Yiziphi izinketho zakho zokuphatha ubuhlungu obungapheli?

Imfundo Yezempilo

Ubuhlungu obungapheli buchazwa njenganoma yibuphi ubuhlungu obudonsa izinyanga ezintathu kuya kweziyisithupha noma ngaphezulu. Imvamisa, kungumphumela oqondile wesimo sezempilo esiyisisekelo njenge ukulimala okwedlule, izinkinga zangemuva, ukulimala kwemizwa, noma i-fibromyalgia . Izibalo zikhomba lokho oyedwa kwabahlanu abadala e-U.S. bahlala nobuhlungu obungapheli. Ngasikhathi sinye, imibiko ikhombisa ukuthi kunjalo ukuphathwa kabi ngokwandayo . Ukuphathwa kobuhlungu obungapheli ezigulini ezinezimo eziningi kungaba yinkimbinkimbi. Kuqala ngokuthola imbangela.

Izinhlobo zobuhlungu obungapheli

Ubuhlungu obungapheli ngokuvamile buwela ezinhlotsheni ezintathu eziyisisekelo zokuhlukaniswa:

• Ubuhlungu be-nociceptive imele impendulo ejwayelekile ekuthukweni noma ekulimaleni kwezicubu ezinjengesikhumba, imisipha, izitho ze-visceral, amalunga, imisipha, noma amathambo. Isibonelo sobuhlungu be-nociceptive yi-arthritis.
• Ubuhlungu be-Neuropathic kwaziwa ngenye indlela ngokuthi ubuhlungu bezinzwa. Luhlobo lobuhlungu obungapheli obenzeka lapho izinzwa ezisesimweni esiyinhloko sezinzwa zilimala noma zilimele. Ubuhlungu bokulimala kwentambo yomgogodla, isitho se-phantom (post-amputation), kanye ne-post-stroke pain central or shingles ngezinye zezibonelo zobuhlungu be-neuropathic.
• Ubuhlungu bokuvuvukala kungumphumela wokusebenza nokuzwela kwendlela yobuhlungu be-nociceptive ngabaxazululi abahlukahlukene abakhishwe endaweni yokuvuvukala kwezicubu. Izibonelo zobuhlungu obubangelwa ukuvuvukala zihlanganisa i-appendicitis, isifo samathambo, isifo sokuvuvukala kwamathumbu, ne-herpes zoster.

Kunezinhlobo ezithile zobuhlungu obungapheli — njenge-fibromyalgia kanye nekhanda lokungezwani - ezingakwazi ukuhlukaniswa kalula, futhi ziwele ngaphandle kwalezi zinhlobo eziyinhloko. Lezi zigaba zibalulekile ngoba uhlobo lobuhlungu ludlala indima enkulu ekutheni yiziphi izindlela zokwelashwa okungapheli ezizosebenza kakhulu.

OKUSHIWO: Ukwelashwa kwama-shingles nemithi

Imithi ejwayelekile yokuphumula kobuhlungu obungapheli

Kunemithi eminingi evame ukubekelwa abantu abanezinhlungu ezingapheli, kufaka phakathi:

• Izidakamizwa ezingezona ukuvuvukala kanye ne-acetaminophen: Kunezinhlobo eziningi zemithi yokulwa nokuvuvukala (ama-NSAID). Ezinye zazo (njenge ibuprofen ) ingatholwa ngaphezu kwe-counter. Abanye, njengeMobic ( meloxicam ), ayatholakala ngemithi kadokotela.
• Imithi yobuhlungu yezihloko : Okhilimu bokwenza izihloko abangaphezu kwamanani bangakunikeza usizo. Noma, iziqeshana ze-lidocaine zemithi ukufakwa kule ndawo (amahora angu-12 noma amahora angu-12 kungasebenzi) kungadambisa izinhlungu.
• Izidakamizwa zokucindezeleka: Ezinye zezigaba ezindala zemithi elwa nokudangala zingasiza kakhulu ekulawuleni ubuhlungu; ikakhulukazi ama-tricyclic antidepressants. Le mithi ingadambisa ubuhlungu emazingeni aphansi kunamanani adingekayo ekwelapheni ukucindezeleka.
• Ama-anticonvulsants (anti-seizure) imithi: Le mithi ingasiza kakhulu kwezinye izinhlobo zobuhlungu bohlobo lwe-nerve (njengokushisa, ubuhlungu bokudubula).
• Ukuphumula kwemisipha : Le mithi isetshenziswa kakhulu kusimo esibuhlungu semisipha.
• Izinzwa zivimbela: Lokhu kufaka ukujova esikhaleni se-epidural yekholomu yomgogodla futhi kunikeze ukuphathwa kobuhlungu besikhathi eside, ikakhulukazi kulabo abanezimo ezingapheli zomqolo. Kunezinhlobo eziningana zamabhulokhi ezinzwa alawulwa esibhedlela, futhi ancike endaweni yomzimba elashwa. Imvamisa, bajojelwa esifundeni somgogodla.
• Umjovo wephuzu le-Trigger: Olunye uhlobo lwezinqubo zokuphathwa kobuhlungu lubizwa ngokuthi yi-trigger point injection (TPI). Lo ngumjovo oqukethe i-corticosteroid kanye / noma i-anesthetic, futhi ujojowe ngqo endaweni edala ubuhlungu.
• Ama-opioid: Uma isetshenziswe ngokufanele, uma imithi engeyona i-opioid ingasebenzi noma ingavunyelwe, ama-opioid angasebenza kakhulu ekulawuleni izinhlobo ezithile zobuhlungu obungapheli. Zivame ukungasebenzi kahle noma zidinge imithamo ephakeme ebuhlungwini bohlobo lwe-nerve. Ngobuhlungu obukhona imini nobusuku bonke, i-opioid esebenza isikhathi eside ivame ukunconywa, futhi ingangezelelwa nge-opioid emfushane esebenza ngobuhlungu bokuqhuma. Isazi sokulawulwa kobuhlungu singahlola isidingo sama-opioid.

OKUSHIWO: Yini okungcono kakhulu ekudambiseni ubuhlungu?

Lapho ubuhlungu bukhulu, iziguli zingakhetha ukuphendukela kuma-opioid ukuze zithole usizo. Kodwa-ke, odokotela kuye kwadingeka bahambisane namazinga amasha kadokotela abekwe yi-U.S. Food and Drug Administration (kanye nezinqubomgomo zombuso ngazinye kanye namakhemisi) kusuka ekusebenziseni ngokweqile ama-opioid. Inani lokufa okuhlobene ne-opioid lenyuke kakhulu kule minyaka embalwa edlule, okushiye odokotela neziguli abathola ubuhlungu obungapheli befuna izindlela zokwelapha amazinga aphansi kuya kokulinganisela obuhlungu obungapheli.

Ukuphumula kobuhlungu obungapheli bemvelo

Ukuphathwa kobuhlungu besikhathi eside okungapheli, izindlela ezingezona ze-opioid ziyakhethwa, njenge:

• Ukwelashwa okuhlukile: Izindlela zokwelashwa ezingezona ezokwelapha ezinconyiwe zifaka phakathi i-acupuncture, i-biofeedback, ukwelashwa kokuziphatha kwengqondo, ukubhucungwa, nokusetshenziswa kwamayunithi we-TENS angaphandle. Imibiko ikhombisa ukuthi lezi zindlela zokuphathwa kobuhlungu ezihambisana ne-psychotherapy zisebenza kahle kakhulu.
• Ukuzivocavoca umzimba: Ukuzivocavoca okulula, njenge-yoga, kungasiza ngezinhlobo ezithile zobuhlungu obungapheli ngokuthuthukisa ukusabalalisa nokunciphisa ukucindezeleka. Kusebenza ikakhulukazi kwi-arthritis nobuhlungu emuva.
• Ukushisa nokubanda : Amapayipi okushisa neqhwa kungasetshenziswa kaningi ngemiphumela emibi kakhulu ukusiza ukuphatha izinhlobo eziningi zobuhlungu obungapheli.
• Ukugqugquzela intambo yomgogodla: SCS ukwelashwa okufihla izimpawu zobuhlungu ngaphambi kokuba kufinyelele ebuchosheni — le nto encane ifakwe emzimbeni ukuze idlulisele amasiginali emgogodleni. Kungaba inketho yobuhlungu obungapheli emhlane, emlenzeni, noma engalweni.

OKUSHIWO: Ukwelashwa kwe-arthritis nemithi

Izinketho zokwelashwa kobuhlungu ezingapheli ezivelayo

Ngenxa yamandla okulutha kwe-opioid, abacwaningi baqhubeka nokufuna ezinye izindlela ezisebenzayo ezivimba imizwa yobuhlungu kunokuba ziyifihle.

Ukukhuthaza okuqondile kwamanje kweTranscranial, noma Ama-TDCS , ibilokhu ithola ukubambeka njengendlela engasebenza engeyona eyemithi yokwelashwa kobuhlungu obungapheli. Isivivinyo somtholampilo sikhombise ukuthuthuka okuphawulekayo ebuhlungwini obuhambisana ne-osteoarthritis yamadolo.

Ucwaningo luye lwagxila nasezimbangela ezizimele zobuhlungu obungapheli. Ukutheleleka noma ukulimala kungabangela impendulo yokuzimela lokho kuvame ukungabonakali, futhi kungaholela ebuhlungu obukhulu. Amaphaneli we-antibody angaba ukwelashwa okusha kobuhlungu obungapheli futhi ucwaningo kufanele ivule izinketho ezintsha ezijabulisayo.

Izindlela zokwelashwa ze-SPR wanikezwa inkontileka engu- $ 6 million okuvela eMnyangweni Wezokuvikela wase-U.S. ocwaningweni lokwelashwa okungelona okwe-opioid therapy. Kuzosiza ukuqhubekisela phambili uhlelo lwe-SPRINT Peripheral Nerve Stimulation System futhi kusize ukwenza izivivinyo zomtholampilo ezithuthukisiwe kulabo abaphila ubuhlungu be-neuropathic . Yenzelwe ukwenza kusebenze imicu yezinzwa eqondisiwe futhi ihambise ukukhululeka kobuhlungu ngaphandle kwama-opioid.

Izinsiza zokuphathwa kobuhlungu obungapheli

I-American Chronic Pain Association inikeza ulwazi oluyigugu kulabo abanobuhlungu obungapheli. Labo abelashwa manje bangahlola ezinye izinketho nemithi, kepha ngaso sonke isikhathi kungcono ukuxhumana nodokotela wakho kanye nosokhemisi kuqala.

Kulabo abathole izinhlungu zithathe impilo yabo ngokomzwelo, t yena I-U.S. Pain Foundation inikeza uhlu lwemikhankaso yokuqwashisa namaqembu okusekela online.