Kune vanhu vazhinji, mushonga unowanzoitika unokundikana kugutsikana kunogadzirisa kurwadziwa. Izvi zvingava chikonzero chimwe chekuti kushandiswa kwemishonga yakasiyana-siyana uye mishonga yakazara inoramba ichikwira muUnited States.
Vanhu veAmerica vane zvakawanda zvakasuruvara zvinorwadza shure. Kutaura zvazviri, chimwe chezvikonzero zvakakosha zvekushanyira hofisi yechiremba uye kusakosha kwemazuva ekushanda, pamwe chete nechikonzero chinonyanya kukonzerwa nekuremara kwakabatanidzwa nebasa, maererano neNational Institute of Neurological Disorders uye Stroke.
Kuwedzerwa, National Center for Complementary and Integrative Health, sangano riri mukati meNational Institutes of Health, iro chikamu chehurumende yehurumende, inotaura nezvekurwa kwemasukirwe uye marwadzo kumashure sekuda kushandiswa kwakasimba kune mamwe maitiro ekurapa.
Spine Medicine muUnited States
Kunyanya chikamu, kunyange zvakadaro, kurapwa kwezvokurapa kwakadzika midzi mune mamwe mararamiro emhando dzakadai semishonga.
Mazita ezvokurapa zvinowanzopiwa navanachiremba kumarwadzo avo anorwadza anosanganisira, pakati pezvimwe zvinhu, zvinodhaka zvinodhaka. Zvimwe zvisingazivikanwi se-opioid, iyi mishonga inogona kutungamirira pasi munzira yekudhakwa kana iwe, chiremba wako uye wemhizha wako asingachenjeri.
Mashoko akanaka ndeokuti marwadzo mazhinji ekurwadziwa anoenda ari oga kana nokutevera akatendeka chirongwa chepurogiramu yakanaka. Nhau dzakaipa (zvichida) ndeyokuti chinhu chekutanga chiremba wako wechigarire angakwanisa kukupa iwe opioid yekutambudzika kwako-kunyange kana simba racho riri runyoro kana kuti rusinganzwisisiki.
Asi CDC inotaura kuti vanachiremba vanofanira kunyatsofungisisa kubatsirwa kwehupi hupi hwehutano maererano nezvinetso zvehutano zvinogona kuitika. Munyaya yekurwadziwa kwemarwadzo anonyadzisa, kana chiremba wako anotarisira zvakanaka izvo zvinodhaka zvinokuita-maererano nehutano hwekurwadziwa uye kushanda kwezuva nezuva-zvichave zvakakura kudarika mungozi yekudhakwa, kuvimbiswa, uye zvimwe zvinokonzerwa nemigumisiro , uye opioid zvingave zvakakodzera kufungisisa.
Ramba uchifunga, zvakadaro, kuti maopioid akanyatsoratidza kuti ivo vanobudirira kwenguva pfupi, kurwadziwa kwakanyanya. Nekurwadziwa kwemazuva kwenguva refu kana kunyoresa, kune zvimwe zvingasarudzwa zvinogona kuunza migumisiro yakanaka.
Kana uri kutora opioid yekutambudzika, unofanira kuziva kuti chiremba wako anofanirwa kutarisa kufambira mberi kwako mukurapa. Simba rako uye simba rako rekuita zvekuita muupenyu hwezuva nezuva rinofanira kuvandudza, uye hutano hwako hunofanira kuderera. Kana zvisina kudaro, zvingava zvakanakisisa kumisa chirwere che opioid, iyo CDC inoti.
Uye pakupedzisira, CDC inokurudzira kuna vanachiremba kuti kare uye panguva yekurapa, vanotaura newe pamusoro pengozi uye kubatsirwa kwekutora opioid.
Zvimwe zvinonzi allopathic mishonga zvinowanzokurudzirwa kuvarwere vachinyunyuta nezvekurwadziwa shure zvinosanganisira kuvhiyiwa, kushandiswa kwemarwadzo ekudzivirira marwadzo, uye zvishoma, chirwere chepanyama.
Kuve wakarurama, kuiswa mumutsipa wepelinha stimulators inowanzowana maitiro akanaka kubva kuvarwere vane chirwere chisingaperi chisingagadziriswi chinorwadza uye vane marwadzo aya akaiswa mukati. Uye nokuda kwekutambudzika kwakanyanya, imwe nzira yekurapa muviri inowanzobatsira-kune avo vanoita basa ravo rechikoro, is.
Chiremba Wako Anoziva Chii Chinofanira Kukurudzira Munzira YeUrapa?
Kazhinji kutaura, vatapi vezvokurapa vanoita mari yakawanda pamishonga yakadaro, asi nhamba dzinoratidza kuti varwere vemawere havawanzofari.
Mari iyo inogona kunge iri shure kwekukwirira kwechikwata apo hutano hwakasimba hwehutano nehutano hwehutano huri kufambira mberi munhangemutange kune nzira dzakachengeteka, dzakanaka, dzisingasviki dzinogutsa varwere kurwadziwa ivo pachavo.
Saka vanachiremba vanoona sei mazano ekukurudzira kwamuri? Chimwe chinogadzirisa chinogona kunge chiri mupepeti chaiwo. Kana iwe uchienda kune chirwere chemaurosurgeon chekutsvaga, somuenzaniso, iwe unogona kunge uine chirwere cheuropiyuta chinokurudzirwa kwauri sechinhu chinogona kubvisa zviratidzo zvako. Asi zvimwe zvingasarudzwa zvinogona kuvapo kubva kwaungasarudza.
Kunyanya, iyi ndiyo nguva yenhamba.
Chiremba wako angave ane unyanzvi hunoshamisa mune imwe nzira yepfungwa dzemawere, asi avhareji chete kana zvishoma pamusoro peyanzvi hwepamusoro mune vamwe izvo zvine chokuita. (Izvi zvingangodaro nokuti chiremba anovhiya anoita izvozvi kakawanda.) Izvozvo zvakati, iyo nzira chaiyo (kana uzivi hwekuvhiyiwa) apo chiremba anopfuura zvakanyanya haingave yakakosha iwe wakapa makore ako, chimiro, zvido zvako , uye rudzi rwechinetso chekushure chaunacho.
Ngatitorei kuvhiyiwa kwechirwere semuenzaniso. Vamwe vanachiremba vakashandisa mari yakawanda kuti vadzidze nzira yekugadzirisa tsvina, iyo ndiyo nzira itsva yemitambo. Vamwe, zvichida avo vakambove mumabhizimisi kwenguva refu, vanobatana neavo vakaedza uye vechokwadi musana fusion. Hazvirevi kuti musana wemasana kana kushandura tsvina zvakakwana mukusachengetedza uye kubudirira, saka pane kugamuchira mutevedzeri mumwechete pane zvaunofanira kurapa, zvingave zvakakunakira kutsvakurudza zvaunosarudza zvakanyanya musati waita.
Uye pakupedzisira, mapurisa makuru ari mune tsika yekubudisa mazano kune vanachiremba ((optionally) kutevera. Iwe, semurwere, unogona (kana kuti usingaiti) unobatsire kubva kune izvi zvinokurudzirwa mukuderera-tsika kwemafashoni. Mirayiridzo yezvinetso zvekare neyemutsipa inobudiswa nemasangano akadai seAmerican Physical Therapy Association, American Society of Interventional Pain Physicians, American College of Physicians, nevamwe. Zvichienderana nechinangwa chaicho chepfungwa, uye muparidzi ndiani, mitemo inonyanya kuratidza zvinodhaka, chirwere, injection injecting, uye / kana chirwere chepanyama sekurapa. Nenzira, ivo vakapa zvishoma kubvuma kuhutano hwemishonga.
A Holistic Slant kuti Pain Treatment May Ive paIri Horizon
Kubvira pakutanga kwegore ra2017, kuchinja kungave kuri kuuya.
Mhemberero yakawanda yakakomberedza Indaneti uye pamapurogiramu eTV anobudiswa munaFebruary naMarch ya2017 apo American College of Physicians yakabudisa mutungamiri wekuti, pakati pezvimwe zvinhu, yakakurudzira maitiro akawanda ehutano sehutano hwehutano hwekumusoro. Izvi zvaisanganisira kuunganidza masasa, kuvhara muviri, kugadzirwa kwepelinha, tai chi, yoga, uye kupisa. Nhungamiro ihwohwo hunoenderana nehupfungwa-hunofanirwa kuti zvinorayirirwa zvakagadzirwa kubva pakugadzirisa kuongororwa kwemigumisiro inobva kuhupamhi hwepamusoro (randomized, controlled) zvidzidzo zvakaongororwa mishonga. Vatsvakurudzi vaida kuziva kuti zvipi zvinorapwa zvakagadzirisa zvakanakisisa zvinhu zvakadai sekubvisa marwadzo ekudzokera shure, kukwanisa kuita muviri, kuvandudza hupenyu hwehupenyu, kuderedza urema nekudzokera kubasa, nezvimwewo.
Vatsvakurudzi vakanga vachitsvaga ruzivo pamusoro pemigumisiro uye kukanganiswa kwemitengo, uyewo kuti varwere vakagutsikana sei nehutachiona hwega.
Iyi mitemo inobata marudzi ose ekurapa-kwete kungofanana nemishonga-yehutachiona, hwechirwere uye yekusagadzikana kunorwadza shure. Zvinorayirwa zvezvipatara zvakasiyana-siyana zvinopesana maererano nerudzi rwemarwadzo. Vanyori vehutungamiri vakati havana huni hwakakwana hwokutaura nenzira imwe neimwe mukurwadziwa kunotumidzwa kubva mumusana, iyo inonzi marwadzo akawandisa uye kazhinji inokonzerwa nekambani yebhedheni.
Iye zvino, usati wanyanyisa kufara (kana, iwe zvirokwazvo iwe uri munhu angada kusarudzira hutenderedze pane nzira yeallopathic), yeuka kuti iyi ndeye hurumende imwe chete inorumbidzwa. Mune mamwe mazwi, holistic therapy sechinhu chinokonzerwa nekurwadziwa kunoshandiswa kunogona kupiwa kwauri nechiremba wako haisi basa rakaitwa.
Izvo Zvingaita Nhungamiro Yakapararira Inosanganisira Hunt Health
Mamwe masangano, akadai seAmerican Medical Association uye Joint Commission (sangano rinogamuchirwa rinogadza kurapwa kwezvipatara) zvakare, munguva yakapfuura, rakabudisa zvinyorwa.
Mishonga yepanyama inoshandiswa mumitambo iyi uye yakafanana inogona kunge isingazivikanwi. Dzimwe nguva, kurapwa kwaunogona kuziva ( chiropractic , massage, acupuncture, mindfulness, yoga, somuenzaniso) inonyanya kutaurwa, asi mushumo unorega kukurumidza kudikanwa kana kuti kukurudzira zvakasimba sekurapa kwepakutanga . Dzimwe nguva, urongwa hwehutano hwakakwana huri hudiki, asi kushandiswa kwavo kunowedzera kukurudzirwa.
"Mutauro wacho unowanzochinja sezvo mabhuku aya ekurudziro anobudiswa, uye apo mazita eti holistic therapies ane zvakawanda nezvisarudzo, apo ekupedzisira kunouya zvishomanana zvinotaurwa," anodaro John Weeks, muparidzi we Integrator Blog News & Report .
Somuenzaniso, munaNovember 2014, Joint Commission yakabudisa "Kusarudzwa kwePauin Management Standard" iyo, mumasvondo mashoko, "yakasimudza kukosha kwekusagadzirisa maitiro. Kuchengetedza chirwere, kurapwa kwemajeri, chiropractic therapy, cognitive behavioral therapy, uye osteopathy yaiva pakati pezviitiro zvinotsanangurwa, "anodaro.
Zvadaro, muna 2017, Joint Commission yakabudisa sarudzo yakatevera yePain Standard yavo. Iwe unogona kufunga kuti ichange iri kupfuurira kwebhuku rekujekesa kubvira makore matatu apfuura, rimwe rinosanganisira, uye kunyange kusimbisa runyora rwegore ra2014 remishonga yakakwana. Pane kudaro, kunyange zvazvo kuwedzerwa kwekurapa kwakadai kwakakurudzirwa, nhamba yehutano hwehutano hwakataurwa inonyanya kuduku.
Nokuda kwechikonzero ichi, Mavhiki mashomanana, zvinyorwa zvemazuva ano zvinoshungurudza. "Nechekudzikisa kana kushambadza, somuenzaniso, zvinotaurwa zvakananga," anodaro. Mavhiki anowedzera kuti kana chirwere chisina kutaurwa zvakananga, vashoma vasikana vachave vachida kuitora muitiro wavo kana kurumbidza iwo kuvarwere vavo.
Chimwe chiitiko chekushandura mutauro uyu chiitiko, maererano neMavhiki, ndiyo CDC ya2016 inotungamira murongwa wezvinyorwa zvemishonga yemarwadzo opioid. (Iyo yekupedzisira yakabva yasunungurwa.) Anoti, "Mutungamiri unosanganisira mutauro unoshamisa wokushandura: 'Kwete-pharmacologic therapy uye kwete-opioid pharmacologic therapy inoshandiswa mukurwadziwa kusingaperi.'"
Asi, semavhiki achinyora muzvinyorwa zvese, kubatanidza uye dzimwe nzira dzokurapa (semuenzaniso kushungurudzwa kwepamuviri, kushambadza, uye kugadziriswa) zvakatumidzwa sezvidikanwa, kwete zvemishonga mishonga inogona kuedzwa nekuda kwekunzwa panzvimbo yekunyora maopioid. "Kushandiswa kweshoko rokuti 'kuda' kunoratidza kutanga," anodaro, "Ichi chete chinoratidza kuchinja kukuru kubva kune tsika ino."
Asi apo CDC yakabudisa shanduro yekupedzisira kwemwedzi mishomanana gare gare, zvakananga zvakasiyana uye zvimwe nzira dzokurapa zvinotaurwa zvainge zvasipo. Izvo zvinoratidzirwa zvino zvinoti: "Kuita muviri, kudzika mumvura, aerobic, mupfungwa, kusanganisa maitiro ekurapa, uye kugoverwa kwebio-psycho-social."
Nevamwe vanhu veAmerica vari kurarama nekurwadziwa kudarika chirwere cheshuga, chirwere chemwoyo, uye kenza pamwe chete (maererano neAmerican Academy of Pain Medicine), kutarisira kurwadziwa nenzira inodhura-inoshandisika, inoshandiswa nevatengi inokosha. Uye izvi zvinongowanikwa zvakakosha nekuti vanhu vazhinji havasi kuwana rubatsiro rwavanotsvaka kubva kune avo vanoita zvechirwere zvechirwere chechirwere.
> Sources:
> ACP. American College of Physicians inotungamirira kurwara > nonradicular > low back pain. American College of Physicians. Feb 2017. https://www.acponline.org/acp-newsroom/american-college-of-physicians-issues-guideline-for-treating-nonradicular-low-back-pain.
> Centres for Disease Control and Prevention. Kushungurudza uye Kufa Vhiki Yevhiki. CDC Guideline yekutsanangura maOpioids for Chronic Pain - > United States >, 2016 > Zvirongwa > uye Zvinyorwa. March 2016. https://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm.
> Quseem > A., MD, > PhD >, MHA, Wilt T., MD, MPH, McLean, R, MD, Chikonzero, M, MD Zvisingatauriki Zvirwere zveAkadaro, Subacute, uye Chronic Chronic Back Pain: A Clinical Practice Guideline Kubva kuAmerican College of Physicians. Anals of Internal Medicine. Feb 2017. http://annals.org/aim/article/2603228/noninvasive-treatments-acute-subacute-chronic-low-back-pain-clinical-practice