Chirongwa Chekudzokera uye Neck Pain
Zviri pachena kuti zvakakwana, kurwadziwa kwemutsipa uye kumashure kunongova ruzivo rwekunzwa kusingafadzi mukati memutsipa wako, pakati pako, uye / kana kumusoro kumashure, kana pasi rako rezasi. Sezvauchaona, kupfava kwepfungwa kunogona kuunzwa nemhando ipi zvayo yezvinhu, zvinogona kunzwisiswa nenzira dzakawanda, uye zvinogona kuunza zviratidzo kune dzimwe nzvimbo dzomuviri wako.
Urombo hwepfungwa hunowanzoshamisa, uye kurwadziwa kunorwadza shure kunosvika kusvika makumi mapfumbamwe kubva muzana yevanhu pane imwe nguva muhupenyu hwavo.
Pane zvinorwadza zvakapetwa kaviri zvakanyanya sekurwadziwa kwemutsipa, uye uwandu hwehutambudzo huri shure uye hutambu hwemabvi hunenge hwakaenzana.
Ndiani Anogamuchira Mushure Mutsipa?
Iwe unogona kunge uri pangozi yakakonzerwa nemarwadzo emusana kana iwe uri mukadzi, iwe unopfuura uremu hurefu kana worema , iwe utsi , une osteoporosis uye / kana iwe unogona kuwana muviri wakawanda kana kuti kwete. Zvimwe zvinokonzera ngozi zvinosanganisira dzidzo yepamusoro, kugara mumaguta, kuva pasi pemakumi mashanu (nemarwadzo emutsipa) uye pasi pemakore makumi matanhatu nemashanu (nekuda kwekunzwa kurwadziwa kwepamusoro), kuwedzera kunetseka, kana kuva nezvinetso zvepfungwa (kushushikana kana kuora mwoyo).
Pa-ye-basa zvinhu zvinoita basa guru mumatambudziko nehuro uye zvakare, zvakare. Kana iwe usina kugutsikana nebasa rako, iwe hauna rubatsiro kubva kune vashandi vako kana vashandi, kana basa rako rinosanganisira kuisa muviri wako kuchisimba (somuenzaniso, kushanda jackhammer) unogona kuva nehupamhi hwepamusoro hwepfungwa. Vashandi veHurumende vanowanzova nemarwadzo emutsipa akawanda kupfuura mamwe maitiro evashandi.
Zvishoma zvishoma zvinozivikanwa pamusoro pepakati nepamusoro kurwadziwa shure shure kwemutsipa kana kuchema kunorwa shure. Izvi zvinonyanya nokuti tsvakurudzo yehurukuro iyi haigone. Asi chidzidzo che 2016 chakabudiswa muEuropean Journal of Pain chinoratidza kuti zvinowanzofanana nehuro nehuro shure.
Kunyangwe kurwadziwa kwemutsipa uye kumashure hakuwanzoitiki, kana kune imwe nguva, kutyisidzira upenyu, zvinogona kuva zvinonetsa uye pane dzimwe nguva zvinogona kukanganisa zvakanyanya mararamiro ako eupenyu kwenguva yakareba. Izvozvo zvakati, maitiro akawanda anova zvikamu zviduku izvo vanhu vanopora kubva kuburikidza nekuderedza basa ravo nekurega dambudziko richitora nguva yaro.
Dzoka uye Neck Pain - The Technical Considerations
Kana tichizoshanda nezvehutano pamusoro payo, mutsi (uye naizvozvo kurwadziwa kwemutsipa) unotsanangurwa se (marwadzo mukati) chikamu chemupenya chinowedzera kubva kune wako wekutanga wekervical vertebra (iyo inenge iri pamucheto wezasi wekunzwa kwako lobe) kusvika kune wechinomwe. Ichinomwe chevervic vertebra iri pamusoro pefudzi rako uye kumusoro.
Iyo midzi nechepamusoro shure inotevera, inobva kubva pasi pezasi ye7 cervical vertebra kusvika pasi pe12th thotic vertebra. Miti 12 inonzi thoracic inokwira kumusoro nechepamusoro pembambo iri yechitatu kubva pasi (technically inonzi mbiru yegumi.) Chibvu ichi ndicho chokupedzisira che "nhovo" dzechibvu (kureva, inosungirirwa nefupa rekushandisa nenzira cartilage iri mberi).
Pasi pechibvu chechigumi pane zvimwe zviviri-izvi zvinonzi "mitsipa dzinokwira" nokuti hazvipoteri kumativi uye hazvibatanidzi kuhombodo.
Iyo yakaderera shure inzvimbo inofanana ne- lumbar spine , iyo inotanga pasi pe 12th thotiti vertebra uye inowedzera pasi kumusoro kwe sacrum bone, inenge iri pakati nepakati kusvika pasi pakati pemakumbo maviri kumashure. Sacroiliac uye kurwadziwa kwechiccyx zvakare marudzi emarwadzo emupfu; kunyanya kurwadziwa kwe sacroiliac kunotora chimiro che sacroiliac joint disysction. Iko coccyx bone ndiyo tailbone yako. Ndiro pfupa rekupedzisira remutsana; iyo inosungirira pasi kubva pasi pe sacrum.
Nzira Yokunzwisisa Sei Nechipfuva Chokumhanya
Kune nzira dzakawanda dzokurondedzera, kunzwisisa, nekuongorora hutano hwepamuviri. Iwe unogona kutarisa mazviri maererano nekureba kwawakave nako; kurwadziwa kwemazuva ano kunonzi kuoma , asi kurwadziwa kunogara kwenguva yakareba kudarika mwedzi mitatu inozivikanwa sekunetseka kusingaperi kana kusingaperi. Chikonzero chinowanzokonzerwa nekurwadziwa kwekusingaperi kwepfungwa dzinokonzerwa nekukwegura (uye kusvika kumaduku akare-akakuvara kwemazuva mazhinji) ndiko kuchinja kunogadzirisa mumasipinha emusana unoitika kubva pakupfeka uye kuparadza kwenguva.
Kurwara kwakasimba uye kusingaperi kunorapwa zvakasiyana zvakasiyana kubva kune mumwe, nenzira.
Kana iwe unogona kunzwisisa kurwadziwa kwepfungwa maererano nezviratidzo zvehutano. Kana iwe uine marwadzo, utera, kushaya simba uye / kana magetsi manzwiro anowira pasi imwe ruoko kana gumbo rimwe, unogona kuva nemamiriro ezvinhu anonzi radiculopathy. Radiculopathy inotsamwisa imwechete kana kupfuura miviri yemaginha midzi, uye kazhinji-asi kwete nguva dzose-inokonzerwa nekukuvadza kunonzi known senio. Mutsara wesimbi miviri inenge yakasanganiswa nemitsetse iyo yakave yakabhururuka ichibva kubva kumusoro, mukati memugero wepelinha uye iri munzira yekubuda kunoshumira nzvimbo dzose dzomuviri. Nhengo imwe neimwe yepinha ine midzi miviri yepelinha (imwe kune rumwe rutivi) iyo inobva kumutsipa wepelinha. Apo chimwe chinhu chinomira pamutsipa wemidzi, mutsara unogona kutsamwa, huchitungamirira mukurwadziwa uye zvimwe zviratidzo zvataurwa pamusoro apa. Zvakare, izvi zvinogona kuitika nekuda kwekadhi yakasungwa asi zvinogonawo kuitika neArthritic (degenerative) kuchinja mumutsana, zvakadai sechikamu chekubatana kwehutano , spinal stenosis, bone spurs, nezvimwewo.
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Sei Chimiro Chakanaka Chingaita Kuti Udzikinure Marwadzo Akadzoka?
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Mharapara Nemazi Root Tsanangudzo
Imwe nzira yokunzwisisa kurwadziwa kwemutsipa uye kumashure ndeyekuti yakatanga sei. Wakave nenjodzi here kana zvimwe zvinetso? Kuongororwa mumatambudziko aya kunogona kusanganisira whiplash, herniated disk, mushure mutsara kana gumbo rinokonzera, kuputika kwepamuviri, kana kukuvara kwepelinha.
Asi kana kurwadziwa kuchiita sekukura pauri zvishoma nezvishoma, zvinogona kunge zvichibva pamusana pokusava nemafungiro kana kupera kwemutsipa, zvakadai sa scoliosis. Marwadzo anowedzera kwenguva yakawanda angangodaro anokonzerwa nekusvibiswa, kufanana nemakore emusana, kufanana neaya ataurwa pamusoro apa, izvo zvinowanzoita kumusana wemaperembudzi uye zvichida sepinal stenosis.
Kunyanya kazhinji, kurwadziwa kwemutsipa kana kumashure kunokonzerwa nezvinetso zve systemic zvakadai sezvirwere, matumire, kana krisst. Basa rako rekuongorora rinogona kunge rinosanganisira kuongororwa kwe " mapuranga matsvuku ," izvo zviratidzo kune chiremba wako izvo zvingamuita kuti ashushike sarudzo panzvimbo yechinetso chemuumbi. Genetic uye congenital zvinokonzerawo zvinogona kuitika. Mienzaniso yekuberekwa kwepakati yemamiriro ezvinhu inosanganisira spina bifida uye congenital torticollis (torticollis rinoreva "musungo wakakombama"). Uye Scheuermann's kyphosis , kukanganisa kunokanganisa vamwe vakomana vechidiki, muenzaniso wepamuviri wehutano hwakabatana nemararamiro.
Urombo hwepamuviri hunobatanidza nezvikonzero zvinopfuura zvinogona kuitika munzvimbo yakawanda chero ipi zvayo - cervical, thoracic (pakati uye / kana kumusoro), lumbar sacral, kana coccyx. Pamwe pamwe nemavhuti, madhishi, mitsipa, nemisumbu, marwadzo emutsipa uye shure zvinogona kuchinja kana kuchinjwa nhengo nemafosheni munzvimbo yacho pamwe nemidziyo yeropa.
Shamba Rokuchengetedza Nechirwere-Icho Chine Mwenga Chenjerera Here?
Nhengo dzakawanda dzechirongwa chechiremba chinowanzogadzirwa, kusanganisira vanachiremba, vatsvakurudzi, vanachiremba vezvepanyama, uye vamwe, vanonyanya kufunga nezvehutano hwakakonzerwa nehutano hwevarwere nemutsipa yavo. Zvinorevei izvo zvinoda kuti vaone uchapupu hwekuti kurapwa kana chirwere chinoshanda musati vashandise kana kurumbidza iyo.
Uye kune zvakawanda, izvi zvakanaka. Nehutano hwehutano huwandu hwekuwedzera huri izvo, uchapupu hwezvesayenzi chinhu chikuru chekurapa kunounza kuponeswa kwehurombo nekuvandudzwa kwehupenyu hwehupenyu. Asi kukwanisa kwekurapa kunoitwa ipapo. Zvakaipisisa, vanachiremba vanowanzorondedzera kurapwa kusina kuratidzwa kushanda nenzira yakachengeteka uye inobudirira kune varwere-kunyange zvazvo vachifanira, uye kunyange zvazvo varwere vanovatarisira kuita kudaro.
Semuenzaniso, vanachiremba vakawanda vanorayira opioids seyokutanga mishonga yokurapa kunyange nematambudziko mashoma emarwadzo emusana. Asi izvi hazvirevi nguva dzose. Bhuku re 2016 rakarongeka uye kuongorora meta rakawana kuti vanhu vakawanda vanotora marwadzo anonyadzisa vanoderedza marwadzo ekudzokera shure (anonziwo opioids) havana kuwana "kurapwa kwakakosha kunorwadza" mumutero wezviyero zvakaongororwa. Kubvunzurudza / meta-analysis inogumisa kuti vanhu vanobvumira opioid vanogona kuwana "kuzvininipisa kwenguva pfupi kwekunonoka" pane zvakanakisisa, uye kuti hapana humwe uchapupu hunotaura pamusoro pekunonoka kwenguva refu kwekunorwadziwa.
Zvakangofanana, kushandiswa kwehuputi hweopioid kunowedzera zvishoma, kunyanya muscloskeletal disorders. Sangano reNational Medical Expenditure Panel Survey rakaratidza kuwedzera kwemazana 104 kubva muzana yezvinyorwa zveopioid muna 2010, uye mumwe muongorori anotaura kuti anenge hafu yevanoshandisa opioid vane kurwadziwa shure. Anotaura kuti kushandiswa kweapioid yekusagadzikana kusingaperi kunopesana nekuda kwekugona kwayo kuchengetedza uye kubudirira kwezvinhu.
Sezvinodhaka, mhando iyi yemishonga inouya ine ngozi yekudhakwa. Usati wabvumirana nemirairo kana kutora mishonga, zvakanakisisa kuongorora kukosha kwayo yekudhakwa pamwe nezvimwewo migumisiro (zvakadai sekudzivirira) pamusoro pemarwadzo ekurwadziwa iwe unogona kuwana nedzimwe nzira.
Chimwe chinhu chinopisa chinoshandiswa muhutano hwepfungwa ndiko kushandiswa kwepfungwa yekufungidzira. Vanachiremba vakawanda vanorayira kubhadhara zvakakwana kune varwere vavo vane kurwadziwa kwemuviri-kunyange matambudziko maduku anokwanisa kugadzirisa ivo pachavo.
Muchidzidzo cha2009 chine musoro unoti, "Kunyanya Kuwedzera Kubva Kudzorera Kwakapera: Nguva Yokudzoka ?," yakabudiswa mu Journal of the American Board of Family Medicine , munyori Rick Deyo, MD, PhD., Akawana kuti kunyange zvazvo mirayiridzo kuvanachiremba zvikuru kuora mwoyo kushandisa shanduko miedzo kana zvisingakodzeri (kunyanya nemhaka yezvikonzero zvinotarisirwa zvekurapa zvisina kukodzera), nhamba yekambarasi yeMMIs yakawedzera ne307 muzana mumakore gumi nemaviri achitevera 1990. Munyori anotaurawo kuti chiyero chekufungidzira kuedzwa kunopiwa musana varwere vanosiyana "nenzira inoshamisa" munyika yose uye kuti kuvhiya kwekare kumashure kwakanyanya kupfuura uko mafungiro ekufungidzira ariwo akakwirira.
Deyo anoratidza kuti kusvika kune zvikamu zviviri kubva muzvitatu zvezviitiko zvekufungidzira zvakapiwa zvinogona kuitwa zvisina kufanira.
Chidzidzo che 2016 chakabudiswa muNhau yePermanente yakawana kuti vanhu vane inshuwarisi yehurumende vakawana MRI yenguva yakawanda kupfuura yevaya vasina inshuwarisi kana inshuwarisi yega.
Deyo anonyorawo zvinhu zvinogona kutungamirira izvi zvichienda mberi mukushandiswa kwekufungidzira mafungiro ekurwadziwa kwepamusoro kwepamusoro: Kukura kwemufananidzo wekufungidzira wehutano hwehutano, kuwedzerwa mune zvinodiwa zvevarwere zveMMIs, "chimiro chinokurudzira cheuchapupu hunoratidzwa," sezvakaitwa Deyo, kutyisidzira mhosva, nemari.
Kuvhima kumashure ndeimwe nzvimbo iyo kunyanya kurapwa kungave kwakapararira. Muchikamu chimwechete chakataurwa pamusoro apa, Deyo anoti chiyero chekuputika kwepamuviri chakaitwa mukati memakore gumi nemakore chakawedzerwa ne 220 muzana. Munyori akataura nezvemaitiro ekuvhiya kwepamusoro (uye zvepamusoro-soro mari) kune avo varwere vane MRIs pakutanga munguva yekurapa kwavo. Dambudziko nderokuti, kuvhiyiwa uku hakuna kuita, zvakakwana, kuvandudza maitiro ehutano hwevarwere kana kukwanisa kushanda, anopedzisa.
Kazhinji, kutsvakurudza kunorayira kuedza kurapwa kwepanyama uye mamwe maitiro anochengetedza kwemavhiki masere. Kana chirwere (uye kubata kwako mukati maro) kukundikana kugadzirisa marwadzo, panguva iyoyo kuvhiyiwa kunogona kunge kuripo. Asi vanachiremba vakawanda havatauri varwere vavo vechipfuva mishonga kuP. Izvi zvinofanira kunge zviri izvo pakati pako nachiremba wako, zvikurudzire nokukumbira. Uye kana akaedza kukukurira kumashure kana kumutsipa mushure usati wanyatsogutsikana, zvingave nguva yekutsvaga pfungwa yechipiri.
> Sources:
> Abdel Shaheed C. Kubudirira, Kushushikana, uye Dose-Migumisiro Yakazvimirira yeOpioid Analgesics yeAkadzoka Kurwadziwa Kushandurwa Kwakarongeka uye Meta-analysis. JAMA Internal Medicine . July 2016. http://archinte.jamanetwork.com/article.aspx?articleid=2522397
> Deyo RA, Mirza SK, Turner JA. uye Martin BI. (kwete zuva) Kunyanya kunetseka kusingaperi kurwadziwa shure: Nguva yekudzokera shure? 22 (1). http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2729142/
> Ndarama R, Esterberg E, Hollombe C, et al. (2016) Kufananidza kumashure kwekare kana kusati kuratidzwa: A rinotsanangurwa-cross-system analysis. The journal Permanente. , 20 (2), mapeji 25-33. http://www.ncbi.nlm.nih.gov/pubmed/26934626
> Johansson, Stochkendahl J, Hartvigsen J, Boyle E. naCassidy J. (2016) Kubatwa uye kufungidzira kwepakati pemarwadzo ekudzoka muhuwandu hwevanhu: Kuongorora kwakarongeka. European Journal of Pain (London, England). http://www.ncbi.nlm.nih.gov/pubmed/27146481
> Nzvimbo B, Beach M, uye Davis M. (2013) Kuwedzerwa mukushandiswa kwechirongwa chekurapa maawa anorooid uye kushayikwa kwekuvandudzwa kwemasimba ekuremara pakati pevashandisi. Regional Anesthesia uye Pain Medicine. , 39 (1), mapeji 6-12. http://www.ncbi.nlm.nih.gov/pubmed/24310049