Kubantu abaninzi, unyango oluqhelekileyo aluphumelelanga ngokukhawuleza ukukhulula intlungu. Esi sisinye sezizathu zokubakho ukusebenzisa iyeza kunye neendlela eziqhubekayo zokwelapha kuyaqhubeka ukunyuka eUnited States.
Abantu baseMelika banamava amaninzi aphantsi. Enyanisweni, esinye sezizathu ezihamba phambili zokutyelela kwi-ofisi yegqirha kunye neentsuku zomsebenzi eziphosakeleyo, kunye nesizathu esivakalayo sokukhubazeka okuhlobene nomsebenzi, ngokweNational Institute of Neurological Disorders and Stroke.
Ukongezelela, iZiko likaZwelonke leMpilo eQinisekisiweyo kunye neNtlangano, i-agqeba kwiZiko leSizwe lezeMpilo, eliyinxalenye yombuso karhulumente, ikhankanya intlungu ye- musculoskeletal and back as mhlawumbi abaqhubi abanamandla ngakumbi.
Spine Medicine eUnited States
Nangona kunjalo, inxalenye enkulu, ukusekwa kwezonyango kusekwe kwiindlela ezininzi zokwelapha ezinjenge-allopathic ezifana neyeza.
Uluhlu lwezonyango oluqhelekileyo olunikezwa ngamagqirha kwizigulane zabo zentlungu lubandakanya, phakathi kwezinye izinto, iziyobisi zamachiza. Ngenye indlela eyaziwa ngokuba yi-opioids, la mayeza angakhokelela ekuhlaleni umlutha ukuba wena, ugqirha wakho kunye ne-pharmist wakho akayinyameki.
Iindaba ezilungileyo kukuba ininzi intlungu ihamba ngokwayo okanye ngokulandela ngokunyanisekileyo inkqubo yovavanyo lomgangatho ophezulu. Iindaba ezimbi (mhlawumbi) kukuba into yokuqala ogqirha wakho angayenzayo ikunikezela i-opioid yakho intlungu-nangona ubunzima bububele okanye bube bukhulu.
Kodwa i-CDC ithi oogqirha kufuneka baqwalasele ngenyameko inzuzo nayiphi na unyango malunga neengxaki zempilo ezinokubangela. Kwimeko yokuxhatshazwa kweentlungu, ukuba ugqirha wakho ulindele ukulungiswa kwezidakamizwa-ngokubhekiselele kwintlungu yokuphucula intlungu kunye nokusebenza kwansuku zonke-kuya kuba mkhulu kunomngcipheko wokubamba umlutha, ukuzithemba kunye nezinye iziphumo ezichaphazelekayo , kwaye i-opioids ku fanele uqikelele.
Gcinani engqondweni, nangona kunjalo, ukuba i-opioids iyakubonisa ukuba iphumelele ngokukhawuleza ngexesha elifutshane, intlungu ebuhlungu. Kwiintlungu zesikhathi eside okanye ezincinci ukuya kweyomodareyitha, kukho ezinye iindlela ezingabangela iziphumo ezingcono.
Ukuba uthatha i-opioids ngentlungu, kufuneka ukwazi ukuba ugqirha wakho kufuneka ahlole inkqubela yakho kulo lonke unyango. Amandla akho kunye nomsebenzi wakho wokusebenza ngokomzimba kwimpilo yemihla ngemihla kufuneka uphuculwe, kwaye amanqanaba akho entlungu ayencipha. Ngaphandle koko, kungcono kakhulu ukumisa unyango lwe-opioid, i-CDC ithi.
Kwaye ekugqibeleni, ii-CDC zincoma oogqirha ukuba ngaphambi nangesikhathi kunyango, bathetha nawe ngeengozi kunye neenzuzo zokuthatha i-opioids.
Olunye unyango lwe-allopathic olucetyiswayo kwizigulana ezikhalazelayo ngentlungu emva koko zibandakanya ukuhlinzwa, iinkqubo zokuphucula iintlungu, kunye neyonyana, unyango lomzimba.
Ukulungelelaniswa, ukunyuswa kweentambo zokugcoba umthambo kudla ukufumana iimpendulo ezilungileyo kwizigulane ezineentlungu ezingapheliyo ezingemva kokuzikhupha ezingenakunzima. .
Ingaba Ugqirha Wakho Uyazi Yintoni Enokuyincoma Ngendlela Yonyango?
Ngokuqhelekileyo, ababoneleli bezonyango benza imali eninzi kwezo zonyango, kodwa iinkalo zibonisa ukuba izigulane zentlambo azihlali ziphucula.
Imali enokuthi ibe yinto engemva kwesantya sogqirha apho iindawo ezinamandla zempilo zonyango kunye noluntu ziqhubela phambili emncintiswaneni ukuya kwindlela ekhuselekileyo, esebenzayo, engeyiyo inomdla eyanelisa izigulane zentlungu ngokwabo.
Ngoko oogqirha banquma njani ukuba zeziphi unyango zokucebisa kuwe? Omnye ummiselo unokuba ngumcebisi othile. Ukuba uya kwi- neurosurgeon ukubonisana, umzekelo, unokufumana i-neurosurgery ephakanyiswa kuwe njengento eyobangela ukuba iimpawu zakho ziphumelele. Kodwa ezinye iinketho zinokuvela kuyo ongakhetha kuyo.
Ngaphezu koko, eli lixesha le-niche.
Udokotela wakho ogqirha unokufumana ubuchule obungavamile kolunye uhlobo lwenkqubo yomgudu, kodwa kuphela umyinge okanye ubuncinane ngaphezu kwekhono eliphakathi kwamanye anxulumene. (Oku kunokwenzeka ukuba ugqirha wenza loo nkqubo ngokuphindaphindiweyo.) Le nto yathi, inqobo ethile (okanye ifilosofi yokuhlinzwa) apho ugqirha ogqithiseleyo akunokuba yinto efanelekileyo yokunika yona iminyaka, imeko, ukukhetha kwakho , kunye nohlobo lwenkinga yangemva.
Masithathe utyando lwe-disc njengomzekelo. Abanye oogqirha baye bachitha imali eninzi ukuze bafunde indlela yokwenza i- disc substitution , eyona hlobo lenkqubo entsha. Abanye, mhlawumbi abo baye bahlala kwishishini ixesha elide, banamathele kunye nokunyaniseka kwamanzi. Akukho fusion yomgudu okanye i-disc substitution epheleleyo ngokukhuselekileyo nokusebenza kakuhle, ngoko kunokuba wamukele umbono womboneleli omnye kwindlela unyango lwakho olufanele ukuba lube nalo, kungenokuba lunomdla kakhulu ukuphanda iinketho zakho ngakumbi phambi kokuba wenze.
Kwaye ekugqibeleni, amaziko ogqirha aphezulu ayenomkhwa wokuvelisa izikhokelo zoogqirha ukuba (balandele). Wena, njengesigulane, unokuthi (mhlawumbi ungeke) uzuze kulezi ziphakamiso kwindlela ekhohlakeleyo yefashoni. Izikhokelo zeengxaki zentsimbi neentamo zinyatheliswa yimibutho efana ne-American Physical Therapy Association, i-American Society of Interventional Pain Physicians, i-American College of Physicians, nabanye. Ngokuxhomekeke kwiingxaki zentlambo, kwaye ngubani na umvakalisi, izikhokelo zikhokelela kakhulu iziyobisi, unyango, unyango lwe-injection, kunye / okanye unyango lomzimba njengonyango. Ngokwesiko, baye banikela ubungqina obuncinane kwiimpawu zokwelapha ezipheleleyo.
Ukutshala okubambisene noPilato lwangethuba Mhlawumbi ube kwiLanga
Ukususela ekuqaleni kuka-2017, utshintsho luya kuza.
I-buzz eninzi nge-Intanethi nakwiinkqubo zeendaba ze-TV zenziwe ngoFebhuwari noMatshi ka-2017 xa i-American College of Physicians yashicilela isikhokelo sokuthi, phakathi kwezinye izinto, ikhuthaze iindlela ezininzi zokwelapha njengezonyango eziphantsi kweentlungu. Ezi zibandakanya ukusikwa, ukuguqula umzimba, ukuguqulwa kwamagqabi, i-tai chi, i-yoga, kunye nokushisa. Isikhokelo sisiseko-esisiseko, esichazela ukuba iingcebiso zahlanganiswa ukusuka kuhlolisiso oluchanekileyo lweziphumo ezivela kumgangatho ophezulu (uphando olungaphelelwanga, olulawulwayo) oluphonononga unyango. Abaphandi bafuna ukwazi ukuba zeziphi izifo ezenzile iziphumo eziphambili zezinto ezifana nokulahla intlungu, ukukwazi ukusebenza ngokomzimba, ukuphucula umgangatho wobomi, ukunciphisa ukukhubazeka nokubuyela emsebenzini, nokunye.
Abaphandi bafuna ulwazi malunga neziphumo kunye neziphumo zengxaki, kunye nezigulane ezanelisekileyo zonyango ngalinye.
Ezi zikhokelo zihlanganisa zonke iintlobo zonyango-kungekhona nje imishanguzo epheleleyo-ngenxa yeentlungu ezibuhlungu, ezixhatshazayo kunye nezingapheliyo. Iziphakamiso zayo zonyango oluthe ngqo zihluke ngohlobo lwentlungu. Ababhali besi sikhokelo bathi abanalo ubungqina obanele ukuba bathethe ngandlela-thile kwiintlungu ezithunyelwa emthonjeni, obizwa ngokuba buhlungu obukhulu kwaye ngokuqhelekileyo kubangelwa idiski ye-herniated.
Ngoku, ngaphambi kokuba ujonge i-wildly (ukuba ngokwenene ungumntu onokukhetha ukunakekelwa okupheleleyo ngeendlela ezinobungozi), khumbula ukuba le yinconywa yonyango kuphela. Ngamanye amagama, unyango olupheleleyo njengendlela yokwenza unyango oluqhelekileyo olunokumiselwa kuwe ngugqirha wakho akukwenziwanga.
Iingeniso zezikhokelo ezibanzi ezibandakanya iMpilo yokuHlonipha
Enye imibutho, efana ne-American Medical Association kunye neKhomishoni yoThutho (i-agunya eligunyazisiweyo elibeka imilinganiselo yonyango yezibhedlele) nayo, ngaphambili, ikhuphe izitatimende.
Ukukhutshwa kweyeza zendalo kule mibiko kunye neengxelo ezifanayo akunakulinganiswa. Ngamanye amaxesha, unyango onokuqhelana nawo ( isifo se-chiropractic , i-massage, i-acupuncture, ingqondo, i-yoga, umzekelo) ngokuthe ngqo kuthiwa, kodwa ingxelo iyanqanda ukufunwa okanye iyakhuthaza ngokuthe ngileyo ezi ndlela zonyango . Ngamanye amaxesha, uluhlu lweentlobo zonyango olupheleleyo luncinci kakhulu, kodwa ukusetyenziswa kwabo kukhuthazwa kakhulu.
Ulwimi luvame ukutshintsha njengoko la maxwebhu encomo eveliswayo, kwaye apho uluhlu lwezonyango ezipheleleyo lucebile ukhetho, xa ukugqibela kukuphuma kubalwa okukhankanywe, "kusho uJohn Weeks, umvakalisi we- Integrator Blog News & Report .
Ngokomzekelo, ngoNovemba 2014, iKomishoni yoQhagamshelwano yakhupha "Ukucaciswa koMgangatho woLawulo lwePain", ngamazwi eveki, "okuphakanyiswe ukubaluleka kweendlela ezingekho ze-pharmacologic. Ukunyangwa kwamathambo, ukunyanga amanoni, unyango lwe-chiropractic, unyango lokuziphatha, kunye ne-osteopathy ziphakathi kweendlela ezibizwa ngokucacileyo, "utsho.
Emva koko, ngo-2017, iKomishoni yoLungeleleneyo yavelisa i-draft ye-Pain Standard. Unokucinga ukuba kuya kuba kukuqhubeka koxwebhu lokucacisa ukususela kwiminyaka emithathu ngaphambili, enye leyo ibandakanya, kwaye iqinisa uluhlu lwe-2014 lwezokwelapha ngokupheleleyo. Endaweni yoko, nangona ukufikelela okuninzi kwezo zonyango kunconywe, inani leempawu ezipheleleyo ezikhankanyiweyo zincinci.
Ngenxa yeso sizathu, iiveki zamagqabaza, i-draft draft yakutsha idideka. Uthi, "Akunamsebenzi okanye ukusikwa, ngokukodwa, kuthiwa," utsho. Iiveki zongezelela ukuba xa unyango olungakhange luchazwe ngokukodwa, oogqirha abambalwa baya kutsalwa ukuba bawuthathe ngendlela yabo okanye bacebise kwizigulane zabo.
Omnye umzekelo wolu tshintsho lweelwimi, ngokweeveki, yi-CDC ye-2016 yomgaqo-nkqubo wokuqulunqwa kwemithi yesifo se-opioid. (Okokugqibela kususela ekukhutshweni.) Uthi, "Isikhokelo siquka ulwimi oluguquguqukayo: 'Ulwaphulo olungekho phantsi kwe-pharmacologic kunye neyeza elingenalo i-opioid unyango lwe-pharmacologic lukhethwa ukuba lubuhlungu obungapheliyo.'"
Kodwa, njengeeveki ezikhankanywe kwidrafti, ezonyango ezongezelelweyo kunye nezinye iindlela (umz. Ukunyanzeliswa komlingo, ukusilalisa kunye nokukhwabanisa) zabizwa ngokuba yizinto ezinqwenelekayo, ezingezizo zonyango ezingayilungelwa intlungu ngenxa ye-opioid ye-narcotic. "Ukusetyenziswa kwegama elithi 'ukukhetha' libonisa ukubeka phambili," utsho, "Oku kuphela kubonisa ukuba utshintsho olukhulu luvela kumsebenzi wangoku."
Kodwa xa i-CDC yashicilela inguqu yokugqibela kwinyanga ezimbalwa kamva, ezikhankanyweyo kunye nezinye iindlela zokwelapha ezikhethiweyo ziye zaphela. Uluhlu luye lwafunda ngoku: "Ukuzivocavoca, amanzi, aerobic, kwengqondo, ingqondo yokuziphatha, kunye ne-bio-psycho-social intervention."
Ngabantu abaninzi baseMerika abahlala neentlungu ezinesifo sikashukela, isifo senhliziyo, kunye nomhlaza kunye kunye nomhlaza (kunye ne-American Academy of Medicine Pain), ulawulo lweentlungu ngendlela echanekileyo, obunomdla kubaluleke kakhulu. Kwaye oko kuyenziwa kuphela ngokubalulekayo kukuba abantu abaninzi abafumani ukuphucula abayifunayo kumagqirha abo aqhelekileyo.
> Imithombo:
> ACP. Ikholeji yaseMerika yaseMgqirha ibonisa izikhokelo zokuphathwa > ezingekho phantsi> iintlungu eziphantsi. Ikholeji yaseMerika yaseMagqirha. Februwari 2017. https://www.acponline.org/acp-newsroom/american-college-of-s-distress-ssues-guideline-for-treating-nonradicular-low-back-pain.
> Amacandelo okuLawula nokuLawula izifo. Ukunyangwa nokufa kweeNgxelo zeveki. I-CDC Isikhokelo sokuLawulwa kwama-Opioids for Pain Chronic - > United States >, 2016 > Iingcebiso > kunye neengxelo. Matshi 2016. https://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm.
> Quseem > A., MD, > PhD >, MHA, Wilt T., MD, MPH, McLean, R, MD, I-Forcesea, M, MD Iinkqubo ezingabonakaliyo kwi-Acute, Subacute, ne-Chronic Low Pain: I-Clinical Practice Guideline Ukusuka kwi-American College of Physicians. Amanqaku angamayeza angaphakathi. Feb 2017. http://annals.org/aim/article/2603228/noninvasive-threatings-acute-subacute-chronic-low-back-pain-clinical-racractice