino. (Stanford Medicine. 2024)
  • Anthu angapemphedwe kuti apume kwa nthawi yochuluka pambuyo pa ndondomekoyi.
  • Malinga ndi mtundu wa kachitidwe kameneka, anthu amatha kukhala m’chipatala kwa masiku angapo.
  • Ululu wina ungakhalepobe, koma sizikutanthauza kuti njirayi sinagwire ntchito.

Anthu akuyenera kukaonana ndi achipatala za kuopsa ndi ubwino wake kuti atsimikizire kuti ndizolondola mankhwala.

Sciatica, Zomwe Zimayambitsa, Zizindikiro, ndi Malangizo

Zothandizira

Johns Hopkins Medicine. (2024). Mitsempha yotchinga. (Zaumoyo, Nkhani. www.hopkinsmedicine.org/health/conditions-and-diseases/nerve-blocks

NYU Langone Health. (2023). Mitsempha ya Migraine (Maphunziro ndi Kafukufuku, Nkhani. nyulangone.org/conditions/migraine/treatments/nerve-block-for-migraine

National Institute of Neurological Disorders ndi Stroke. (2023). Ululu. Zabwezedwa kuchokera www.ninds.nih.gov/health-information/disorders/pain#3084_9

Johns Hopkins Medicine. (2024). Chithandizo cha pancreatitis yosachiritsika (Thanzi, Nkhani. www.hopkinsmedicine.org/health/conditions-and-diseases/chronic-pancreatitis/chronic-pancreatitis-treatment

Cappellari, AM, Tiberio, F., Alicandro, G., Spagnoli, D., & Grimoldi, N. (2018). Intercostal Neurolysis for The Treatment of Postsurgical Thoracic Pain: a Case Series. Minofu & mitsempha, 58 (5), 671-675. doi.org/10.1002/mus.26298

Choi, EJ, Choi, YM, Jang, EJ, Kim, JY, Kim, TK, & Kim, KH (2016). Neural Ablation and Regeneration in Pain Practice. Nyuzipepala ya ku Korea ya ululu, 29 (1), 3-11. doi.org/10.3344/kjp.2016.29.1.3

Chipatala cha Opaleshoni Yapadera. (2023). Opaleshoni yachigawo. www.hss.edu/condition-list_regional-anesthesia.asp

Stanford Medicine. (2024). Mitundu ya mitsempha ya mitsempha (Kwa Odwala, Nkhani. med.stanford.edu/ra-apm/for-patients/nerve-block-types.html

Nyimbo ya BlueCross. (2023). Zotumphukira mitsempha midadada kuchiza ululu wa neuropathic. (Medical Policy, Nkhani. www.anthem.com/dam/medpolicies/abc/active/policies/mp_pw_c181196.html

O'Flaherty, D., McCartney, CJL, & Ng, SC (2018). Kuvulala kwa mitsempha pambuyo pa kutsekeka kwa mitsempha yotumphukira-kumvetsetsa kwamakono ndi malangizo. Maphunziro a BJA, 18 (12), 384-390. doi.org/10.1016/j.bjae.2018.09.004

Stanford Medicine. (2024). Mafunso wamba odwala okhudza mitsempha. (Kwa Odwala, Nkhani. med.stanford.edu/ra-apm/for-patients/nerve-block-questions.html

Kuyang'ana Kwambiri pa Mitsempha ya Thoracodorsal

Kuyang'ana Kwambiri pa Mitsempha ya Thoracodorsal

by | Chiropractic, Kuvulaza Mitsempha

Anthu omwe akukumana ndi zizindikiro zowawa monga kuwombera, kubayidwa, kapena kumverera kwa magetsi ku latissimus dorsi kumtunda kwa msana kungayambitsidwe ndi kuvulala kwa mitsempha ku mitsempha ya thoracodorsal. Kodi kudziwa mawonekedwe a thupi ndi zizindikiro kungathandize othandizira azaumoyo kupanga dongosolo lothandizira lamankhwala?

Kuyang'ana Kwambiri pa Mitsempha ya Thoracodorsal

Mitsempha ya Thoracodorsal

Amatchedwanso kuti minyewa yapakatikati ya scapular kapena mitsempha yayitali ya subscapular, imatuluka kuchokera ku mbali ya brachial plexus ndipo imapangitsa kuti injini ikhale yogwira ntchito latissimus dorsi minofu.

Anatomy

Brachial plexus ndi maukonde a minyewa yomwe imachokera ku msana wa khosi. Mitsempha imapereka zambiri zomveka komanso kuyenda kwa manja ndi manja, ndi imodzi kumbali iliyonse. Mizu yake isanu imachokera ku mipata yapakati pachisanu mpaka chachisanu ndi chitatu cha chiberekero cha chiberekero ndi vertebra yoyamba ya thoracic. Kuchokera pamenepo, amapanga dongosolo lalikulu, kenaka amagawanitsa, kugwirizanitsa, ndikugawanitsanso kuti apange mitsempha yaing'ono ndi mitsempha ya mitsempha pamene akuyenda pansi pakhwapa. Kupyolera mu khosi ndi pachifuwa, mitsempha pamapeto pake imalumikizana ndikupanga zingwe zitatu zomwe zimaphatikizapo:

  • Lateral chingwe
  • Chingwe chapakati
  • Chingwe chakumbuyo

Chingwe chakumbuyo chimapanga nthambi zazikulu ndi zazing'ono zomwe zimaphatikizapo:

  • Axillary mitsempha
  • Radial mitsempha

Nthambi zazing'ono zikuphatikizapo:

  • Superior subscapular mitsempha
  • Mitsempha yotsika ya subscapular
  • Mitsempha ya thoracodorsal

Kapangidwe ndi Udindo

  • Nthambi za mitsempha ya thoracodorsal kuchokera ku chingwe cham'mbuyo m'khwapa ndikuyenda pansi, potsatira mitsempha ya subscapular, kupita ku minofu ya latissimus dorsi.
  • Imalumikizana ndi kumtunda kwa mkono, imatambasula kumbuyo kwakhwapa, kupanga axillary arch, ndiyeno imatambasula kukhala makona atatu aakulu omwe amazungulira nthiti ndi kumbuyo.
  • Mitsempha ya thoracodorsal imakhala mkati mwa latissimus dorsi, ndipo m'mphepete mwa m'munsi nthawi zambiri imafika pafupi ndi chiuno.

Kusiyanasiyana

  • Pali malo okhazikika komanso njira ya mitsempha ya thoracodorsal, koma minyewa yapayekha siili yofanana mwa aliyense.
  • Mitsempha nthawi zambiri imachoka pa chingwe chakumbuyo cha brachial plexus kuchokera ku mfundo zitatu zosiyana.
  •  Komabe, ma subtypes osiyanasiyana adziwika.
  • Mitsempha ya thoracodorsal imapereka minofu yayikulu ya teres pafupifupi 13% ya anthu. (Brianna Chu, Bruno Bordoni. 2023)
  • Ma lats amatha kukhala ndi kusiyana kosowa kwa anatomical komwe kumadziwika kuti a Chigawo cha Langer, yomwe ndi gawo lowonjezera lomwe limalumikizana ndi minofu kapena minofu yolumikizana ya kumtunda kwa mkono pansi pa malo omwe amalumikizana nawo.
  • Kwa anthu omwe ali ndi vuto ili, mitsempha ya thoracodorsal imapereka ntchito / innervation) ku chigoba. (Ahmed M. Al Maksoud et al., 2015)

ntchito

Minofu ya latissimus dorsi sungagwire ntchito popanda mitsempha ya thoracodorsal. Chithandizo cha minofu ndi mitsempha:

  • Kukhazikika kumbuyo.
  • Kokani kulemera kwa thupi pamene mukukwera, kusambira, kapena kuchita kukoka.
  • Thandizani kupuma pokulitsa nthiti pamene mukukoka mpweya komanso kutsika potulutsa mpweya. (Encyclopaedia Britannica. 2023)
  • Tembenuzani mkono mkati.
  • Kokani mkono pakati pa thupi.
  • Wonjezerani mapewa pogwira ntchito ndi teres yaikulu, teres minor, ndi posterior deltoid minofu.
  • Bweretsani pansi lamba wa pamapewa pogwedeza msana.
  • Kupinda m'mbali mwa kupindika msana.
  • Pendekera chiuno patsogolo.

zokwaniritsa

Mitsempha ya thoracodorsal imatha kuvulazidwa paliponse panjira yake ndi zoopsa kapena matenda. Zizindikiro za kuwonongeka kwa mitsempha zingaphatikizepo: (US National Library of Medicine: MedlinePlus. 2022)

  • Ululu womwe ungakhale kuwombera, kubayidwa, kapena kumva magetsi.
  • Dzanzi, kumva kuwawa.
  • Kufooka ndi kutayika kwa ntchito mu minofu yogwirizana ndi ziwalo za thupi, kuphatikizapo kugwa kwa dzanja ndi chala.
  • Chifukwa cha njira ya mitsempha yodutsa m'khwapa, madokotala amayenera kusamala ndi mitundu ya anatomical kuti asawononge mwangozi mitsempha panthawi ya khansa ya m'mawere, kuphatikizapo axillary dissection.
  • Njirayi imachitidwa pofuna kufufuza kapena kuchotsa ma lymph nodes ndipo amagwiritsidwa ntchito popanga khansa ya m'mawere ndi kuchiza.
  • Malinga ndi kafukufuku, 11% ya anthu omwe ali ndi axillary lymph node dissection adawonongeka ndi mitsempha. (Roser Belmonte et al., 2015)

Kumangidwanso kwa Amayi

  • Pakuchita opaleshoni yomanganso mawere, ma lats amatha kugwiritsidwa ntchito ngati chomangira pa implant.
  • Malingana ndi momwe zinthu zilili, mitsempha ya thoracodorsal imatha kusiyidwa kapena kudulidwa.
  • Achipatala sanagwirizane kuti ndi njira iti yomwe ili ndi zotsatira zabwino kwambiri. (Sung-Tack Kwon et al., 2011)
  • Pali umboni wina wosonyeza kuti kusiya minyewayo kungachititse kuti minofu igwirizane ndi kusokoneza implant.
  • Mitsempha ya thoracodorsal yokhazikika ingayambitsenso atrophy ya minofu, yomwe ingayambitse kufooka kwa mapewa ndi mkono.

Kugwiritsa Ntchito Graft

Gawo la mitsempha ya thoracodorsal imagwiritsidwa ntchito pomanganso mitsempha kuti abwezeretse ntchito pambuyo povulala, zomwe zimaphatikizapo izi:

  • Mitsempha ya musculocutaneous
  • Zowonjezera mitsempha
  • Axillary mitsempha
  • Mitsempha imatha kugwiritsidwanso ntchito kubwezeretsa ntchito ya mitsempha ku minofu ya triceps pa mkono.

konzanso

Ngati mitsempha ya thoracodorsal yavulala kapena kuwonongeka, mankhwala angaphatikizepo:

  • Braces kapena splints.
  • Thandizo lakuthupi lothandizira kusuntha kosiyanasiyana, kusinthasintha, ndi mphamvu za minofu.
  • Ngati pali kuponderezana, opaleshoni ingafunike kuti muchepetse kupanikizika.

Kufufuza Integrative Medicine

Zothandizira

Chu B, Bordoni B. Anatomy, Thorax, Thoracodorsal Mitsempha. [Yosinthidwa 2023 Jul 24]. Mu: StatPearls [Intaneti]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Zikupezeka kuchokera: www.ncbi.nlm.nih.gov/books/NBK539761/

Al Maksoud, A. M., Barsoum, A. K., & Moneer, M. M. (2015). Langer's arch: chosowa chosowa chimakhudza axillary lymphadenectomy. Journal ya malipoti a milandu ya opaleshoni, 2015(12), rjv159. doi.org/10.1093/jscr/rjv159

Britannica, The Editors of Encyclopaedia. “latissimus dorsi“. Encyclopedia Britannica, 30 Nov. 2023, www.britannica.com/science/latissimus-dorsi. Adafikira pa 2 Januware 2024.

US National Library of Medicine: MedlinePlus. Matenda a ubongo.

Belmonte, R., Monleon, S., Bofill, N., Alvarado, M. L., Espadaler, J., & Royo, I. (2015). Kuvulala kwamtundu wautali wa thoracic mu odwala khansa ya m'mawere omwe amathandizidwa ndi axillary lymph node dissection. Chisamaliro chothandizira mu khansa: magazini yovomerezeka ya Multinational Association of Supportive Care in Cancer, 23 (1), 169-175. doi.org/10.1007/s00520-014-2338-5

Kwon, S. T., Chang, H., & Oh, M. (2011). Maziko a anatomiki a interfascicular nerve splitting of innervated partial latissimus dorsi muscle flap. Journal of plastic, reconstructive & aesthetic surgery : JPRAS, 64(5), e109–e114. doi.org/10.1016/j.bjps.2010.12.008

Ubwino Wopanda Kuchita Opaleshoni Kuwonongeka Kwa Mitsempha

Ubwino Wopanda Kuchita Opaleshoni Kuwonongeka Kwa Mitsempha

by | Ululu Wabwerere, Chiropractic, aakulu Chisoni, Kuvulaza Mitsempha, Chithandizo cha Spinal Decompression, Kuchiza, Viscerosomatic Reflex

Kodi anthu omwe ali ndi vuto la minyewa angaphatikizepo kuponderezedwa kosachita opaleshoni kuti abwezeretse kugwira ntchito kwa matupi awo?

Introduction

Msana wa msana mu musculoskeletal system uli ndi mafupa, mafupa, ndi mitsempha yomwe imagwira ntchito pamodzi ndi minofu ndi minofu yosiyanasiyana kuti zitsimikizire kuti msana wa msana umatetezedwa. Mphepete mwa msana ndi gawo la dongosolo lapakati la mitsempha kumene mizu ya mitsempha imafalikira kumtunda ndi kumunsi kwa thupi komwe kumapereka ntchito zomveka-motor. Izi zimathandiza kuti thupi liziyenda ndikugwira ntchito popanda kupweteka kapena kupweteka. Komabe, thupi ndi msana zikakalamba kapena pamene munthu akuvulala, mizu ya mitsempha imatha kukwiyitsa ndi kuyambitsa zowawa zachilendo monga dzanzi kapena kumva kuwawa, zomwe nthawi zambiri zimayenderana ndi ululu wamthupi. Izi zingayambitse mavuto azachuma pa anthu ambiri ndipo, ngati sizikuthandizidwa nthawi yomweyo, zimatha kuyambitsa kupweteka kosalekeza. Kufikira pamenepo, zitha kupangitsa anthu ambiri kuthana ndi ululu wam'mimba womwe umakhudzana ndi kusokonezeka kwa mitsempha. Izi zimapangitsa kuti anthu ambiri omwe ali ndi vuto la musculoskeletal ayambe kufunafuna chithandizo. Nkhani yamasiku ano ikuwunika momwe kusokonezeka kwa mitsempha kumakhudzira malekezero komanso momwe kuponderezana popanda opaleshoni kungathandizire kuchepetsa kusokonezeka kwa mitsempha kulola kuyenda kubwerera kumtunda ndi kumunsi kwa miyendo. Timalankhula ndi madokotala ovomerezeka omwe amaphatikiza zambiri za odwala athu kuti apereke njira zopanda opaleshoni monga decompression kuthandiza anthu omwe ali ndi vuto la mitsempha. Timadziwitsanso odwala momwe kuponderezedwa kosagwiritsa ntchito opaleshoni kungabwezeretse kusuntha-kuzindikira kumtunda ndi kumunsi. Timalimbikitsa odwala athu kuti afunse mafunso ovuta komanso ophunzirira kwa othandizira azachipatala omwe amagwirizana nawo za zizindikiro zonga zowawa zomwe akukumana nazo zogwirizana ndi kusokonezeka kwa mitsempha. Dr. Alex Jimenez, DC, amagwiritsa ntchito chidziwitsochi ngati ntchito ya maphunziro. chandalama.

 

Momwe Kusokonekera kwa Mitsempha Kumakhudzira Malekezero

Kodi mumamva kumva kunjenjemera kapena dzanzi m'manja kapena kumapazi komwe sikukufuna kuchoka? Kodi mumamva kuwawa m'magawo osiyanasiyana ammbuyo omwe amatha kumasuka potambasula kapena kupumula? Kapena kodi zimakupwetekani kuyenda mtunda wautali umene umaona ngati mukufunika kupumula nthawi zonse? Zochitika zambiri zowawa zimagwirizanitsidwa ndi kusokonezeka kwa mitsempha ya mitsempha yomwe ingakhudze kumtunda ndi kumunsi. Anthu ambiri akakhala ndi vuto la mitsempha ya m'mitsempha ndikuchita zinthu zodabwitsa m'miyendo yawo, ambiri amaganiza kuti ndi chifukwa cha kupweteka kwa minofu m'khosi, mapewa, kapena kumbuyo. Ichi ndi gawo limodzi chabe la nkhaniyi, chifukwa zinthu zambiri zachilengedwe zimatha kugwirizanitsidwa ndi ululu wa mitsempha ya mitsempha, monga momwe mizu ya mitsempha ikuphwanyidwa ndi kugwedezeka, zomwe zimayambitsa kusokonezeka kwa mitsempha m'malekezero. Popeza kuti mizu ya mitsempha imafalikira kuchokera ku msana, ubongo umatumiza chidziwitso cha neuron ku mizu ya mitsempha kuti ilole kugwira ntchito kwa minyewa kumtunda ndi kumunsi. Izi zimathandiza kuti thupi liziyenda popanda kukhumudwa kapena kupweteka komanso kugwira ntchito kudzera muzochita za tsiku ndi tsiku. Komabe, anthu ambiri akayamba kuchita zinthu zobwerezabwereza zomwe zimapangitsa kuti msana wa msana ukhale wopanikizika nthawi zonse, ukhoza kuyambitsa kusokonezeka kwa disc ndi matenda a musculoskeletal. Popeza kuti mizu yambiri ya mitsempha imafalikira kumadera osiyanasiyana, pamene mizu yaikulu ya mitsempha ikukulirakulira, imatha kutumiza zizindikiro zowawa kumalo aliwonse. Chifukwa chake, anthu ambiri akukumana ndi vuto la mitsempha yomwe imatsogolera kumunsi kumbuyo, matako, ndi kupweteka kwa mwendo zomwe zingakhudze zochita zawo za tsiku ndi tsiku. (Karl et al., 2022) Panthawi imodzimodziyo, anthu ambiri omwe ali ndi sciatica akukumana ndi vuto la mitsempha ya mitsempha yomwe imakhudza luso lawo loyenda. Ndi sciatica, imatha kugwirizanitsidwa ndi spinal disc pathology ndipo imapangitsa anthu ambiri kupeza chithandizo. (Bush ndi al., 1992)

 

Zinsinsi za Sciatica Zawululidwa-Kanema

Pankhani yofuna chithandizo chochepetsera kusokonezeka kwa mitsempha, anthu ambiri amasankha njira zopanda opaleshoni kuti achepetse zizindikiro zopweteka komanso kuchepetsa zizindikiro zowawa zomwe zimapangitsa kuti kumtunda ndi kumunsi kuvutike. Mayankho osachita opaleshoni monga decompression angathandize kubwezeretsa magwiridwe antchito a minyewa kudzera pakukoka pang'onopang'ono pochititsa kuti msana wa msana uchotse muzu wokulirapo wa minyewa ndikuyamba kuchiritsa kwachilengedwe kwa thupi. Panthawi imodzimodziyo, zimathandiza kuchepetsa matenda a minofu ndi mafupa kuti asabwerere. Vidiyo yomwe ili pamwambayi ikuwonetsa momwe sciatica yokhudzana ndi kusokonezeka kwa mitsempha ya mitsempha imatha kuchepetsedwa kupyolera mu mankhwala osagwiritsa ntchito opaleshoni kuti malekezero a thupi amve bwino.

Kusokonezeka Kopanda Opaleshoni Kuchepetsa Kuwonongeka Kwa Mitsempha

Thandizo lopanda opaleshoni lingathandize kuchepetsa ululu wochepa wammbuyo womwe umagwirizanitsidwa ndi kusokonezeka kwa mitsempha ya msana kuti abwezeretse ntchito yamagetsi kumtunda ndi kumunsi. Anthu ambiri omwe amaphatikiza chithandizo chamankhwala osachita opaleshoni monga decompression monga gawo la thanzi lawo komanso thanzi lawo amatha kuwona kusintha atalandira chithandizo motsatizana. (Chou et al., 2007) Popeza kuti madokotala ambiri amaphatikizirapo mankhwala osachita opaleshoni monga kukomoka m'zochita zawo, pakhala kusintha kwakukulu pakuwongolera ululu. (Bronfort et al., 2008) 

 

 

Anthu ambiri akayamba kugwiritsa ntchito decompression popanda opaleshoni chifukwa cha kusokonezeka kwa mitsempha, ambiri amawona kusintha kwa ululu wawo, kuyenda, ndi zochita za tsiku ndi tsiku. (Gose et al., 1998). Chomwe chimapangitsa kuti mitsempha ya msana ikhale mizu ya mitsempha ndiyo imathandiza diski yomwe imakhudzidwa yomwe ikuwonjezera mizu ya mitsempha, imakokera diskiyo kumalo ake oyambirira, ndikuyibwezeretsanso. (Ramos & Martin, 1994) Pamene anthu ambiri ayamba kuganizira za thanzi lawo ndi thanzi lawo, chithandizo chopanda opaleshoni chingakhale chothandiza kwa iwo chifukwa cha mtengo wawo wotsika mtengo komanso momwe angagwirizanitsire ndi mankhwala ena kuti athe kusamalira bwino ululu wokhudzana ndi kusokonezeka kwa mitsempha yomwe imakhudza matupi awo.

 

Zothandizira

Bronfort, G., Haas, M., Evans, R., Kawchuk, G., & Dagenais, S. (2008). Umboni wodziwika bwino wa ululu wopweteka kwambiri wa msana ndi kusintha kwa msana ndi kusonkhanitsa. Spine J, 8(1), 213-225. doi.org/10.1016/j.spinee.2007.10.023

Bush, K., Cowan, N., Katz, DE, & Gishen, P. (1992). Mbiri yachilengedwe ya sciatica yokhudzana ndi disc pathology. Kafukufuku woyembekezeredwa ndi kutsata kwachipatala komanso kodziyimira pawokha kwa radiologic. Mpaka (Phila Pa 1976), 17(10), 1205-1212. doi.org/10.1097/00007632-199210000-00013

Chou, R., Huffman, LH, American Pain, S., & American College of, P. (2007). Chithandizo cha Nonpharmacologic cha ululu wopweteka kwambiri komanso wopweteka kwambiri: kubwereza umboni wa American Pain Society / American College of Physicians clinic practice guideline. Ann Intern Med, 147(7), 492-504. doi.org/10.7326/0003-4819-147-7-200710020-00007

Gose, EE, Naguszewski, WK, & Naguszewski, RK (1998). Vertebral axial decompression therapy ya ululu wokhudzana ndi herniated kapena degenerated discs kapena facet syndrome: kafukufuku wotsatira. Neurol Res, 20(3), 186-190. doi.org/10.1080/01616412.1998.11740504

Karl, HW, Helm, S., & Trescot, AM (2022). Superior and Middle Cluneal Nerve Entrapment: Choyambitsa Chakumbuyo Chakumbuyo ndi Kupweteka Kwambiri. Pain Physician, 25(4), E503-E521. www.ncbi.nlm.nih.gov/pubmed/35793175

Ramos, G., & Martin, W. (1994). Zotsatira za vertebral axial decompression pa intradiscal pressure. J Neurosurgery, 81(3), 350-353. doi.org/10.3171/jns.1994.81.3.0350

chandalama

Kusankha Katswiri Woyenera Kuwongolera Ululu

Kusankha Katswiri Woyenera Kuwongolera Ululu

by | aakulu Chisoni, Kuvulaza Mitsempha

Kwa anthu omwe ali ndi vuto lopweteka kwambiri, kodi kumvetsetsa bwino kwa akatswiri osamalira ululu kungathandize kupanga mapulani othandiza amitundu yosiyanasiyana?

Kusankha Katswiri Woyenera Kuwongolera Ululu

Akatswiri Oyang'anira Ululu

Kusamalira ululu ndi chitukuko chachipatala chomwe chikukula chomwe chimatenga njira zosiyanasiyana zochizira mitundu yonse ya ululu. Ndi nthambi yamankhwala yomwe imagwiritsa ntchito njira ndi njira zotsimikiziridwa mwasayansi zochepetsera, kuchepetsa, ndikuwongolera zizindikiro zowawa ndi zomverera. Akatswiri osamalira ululu amayesa, kukonzanso, ndi kuchiza matenda osiyanasiyana, kuphatikizapo ululu wa neuropathic, sciatica, kupweteka kwapambuyo, kupweteka kosalekeza, ndi zina. Ambiri opereka chithandizo chamankhwala oyambirira amatumiza odwala awo kwa akatswiri osamalira ululu ngati zizindikiro zowawa zikupitirira kapena zofunikira pakuwonekera kwawo.

Akatswiri

Othandizira zaumoyo omwe ali odziwika bwino pakuwongolera ululu amazindikira zovuta za ululu ndikuyandikira vutoli kuchokera mbali zonse. Kuchiza pachipatala cha zowawa kumangokhudza odwala koma kumadalira zomwe chipatalacho chilipo. Pakali pano, palibe miyezo yokhazikitsidwa ya mitundu ya chilango chofunikira, chifukwa china njira zachipatala zimasiyana malinga ndi chipatala. Akatswiri amanena kuti malo ayenera kupereka odwala:

  • Katswiri wogwirizira yemwe ali wodziwa bwino za kasamalidwe ka ululu ndi kufunsira akatswiri m'malo mwa wodwalayo.
  • Katswiri wokonzanso thupi.
  • Katswiri wa zamaganizo kuti athandize munthuyo kuthana ndi vuto lililonse lachisokonezo kapena nkhawa, makamaka pamene akulimbana ndi ululu wosatha. (American Society of Regional Anesthesia ndi Pain Medicine. 2023)

Zina Zamankhwala Zamankhwala

Zina mwapadera zomwe zimayimiridwa pakuwongolera ululu ndi anesthesiology, neurosurgery, ndi mankhwala amkati. Wogwirizanitsa wothandizira zaumoyo angatumize munthu wina kuti athandizidwe kuchokera ku:

Wothandizira zaumoyo ayenera kukhala atamaliza maphunziro owonjezera ndi kuvomerezeka pamankhwala opweteka ndikukhala MD wokhala ndi certification ya board mu chimodzi mwa zotsatirazi (American Board of Medical Specialties. 2023)

  • Anesthesiology
  • Kubwezeretsa thupi
  • Psychiatry
  • Neurology

Dokotala wosamalira ululu ayeneranso kukhala ndi machitidwe awo ochepera pazomwe ali ndi satifiketi.

Zolinga Zoyang'anira

Munda wowongolera ululu umagwira mitundu yonse ya zowawa ngati matenda. Matenda, monga mutu; pachimake, kuchokera ku opaleshoni, ndi zina. Izi zimalola kugwiritsa ntchito sayansi ndi kupita patsogolo kwachipatala kwaposachedwa pakuchepetsa ululu. Pano pali njira zambiri, kuphatikizapo:

  • Mankhwala
  • Njira zothandizira kupweteka kwapakati - mitsempha ya mitsempha, zolimbikitsa msana, ndi mankhwala ofanana.
  • Kuchiza thupi
  • Njira zamankhwala
  1. Cholinga chake ndikuchepetsa ndikupangitsa kuti zizindikiro zitheke.
  2. Sinthani ntchito.
  3. Wonjezerani moyo wabwino. (Srinivas Nalamachu. 2013)

Chipatala chowongolera ululu chidzadutsa motere:

  • Kuwunika.
  • Kuyeza matenda, ngati kuli kofunikira.
  • Thandizo la thupi - kumawonjezera kusuntha, kumalimbitsa thupi, ndikukonzekeretsa anthu kuti abwerere kuntchito ndi zochitika za tsiku ndi tsiku.
  • Chithandizo chothandizira - jekeseni kapena kukondoweza kwa msana.
  • Kutumiza kwa dokotala wa opaleshoni ngati kuwonetseredwa ndi mayeso ndi kuunika.
  • Psychiatry kuthana ndi kukhumudwa, nkhawa, ndi / kapena zovuta zina zomwe zimatsagana ndi zowawa zosatha.
  • Njira ina yothandizira ndi kupititsa patsogolo mankhwala ena.

Anthu omwe amachita bwino ndi pulogalamu yosamalira ululu

Anthu omwe ali ndi:

  • Ululu wammbuyo
  • kupweteka khosi
  • Anali ndi maopaleshoni ambiri amsana
  • Maopaleshoni analephera
  • Neuropathy
  • Anthu adatsimikiza kuti opaleshoni sikupindulitsa mkhalidwe wawo.

Kumvetsetsa bwino kwa ma syndromes opweteka ndi madera ndi makampani a inshuwaransi komanso kuchuluka kwa maphunziro opweteka kumathandizira kuonjezera chithandizo cha inshuwaransi pazamankhwala ndi ukadaulo kuti apititse patsogolo zotsatirapo.

Chiropractic Care for Kusakhazikika kwa Miyendo

Zothandizira

American Society of Regional Anesthesia ndi Pain Medicine. (2023). Zapadera za kasamalidwe ka ululu kosatha.

American Academy of Pain Medicine (2023). Za American Academy of Pain Medicine.

American Board of Medical Specialties. (2023). Bungwe lodalirika kwambiri la Medical Specialty Certification Organisation.

Nalamachu S. (2013). Chidule cha kasamalidwe ka ululu: mphamvu yachipatala komanso kufunika kwa chithandizo. Nyuzipepala yaku America yosamalira chisamaliro, 19 (14 Suppl), s261-s266.

American Society of Interventional Pain Physicians. (2023). Pain Physician.

Kusamalira Paresthesia: Pewani Dzanzi ndi Kupweteka M'thupi

Kusamalira Paresthesia: Pewani Dzanzi ndi Kupweteka M'thupi

by | Kuvulaza Mitsempha, Sciatica

Anthu omwe akumva kumva kulasalasa kapena mapini ndi singano zomwe zimadutsa mikono kapena miyendo zimatha kukhala ndi paresthesia, yomwe imachitika pamene mitsempha yaphwanyidwa kapena kuwonongeka. Kodi kudziwa zizindikiro ndi zomwe zimayambitsa zingathandize kudziwa ndi kuchiza?

Kusamalira Paresthesia: Pewani Dzanzi ndi Kupweteka M'thupi

Paresthesia Thupi Sensations

Kumva dzanzi kapena kumva kulasalasa pamene mkono, mwendo, kapena phazi lagona sikuli zambiri zokhudzana ndi kayendedwe ka magazi koma kugwira ntchito kwa mitsempha.

  • Paresthesia ndi kumverera kwachilendo m'thupi chifukwa cha kukanikiza kapena kukwiya kwa mitsempha.
  • Itha kukhala chifukwa chomangika ngati minyewa yoponderezedwa/yotsina.
  • Kapena mwina chifukwa cha matenda, kuvulala, kapena matenda.

zizindikiro

Paresthesia imatha kuyambitsa zizindikiro zosiyanasiyana. Zizindikirozi zimatha kukhala zofatsa mpaka zowopsa ndipo zimatha kukhala zazifupi kapena zokhalitsa. Zizindikiro zingaphatikizepo: (National Institute of Neurological Disorders ndi Stroke. 2023)

  • Kugwiritsa ntchito
  • Zikhomo ndi singano sensations
  • Kumva ngati mkono kapena mwendo wagona.
  • Numbness
  • Kuyabwa.
  • Kutentha kumverera.
  • Kuvuta kulumikiza minofu.
  • Kuvuta kugwiritsa ntchito mkono kapena mwendo womwe wakhudzidwa.
  1. Zizindikiro zake nthawi zambiri zimakhala kwa mphindi 30 kapena kuchepera.
  2. Kugwedeza mwendo womwe wakhudzidwa nthawi zambiri kumachepetsa zomverera.
  3. Paresthesia nthawi zambiri imakhudza mkono umodzi kapena mwendo umodzi panthawi.
  4. Komabe, manja ndi miyendo yonse imatha kukhudzidwa, malinga ndi zomwe zimayambitsa.

Funsani achipatala ngati zizindikirozo zikupitilira mphindi 30. Kuchiza kungafunike ngati paresthesia kumverera kwa thupi kumabweretsedwa ndi chifukwa chachikulu.

Zimayambitsa

Kukhala ndi kaimidwe kolakwika komanso kosayenera kungathe kupondereza minyewa ndikupanga zizindikiro. Komabe, zifukwa zina zimakhudzidwa kwambiri ndipo zingaphatikizepo:

Kufunafuna Thandizo Lachipatala

Ngati zizindikirozo sizikutha pakatha mphindi 30 kapena kubwereranso pazifukwa zosadziwika, funsani wothandizira zaumoyo kuti mudziwe chomwe chikuyambitsa kumverera kwachilendo. Mlandu woipitsitsa uyenera kuyang'aniridwa ndi wothandizira zaumoyo.

  • Peripheral neuropathy yomwe imayambitsa matenda a shuga nthawi zambiri imayamba ndi kumverera kwa paresthesia pamapazi/mapazi ndipo imatha kukulirakulira ndikuyambitsa zovuta zina.
  • Ichi ndi chizindikiro chakuti matenda a shuga sakuyendetsedwa bwino ndipo amafunika kuwongolera moyenera. (National Institute of Diabetes and Digestive and Kidney Diseases. 2018)

Matendawa

Wothandizira zaumoyo adzagwira ntchito ndi munthuyo kuti amvetsetse zizindikirozo ndikuyesa mayeso oyenerera kuti adziwe chomwe chimayambitsa. Wopereka chithandizo chamankhwala adzasankha kuyezetsa malinga ndi kuyezetsa thupi. Njira zodziwika bwino zodziwira matenda ndi monga: (Merck Manual Professional Version. 2022)

  • Magnetic resonance imaging - MRI ya msana, ubongo, kapena malekezero.
  • X-ray kuti athetse vuto la mafupa, monga kupasuka.
  • Kuyesa magazi.
  • Electromyography - maphunziro a EMG.
  • Kuthamanga kwa mitsempha - kuyesa kwa NCV.
  1. Ngati paresthesia ikutsatiridwa ndi ululu wammbuyo kapena wa khosi, wothandizira zaumoyo akhoza kukayikira kuti ali ndi mitsempha ya msana.
  2. Ngati munthuyo ali ndi mbiri ya matenda a shuga omwe samayendetsedwa bwino, amatha kukayikira kuti peripheral neuropathy.

chithandizo

Chithandizo cha paresthesia zimadalira matenda. Wopereka chithandizo chamankhwala atha kuthandizira kudziwa njira yabwino kwambiri yothanirana ndi vutoli.

mantha System

  • Ngati zizindikiro zimayambitsidwa ndi vuto lalikulu la mitsempha monga MS, anthu adzagwira ntchito limodzi ndi wothandizira zaumoyo wawo kuti alandire chithandizo choyenera.
  • Thandizo lolimbitsa thupi litha kulangizidwa kuti lithandizire kusintha magwiridwe antchito. (Nazanin Razazian, et al., 2016)

Mitsempha ya Msana

  • Ngati paresthesia imayamba chifukwa cha kupsinjika kwa mitsempha ya msana, monga sciatica, anthu akhoza kutumizidwa chiropractor ndi gulu lachipatala kuti amasule mitsempha ndi kupanikizika. (Julie M. Fritz, et al., 2021)
  • Katswiri wamankhwala amatha kupereka masewera olimbitsa thupi a msana kuti athetse kupsinjika kwa mitsempha ndikubwezeretsanso kumva bwino komanso kuyenda.
  • Zolimbitsa thupi zolimbitsa thupi kuti zibwezeretse kusinthasintha ndi kuyenda zitha kuperekedwa ngati kufooka kumapezeka pamodzi ndi zomverera za thupi la paresthesia.

Herniated Disc

  • Ngati diski ya herniated imayambitsa kumverera kwachilendo, ndipo sipanakhalepo kusintha ndi njira zowonongeka, wothandizira zaumoyo angapangire opaleshoni kuti athetse kupanikizika kwa mitsempha / s. (American Association of Neurological Surgeons. 2023)
  • Pochita opaleshoni monga laminectomy kapena discectomy, cholinga chake ndi kubwezeretsa mitsempha.
  • Pambuyo pa opaleshoni, anthu akhoza kulangizidwa kwa akatswiri a thupi kuti athe kuyambiranso kuyenda.

Matenda a Mitsempha

Kodi Plantar Fasciitis Ndi Chiyani?

Zothandizira

National Institute of Neurological Disorders ndi Stroke. (2023) Paresthesia.

American Association of Neurological Surgeons. (2023) Herniated disc.

National Institute of Diabetes and Digestive and Kidney Diseases. (2018) Matenda a ubongo.

Merck Manual Professional Version. (2022) Numbness.

Razazian, N., Yavari, Z., Farnia, V., Azizi, A., Kordavani, L., Bahmani, DS, Holsboer-Trachsler, E., & Brand, S. (2016). Kugwiritsa Ntchito Mphamvu pa Kutopa, Kukhumudwa, ndi Paresthesia kwa Odwala Azimayi Omwe Ali ndi Multiple Sclerosis. Mankhwala ndi sayansi pamasewera ndi masewera olimbitsa thupi, 48 (5), 796-803. doi.org/10.1249/MSS.0000000000000834

Fritz, JM, Lane, E., McFadden, M., Brennan, G., Magel, JS, Thackeray, A., Minick, K., Meier, W., & Greene, T. (2021). Physical Therapy Referral From Primary Care for Acute Back Back Pain With Sciatica : Mayesero Olamulidwa Mwachisawawa. Annals za mankhwala amkati, 174 (1), 8-17. doi.org/10.7326/M20-4187