Ingqwalasela ye-Back and neck Pain
Kucacile ukuba ngokwaneleyo, intlungu kunye nentlungu yangemuva yinto nje yevalelo engathandekiyo kwintsimi yakho, phakathi kwakho, kunye / okanye ngasentla, okanye ngasemva kwakho. Njengoko uza kubona, ubuhlungu beentlungu buya kuziswa ngazo nayiphi na inani lezinto, kunokuqondwa ngeendlela ezininzi, kwaye kunokuzisa iimpawu kwezinye iindawo zomzimba wakho.
Iintlungu zentlungu zixhaphake kakhulu, kunye nentlungu ephantsi ye-back affecting to 80 percent of the population at some time in their life.
Kukho intlungu ephindwe kabini kwintlungu efana nentlungu yentamo, kwaye ubuninzi beentlungu ezibuhlungu kunye neentlungu ezidolo zilingana.
Ngubani ofumana i-Back and neck Pain?
Unokuba ngumngcipheko ophezulu wokuba utyumle umlenze xa unesifazana, ukhuluphele okanye ukhuluphele , utshaya , une-osteoporosis kunye / okanye ufumana umzimba omningi okanye awufumaneki. Ezinye izinto ezinobungozi zibandakanya izinga lemfundo engezantsi, zihlala kwidolophana, zibe ngaphantsi kwe-50 (intlungu yentlungu) kunye ngaphantsi kwama-65 (ngenxa yentlungu ephantsi), amanqanaba angaphezu kweengxaki, okanye ubunzima beemeko (uxhala okanye ukudandatheka).
Izinto ezisemsebenzini zidlala indima enkulu entlekweni yentlungu kunye nentlungu yomqolo, kwakhona. Ukuba awunelisekile ngomsebenzi wakho, unako inkxaso evela kubasebenzi bakho okanye abaqashi, okanye umsebenzi wakho uquka ukubeka umzimba wakho kwisigxina (umzekelo, ukusebenzisa i-jackhammer) unokuba nobunzima obunomlenze obuhlungu. Abasebenzi base-Ofisi bavame ukufumana intlungu engaphezu kwezinye iintlobo zabasebenzi.
Okuncinci kakhulu kuyaziwa malunga nobuhlungu beentsimbi eziphakathi nangaphezulu ngaphezu kwentamo okanye iintlungu ezisezantsi. Oku kubangelwa kukuba uphando olulinganiselwe kwesi sihloko. Kodwa u-2016 uphando olushicilelwe kwi- European Journal of Pain lubonisa ukuba lufana nje nentlungu nentlungu.
Nangona intlungu kunye nentlungu emva kwexesha, ukuba kukho, ukusongela ubomi, kunokuxhalabisa kwaye kwezinye iimeko kunokuphazamisa umgangatho wobomi ixesha elide. Oko kwathiwa, ezininzi iimeko ziba ziincwadana ezincinci abantu abayifumanayo ngokunciphisa umsebenzi wabo nokuvumela ingxaki ithathe ikhosi.
Umva kunye neNtlungu Yobuhlungu - Iingqwalasela zobuGcisa
Ukuba siza kuba nobuchwepheshe malunga nayo, intamo (kwaye intlungu yentlungu) ichazwa njengokuba (intlungu) apho inxalenye yomgudu ephuma kwi- vertebra yakho yokuqala yomlomo (oku malunga nezantsi kwendlebe yakho lobe) ukuya kweyesixhenxe. I-vertebra yesixhenxe yentsholongwane iphezu kwiphepha lakho nasemacaleni angaphezulu.
Umva kunye nomphezulu ongentla ulandelayo, ukwanda ukusuka ngaphantsi kwe-vertebra yesi-7 yesibeletho ukuya kwezantsi kwe-vertebra ye-thoracic. I-vertebra engama-12 ejikelezayo ihamba malunga nantoni yombhobho owesithathu ukusuka ngasezantsi (obizwa ngokuba yi-rib 10). Lo mbambo ngowokugqibela kwiimbambo "zinyani" (okt, ziqhotyoshelwe kwisibilini ngeendlela i-cartilage ngaphambili).
Ngaphantsi kombhobho we-10 uninzi ezimbini-ezi zibizwa ngokuthi "izibambo ezinamanzi" kuba azijikelezi ngapha nangapha kwaye aziqhotyoshelwanga kwibele.
Umqolo ophantsi ungummandla ohambelana nomlenze we-lumbar , oqala ngaphantsi kwe-vertebra ye-thoracic ye-12 kwaye ubheke phezulu kwi-sacrum bone, phantse phakathi kweendlela phakathi kwamathambo amabini asempuphu. I-Sacroiliac kunye nentlungu ye-coccyx ziintlobo zentlungu; ikakhulu ubuhlungu be-sacroiliac buyifom ye-sacroiliac kunye nokusebenza kakubi. Ithambo le-coccyx ngumsila wakho. Yona ithambo lokugqibela lomgudu; ixhoma phantsi kwe-sacrum.
Indlela Yokuyiqonda Intlungu Yengxaki
Kukho iindlela ezininzi zokuchaza, ukuqonda, nokuxilonga ubuhlungu besisu. Unokuwujonga ngokubhekiselele kwithuba elide ubenalo; Intlungu yakutshanje kuthiwa yinto enzima , ngelixa ubuhlungu obude bude ngaphezu kweenyanga ezintathu bubizwa ngokuba buhlungu okanye obungapheliyo. Isizathu esiqhelekileyo sobuhlungu obungapheliyo obunomlenze obuhlobene nokuguga (kunye nobuncinci obunokuma kwexesha elide) ukuguqulwa okwenyukayo kumathambo omgudu ovela kwiingubo kunye nokukhawulela ixesha.
Iintlungu ezibuhlungu kunye nezingapheliyo ziphathwa ngokugqithisileyo komnye nomnye, ngendlela.
Okanye unokuqonda ubuhlungu bentwaba ngokwempawu zesibindi. Ukuba unentlungu, ubuthathaka, ukuphazamiseka kunye / okanye uvakalelo lombane olwenzela ingalo enye okanye umlenze owodwa, unokufumana imeko ebizwa ngokuba yi-radiculopathy. I-Radiculopathy inomsindo omnye okanye ngaphezulu kweengcambu zesisu, kwaye ngokuqhelekileyo-kodwa ayisoloko ibangelwa yingozi eyenziwa njenge-disc. Iingcambu zesisu zomgudu ziqoqo lweentsimbi eziye zaxhuma kwi-central, intambo yomthambo ophakathi kwaye zisendleleni yokuphuma kuzo zonke iinkalo zomzimba. Ngalinye ithambo lomthambo luneengcambu zomgulane ezimbini (enye ngecala) ephuma emthonjeni womgogodla. Xa into ethile igxininisa ingcambu yesondlo, ingcambu yomnyoba ingabacaphukisa, iholele intlungu kunye nezinye iimpawu ezikhankanywe ngasentla. Kwakhona, oku kungenziwa ngenxa yeriskhi ye-herniated kodwa kungakho nangenxa yokuguqulwa kwe-arthritic (ukuguqulwa kwesiguqulelo) kwisigxina, njenge- facet hypertrophy , u-spinal stenosis, i-bone spurs, kunye nokunye.
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Kutheni iimeko ezifanelekileyo zingaphumelela ukuNciphisa intlungu yakho
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Inkcazo yeNtsholongwane yeNtsholongwane
Enye indlela yokuqonda intlungu nentlungu emva kokuqala kwayo. Ngaba unengozi okanye enye ingozi? Ukuxilongwa kwezi ziko kunokubandakanya i-whiplash, i-disni-heated disc, i-muscle sprain okanye i-ligament strain, i-spinal break, okanye umonakalo wentambo yomgca.
Kodwa ukuba intlungu ibonakala ikhula kancinci, inokubangelwa kukunyameka okanye ukukhubazeka komgulane, njengokwi-scoliosis. Ubunzima obunokuthi bube ngaphezu kwexesha lunokubangelwa ukuguqulwa, ukuguquka kweminyaka eminzini, njengalezo zikhankanywe ngasentla, ezikhokelela ekugqibeleni umthambo wesifo somgudu kunye nokuba mhlawumbe umlenze wesisu.
Okungaqhelekanga, intlungu okanye intlungu emva koko kubangelwa iingxaki zesistim ezifana nezifo, izicubu, okanye i-cysts. Umsebenzi wakho wokuxilonga uya kuqukwa ukuquka ukujonga " iiflegi ezibomvu ," ezibonakalisa ugqirha wakho okubangela ukuba akrokre inkqubo yenkqubo ngaphandle kweengxaki zesakhiwo. Iingxaki ze-Genetic kunye ne-congenital nazo zinokwenzeka. Imizekelo yeemeko zomnxeba zomntwana zibandakanya i-spina bifida kunye ne-torinol congenital (i-torticolli ithetha "intamo ephothiweyo"). Futhi i -kyphosis kaSuermermann , ukukhubazeka okuchaphazela amanye amakhwenkwe amakhwenkwe, ngumzekelo wemeko yomgulane ehambelana nemfuza.
Ubuhlungu bomlwelwane obuhambelana nalezi zizathu zingentla zingenzeka kwiindawo ezintle kunoma yimuphi ummandla - umlomo wesibeleko, i-thoracic (phakathi kunye / okanye ngasentla), i-sacral lumbar, okanye i-coccyx. Kanye kunye ne-vertebrae, i-disc, i-nerfs, ne-muscle, intlungu kunye nentlungu yangasemva iyakuchaphazela okanye ichaphazeleka ngamalungu kunye neengqungquthela kwindawo kunye nemithambo yegazi.
Icandelo loNonophelo loLondolozo-Ngaba Umthengi Qaphela?
Amalungu amaninzi okwakhiwa kwezonyango eziqhelekileyo, kuquka oogqirha, abaphandi, abaphandi bezempilo kunye nabanye, bajolise kakhulu kwiinkqubo zonyango ezisekelwe kwintliziyo kunye nezigulane zentlungu. Oko kuthetha ukuthini ukuba bafuna ukubona ubungqina bokuba unyango okanye utyando lusebenza ngaphambi kokuba basebenzise okanye bayincome.
Kwaye kuninzi, oku kulungile. Ngokunakekelwa kwezempilo kwishishini elikhulayo, ubungqina benzululwazi bubalulekileyo kwonyango enokuphucula intlungu kunye nokuphucula umgangatho wobomi. Kodwa i-potential potential for over-treatment isigqibo apho. Okugqithisileyo, oogqirha bavame ukunika unyango olungabonakali ukuba lusebenze ngendlela ekhuselekileyo nefanelekileyo kwizigulane-nangona kunjalo, kwaye nangona izigulane zixhomekeke kuzo.
Ngokomzekelo, oogqirha abaninzi banikezela i-opioids njengonyango wokuqala kumanqaku amancinci. Kodwa oku akusoloko kuyimfuneko. Ukuhlaziywa okucwangcisiweyo kwango-2016 kunye nokuhlaziywa kwe-meta kuboniswe ukuba abaninzi abantu bathatha intlungu ye-narcotic iyanciphisa ubuhlungu bentlungu (eyaziwa nangokuthi i-opioids) ayifumananga "ukuphulukana kwentlungu ebalulekileyo" kwinqanaba lexabiso. Ukuhlaziywa / ukuhlaziywa kweemeta kugqiba ukuba abantu ababekezelela i-opioids banokufumana "ukuthotywa kwexesha elifutshane", kwaye akukho bukho ubungqina bokuthetha ngoxinzelelo lwexesha elide.
Ngokufanayo, ukusetyenziswa kweentlungu ze-opioid kukhula ngokukhawuleza, ngakumbi ukukhathazeka kwe-muscloskeletal. Uphando lweNgcaciso yeeNkcazo zeSizwe luye lwabonisa ukwanda kweepesenti ezingama-104 kwimimiselo ye-opioid ngo-2010, kwaye omnye uphando uphawula ukuba malunga nesiqingatha sabasebenzisi be-opioid babuhlungu buhlungu. Uyabonisa ukuba ukusebenzisa i-opioids yexinzelelo engapheliyo yintlungu ixabana ngenxa yokuphepha kwayo kunye nokusebenza kwayo.
Njengama-narcotics, olu hlobo lonyango luya kumngcipheko wokulutha. Ngaphambi kokuvuma isigunyaziso okanye ukuthatha izidakamizwa, kukulungele ukulinganisela amandla okuxhatshazwa kunye nezinye iziphumo ezichaphazelekayo (ezifana nokuqhawulwa) malunga nokuphulukana kwentlungu enokuthi ufumane ezinye iindlela.
Enye inkcenkceshe yokutshintshwa kwenkcenkcesha yonyango kukusetyenziswa ngokugqithiseleyo kokucinga ngeso lengqondo. Oogqirha abaninzi banokukhupha ngokupheleleyo izigulane zabo ngenxa yentlungu-nangona maxesha amancinci angasombulula.
Kuhlolisiso luka-2009 olunesihloko elinesihloko esithi, "Ukugqithisa ukubuyisela ubuhlungu obungapheliyo: Isikhathi sokubuyela emuva," esapapashwa kwiNcwadi ye-American Board yoLondolozo lwezeMpilo , umbhali uRick Deyo, MD, PhD., Yafumanisa ukuba nangona izikhokelo zoogqirha ukudikibala ukusebenzisa iimvavanyo zengqondo xa zingekho mfuneko (ikakhulu ngenxa yeendleko zonyango ezingadingekile), inani le-MRI ye-Lumbar spine lenyuke ngamaphesenti angama-307 kwiminyaka eyi-12 elandelayo ngo-1990. Umbhali uphinde uchaze ukuba izinga leemvavanyo zinikwe umqolo izigulane zihluka "ngokuphawulekayo" kulo lonke ilizwe kwaye ukuba amazinga okuhlinzwa aphezulu aphezulu apho amazinga okucinga aphezulu.
UDeyo ubonisa ukuba ukufikelela kwiibini kwisithathu kwiimvavanyo zengcamango ezinikeziweyo zingenziwa ngokungafanelekanga.
Ucwaningo olwenziwa ngo-2016 olupapashwe kwiNgxelo yePermanente lubonise ukuba abantu abane-inshuwalense kawonkewonke bafumana ii-MRI zengxowankulu rhoqo kunezinye ezingekho ninshuwalense okanye i-inshurensi yabucala.
UDeyo naye uphawula izinto ezinokuqhuba le ndlela ephakamileyo ekusebenziseni ukucinga ngeso lengqondo kwiintlungu ezisezantsi: Ukukhula kwecandelo lokucatshulwa kwimboni yonyango, ukwanda kwimeko yesigulane se-MRIs, "uhlobo olushukumisayo lobungqina obubonwayo," njengoko uDeyo ebeka, ukusongelwa kwecala kunye nemali.
Ukuhlinzwa ngokutsha ngenye indawo apho unyango olungaphezu kwonyango lunokuba luninzi. Kwinqaku elikhankanywe ngasentla, uDeyo uthi izinga lokunyuka kwamagqabi olwenziwe ngexesha le-12 leminyaka linyuka ngama-220 ekhulwini. Umlobi wachaza indlela eya kutyando olongezelelweyo (kunye neendleko eziphezulu nakwii-course) kwezo zi gulane ezifumana ii-MRIs ekuqaleni kwexesha lokunyanga kwabo. Ingxaki kukuba, ezi zonyango azizange, ngokubanzi, zithuthukise amanqanaba ezigulane okanye ubuchule bokusebenza, ugqiba.
Ngokuqhelekileyo, uphando lucebisa ukuba unyango lwamaziko olwenziwe kunye nolunye unyango olulondolozayo lweeveki ezintandathu. Ukuba unyango (kunye nokuthatha inxaxheba kuwo) luhluleka ukunciphisa intlungu, kweso sikhundla ukuhlinzwa kungenzeka. Kodwa oogqirha abaninzi abanikeli izigulane zabo zomgudu umyalelo kwi-PT. Ngaba le nto mayiyimeko phakathi kwakho kunye nodokotela wakho, zizithethelele ngokuzicela. Yaye ukuba uzama ukutshintshela kumva okanye ukunyangwa kwentamo ngaphambi kokuba uqiniseke, kusenokuba ixesha lokufuna umbono wesibini.
> Imithombo:
> Abdel Shaheed C. Ukusebenza, Ukunyanzeliswa, kunye ne-Dose-Iimiphumo ezixhomekeke kwii-opioid Analgesics kwi-Low Back Pain Ukuhlaziywa koHlolo kunye nokuhlaziywa kweMeta. JAMA lwangaphakathi lweMithi . Julayi 2016. http://archinte.jamanetwork.com/article.aspx?articleid=2522397
> Deyo RA, Mirza SK, Turner JA. noMartin BI. (akukho mhla) Ukugqithisa ubuhlungu obungapheliyo: Imva yokubuya? 22 (1). http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2729142/
> I-Gold R, i-Esterberg E, i-Hollombe C, ne-al. (2016) Ukujonga umfanekiso ongaphantsi xa ungaboniswa: Uhlalutyo oluchanekileyo lwenkqubo. Inkcazelo yePermanente. , 20 (2), iphe. 25-33. http://www.ncbi.nlm.nih.gov/pubmed/26934626
> Johansson, Stochkendahl J, uHartvigsen J, uBoyle E. kunye noCassidy J. (2016) Isiganeko kunye nokuhlaselwa kweentlungu zentsimbi phakathi kwabantu bonke: Ukuhlaziywa okucwangcisiweyo. I-European Journal ye-Pain (eLondon, eNgilani). http://www.ncbi.nlm.nih.gov/pubmed/27146481
> Amasayithi B, i-Beach M, kunye no-Davis M. (2013) Ukwandisa ekusebenziseni i-analgesics ye-opioid kunye nokuntuleka kokuphuculwa kweemetrikhi zokukhubazeka phakathi kwabasebenzisi. I-Anesthesia yeSithili kunye neMpilo yezoPilisi. , 39 (1), iphe. 6-12. http://www.ncbi.nlm.nih.gov/pubmed/24310049