Nhoroondo yePathophysiology yeNeuropathic Pain

Uturu hweNeuropathic ihwo hwakaoma, hunogara husingaperi huripo hunoenda pamwe nekurwara kwemavara. Kutambudzika kweurouropathi kunowanikwa muchechi yekliniki uye kunowedzera zvinetso kuvarwere uye navanachiremba zvakafanana. Nemarwadzo europathy, hutachiona hwehutano pachahwo hungave hunove hwakakuvadzwa, husingaiti kana hukuvara. Utano hweNeuropathic hunokonzera kukanganisa kubva mumatambudziko kana zvirwere kusvika kune imwe nzvimbo kana pakati penheyo system, apo chironda chinogona kuitika pane chero nzvimbo. Somugumisiro, izvi zvinokanganisa tsinga dzesimbi zvinogona kutumira zviratidzo zvisina kunaka kune dzimwe nzvimbo dzinorwadza. Izvozvo zvinoshandiswa nehutachiona hwekukuvara zvinoshandiswa nechinoshandiswa neural nechokuita, zvose munharaunda yekukuvadzwa uyewo kune chakakomberedza kukuvara. Zviratidzo zvehutano hwepurovhesi zvinowanzobatanidza manzwiro evanhu, zvakadai sekurwadziwa kwepakati, paresthesias uye hyperalgesia.

 

Hurukuro yeurouropathi, sezvinotsanangurwa neInternational Association of the Study of Pain kana IASP, kurwadziwa kwakatangwa kana kunokonzerwa nechirwere chepakutanga kana kusagadzikana kwemamiriro emagetsi. Izvozvo zvinogona kuguma nekukuvara kupi zvako kune neuraxis: purogiramu yenheyo yenheyo, musipinha kana supraspinal nervous system. Tsika dzinosiyanisa marwadzo europathika kubva kune mamwe marudzi ekurwadziwa dzinosanganisira kurwadziwa uye zviratidzo zvinotarirwa zvinogara zvisingaperi nguva yekudzoka. Inoratidzwa nevanhu kuburikidza nekurwadziwa kwepachivande, allodynia, kana ruzivo rwekusava nekutya kunotyisa sezvinorwadza, uye causalgia, kana kurwadziwa kunopisa kunopfuurira. Kurwadziwa kwepanyama kunosanganisira kunzwa kwe "pini uye nheyo", kupisa, kupfura, kupwanya uye kupisa kwepodysysmal, kana kushamiswa kwemagetsi sekurwadziwa, kazhinji kunobatanidza nedysesthesias uye paresthesias. Izvi zvinonzwa kwete kungogadzirisa mafungiro evarwere, asiwo murwere, hutano, kufunga uye kufunga. Hurwa neuropathic inoumba zviratidzo zviviri "zvisina kunaka," zvakadai sokurasikirwa kwekunzwa uye kuonekwa kwekunzwa, uye "zviratidzo" zvakadai, paresthesias, kurwadziwa kwepfungwa uye kuwedzera kurwadziwa.

 

Mamiriro ezvinhu anowanzoenderana nemarwadzo europathic anogona kuiswa mumapoka maviri makuru: kurwadziwa kunokonzerwa nekuparara mukati mehutano hwehutano nekurwadziwa nekuda kwekuvhiringidzwa kwehutachiona hwehutachiona hwehutano. Cortical and sub-cortical strokes, zvinoshungurudza ruvara rwemutsara, syringo-meria uye syringobulbia, trigeminal uye glossopharyngeal neuralgias, neoplastic nedzimwe nzvimbo dzinoshandiswa-zvipembenene zvipatara zvinenge zviri zveboka rekare. Nhere compress or entrapment neuropathies, ischemic neuropathy, puroopheral polyneuropathies, plexopathies, nerve root compression, post-amputation stump uye kurwadziwa kwomuviri kwepfungwa, neuralgia yepamusoro uye neuropathies zvine chokuita nekenza ndeyezvipatara zvinenge zviri zveboka rekupedzisira.

 

Pathophysiology yeNeuropathic Pain

 

Iyo pathophysiologic maitiro uye pfungwa dzinotangira marwadzo europathika akawanda. Usati wavhara matanho aya, kubvunzurudzwa kwezvakawanda zvinorwadza kutenderera kunokosha. Kurwisana kunogara kwenguva dzose kunosanganisira kushandiswa kwekwenciceptor, iyo inozivikanwawo seyakagamuchira kurwadziwa, mukupikisa kukurudzira kunorwadza. Chimwe chemafuridziro chinopiwa kune-first-order neurons, pamwe chete neyamudium inomhanya nenzira dzeyerodium uye potasium ichimhanya kunze. Neurons inopera muuropi inowanikwa mumusara wetatu kana kuti mune runyanga rwenzira yepelinha. Iko pano apo chiratidzo chinotanga magetsi-gated calcium chiteshi mu-pre-synaptic terminal, zvichiita kuti calcium inopinda. Calcium inobvumira glutamate, neurotransmitter yekunakidza, kuti ibudiswe muS synaptic. Glutamate inosunga kune avo vanopinda NMDA pamusana wechipiri-neurons, zvichikonzera kuora mwoyo.

 

Aya neuroni anoyambuka nomumutsipa wepelinha uye anofamba kusvikira thalamus, uko vanobatanidza pamwe ne-third-order neurons. Izvi zvinobatanidza kune chimbichikiti uye cerebral cortex. Ikoko kunewo nzira inodzivisa iyo inodzivisa kurwadziwa kwechiratidzo chekuparidzira kubva kune runyanga rwenheyo. Anti-nociceptive neurons inotangira muuropi dzinokonzera uye inofamba pasi musambo weropa remusana apo inopindirana nemapfupi ekutsvaga mukati meganda rekudzivirira nekubudisa dopamine uye norepinephrine. Iro interneurons inogadzirisa synapse pakati pekutanga-order neuron uye yechipiri-kuronga neuron nokubudisa gamma amino butyric acid, kana GABA, inonzi neurotransmitter inhibitory. Somugumisiro, kurwadziwa kupera kunokonzerwa nekudziviswa kwemasapapapakati pakati pekutanga neyechipiri neurons, apo kuwedzera kunorwa kunogona kuva mugumisiro wekudziviswa kwechibvumirano chechibvumirano.

 

 

Izvo zvinokonzera marwadzo europathic, zvisinei, hazvisi zvakajeka. Zvidzidzo zvezvipfuwo zvakasiyana siyana zvakaratidza kuti nzira dzakawanda dzingave dzakabatanidzwa. Zvisinei, mumwe anofanirwa kuyeuka kuti izvo zvinoshandiswa kune zvisikwa zvingasawanzoshanda kuvanhu. Kutanga neurons yekutanga kunogona kuwedzera kupisa kwavo kana vakanganisa zvishoma uye kuwedzera huwandu hwemigero ye sodium. Ectopic discharges inokonzerwa nekudengenyeka kwepamusoro kune dzimwe nzvimbo panzvimbo ye fiber, zvichikonzera kurwadziwa kwepfungwa uye kushungurudza-kwakabatana. Zvirwere zvekudzivirira zvinogona kuderedzwa mumwero weguruva runyanga kana uropi hunokonzera masero, uyewo zvose zviri zviviri, zvichibvumira zvinetso zvekurwa kuti zvifambe zvisina kukanganiswa.

 

Mukuwedzera, panogona kuve nekuchinjwa mukati mekugadzirisa marwadzo apo, nekuda kwekutambudzika kusingaperi uye kushandiswa kweimwe mishonga uye / kana mishonga, yechipiri-uye chechitatu-order neurons inogona kuve "nekuyeuka" kwekutambudzika uye kunzwisiswa. Iko zvino kunzwisisika kunzwisisika kwepinini neuroni uye kuderedzwa kushandiswa kwemiromo. Imwe nyanzvi inoratidzira pfungwa yekunzwira tsitsi-yakachengetwa neuropathic kurwadziwa. Iyi pfungwa yakaratidzwa neanalgesia inotevera sympathectomy kubva kumhuka nevanhu. Zvisinei, kusanganiswa kwema mechanics kunogona kusanganiswa mune dzakawanda zvisingaverengeki neuropathic kana zvakasanganiswa somatic uye mamiriro ekurwadziwa kweuropathy. Pakati pezvinetso mumunda unorwadziwa, uye zvakanyanya zvakanyanya sekureva kurwadziwa kweuropa, ndiko kukwanisa kuzviongorora. Pano pane chikamu chechipiri kune izvi: kutanga, kuongorora unhu, kuwedzera uye kufambira mberi; uye wechipiri, kunyatsoongorora chirwere cheuropathy.

 

Kune, zvisinei, zvimwe zvishandiso zvinoshandiswa zvinogona kubatsira vhigirizheni mukuongorora kuora kweuropathi. Kutanga, zvidzidzo zvehutano hwehutano uye zvinogona kuonekwa-zvinokanganisa zvinogona kuziva uye kuenzanisa kuwanda kwekuvhiringidzika kwemazwi, asi kwete maitiro, maitiro nekutarisa neurophysiological mhinduro kumagetsi emagetsi. Uyezve, kuwanda kwezvinhu zvinongororwa kuongororwa matanho ekuona kusangana kune zvinowedzera kunze kwekutsvaga kwakasimba kuburikidza nekushandura kweganda. Inyanzvi yehutachiona yehutachiona hunogadziriswa inotaridzwa nemashandisirwo akadai, anosanganisira von Frey vhudzi, pinprick ine nheyo dzinopindira, pamwe nekuderera kwekudzivirira pamwe chete nema vibrameter uye kupisa kwemafuta ne thermodes.

 

Zvinonyanya kukosha kuti uite zvakananga neurological assessment kuti uone motokari, manzwiro uye kuvhiringidzika. Pakupedzisira, kune mibvunzo yakawanda inoshandiswa kusiyanisa marwadzo europathik mukurwadziwa kwema nociceptive. Zvimwe zvacho zvinosanganisira mibvunzo yekubvunzurudza (semuenzaniso, Mibvunzo yeNeuropathic uye ID Pain), asi vamwe vane mibvunzo yekubvunzurudza uye miedzo yenyama (semuenzaniso, Leeds Assessment ye Neuropathic Symptoms and Signs scale) uye iyo chaiyo inozive chinhu, Kuongororwa Kwemaitiro Pain, iyo inobatanidza mibvunzo mitanhatu yekukurukurirana uye gumi yekuongorora kwepanyama.

 

 

Kurapa Kuenzanisa Neuropathic Pain

 

Dzidzo yepamusoro yepamusoro inotarirwa nenzira dzehutano hwepfungwa. Zvisinei, zvose pharmacologic uye kwete-pharmacologic mishonga inopa ruregerero rwakakwana kana rusununguko anenge anenge hafu yevarwere. Uzhinji hunopupurirwa hunopupurirwa hunoti hunoshandisa kusanganiswa kwezvinodhaka uye / kana mishonga yekushandira nzira dzakawanda sezvingagona. Ruzhinji rwekutsvakurudza rwakatsvakurudza kunyanya post-herpetic neuralgia uye kurwadza kwechirwere cheshuga neuropathies asi zvinoguma zvisingashandisi kune zvose zvinorwadza neuropathic.

 

Antidepressants

 

Zvinodhaka zvinokonzera synaptic serotonin uye norepinephrine mazinga, zvichiita kuti iwedzere kuguma kwechirwere chechirwere chinokonzera marwadzo europathic. Vanga vari iyo inonyanya kukosha yehutano hwehutano hwehutano. Maitiro anonzi Analgesic angangodaro anokonzerwa ne-nor-adrenaline uye dopamine reuptake blockade, iyo inogona kunge ichiwedzera kukura kwekudzivirira, NMDA-receptor kupikisana uye sodium-channel blockade. Tricyclic vanodzvinyirira, zvakadai seTCAs; somuenzaniso, amitriptyline, imipramine, nortriptyline uye doxepine, vane simba pakurwisana nekuputika kana kurwadziwa kunopisa pamwe nekurwadziwa kwepfungwa.

 

Tricyclic zvinodzvinyirira zvakave zvichiratidzwa zvakajeka zvakanyanya pakurwadziwa kweuropathic kupfuura serotonin reuptake inhibitors, kana SSRIs, zvakadai se fluoxetine, paroxetine, sertraline uye citalopram. Chikonzero chinogona kunge chiri chokuti vanovhara reuptake ye serotonin uye nor-epinephrine, nepo SSRI inongorambidza serotonin reuptake. Tricyclic vanodzvinyirira vanogona kuva nemigumisiro yakaipa, kusanganisira kushungurudza, kuvhiringidzika, kutengesa mwoyo mukati, tachycardia uye ventricular arrhythmias. Zvinogonawo kuita kuti uwedzere uremu, chidimbu chinoputika chikumbaridzo uye hutachiona hwehutano. Tricyclics inofanira kushandiswa nekutarisira kune vakwegura, avo vari kunyanya kunetseka pamigumisiro yavo yakaoma. Mushonga wezvinodhaka muropa unofanira kuongororwa kuti urege kutyisa kune varwere vanononoka mishonga metabolizers.

 

Serotonin-norepinephrine reuptake inhibitors, kana SNRIs, iboka idzva revanodzvinyirira. Kufanana neTCAs, vanoita sevanoshanda kupfuura SSRIs pakurapa marwadzo europathic nokuti vanodzivisa zvakare reuptake yezvose kana-epinephrine uye dopamine. Venlafaxine inoshanda zvakasimba pakurwisana nehutachiona hwepuroneuropathies, dzakadai sekurwadziwa kwechirwere cheshuga yeuropathy, semipramine, mukutaura kweTCA, uye iyo mbiri inokosha zvikuru kupfuura placebo. Kufanana neTCAs, SNRIs inoratidzika kuti inopa rubatsiro rusununguko rwemagariro avo anodzvinyirira. Zvimwe zvinokonzera zvinosanganisira sedation, kuvhiringidzika, kuwedzera kwehutano uye kuregera chirwere.

 

Antiepileptic Zvinodhaka

 

Antiepileptic zvinodhaka zvinogona kushandiswa sekurapa kwekutanga-kunyanya kune mamwe marudzi ekurwadziwa kweuropathy. Vanoita nekugadzirisa magetsi-gated calcium uye michina ye sodium, kuburikidza nekuvandudza migumisiro yekudzivirira yeGABA uye nekudzivisa kupindira kwekutengesa glutaminergic. Anti-epileptic mishonga haina kuratidzirwa kuti inoshanda mukurwadziwa kwakanyanya. Mumakumbo asingagumi, antiepileptic zvinoratidzika seinobudirira chete muzvitatu zveeuralgia. Carbamazepine inowanzoshandiswa pane izvi. Gabapentin, iyo inoshanda nekudzivisa calcium channel inoshanda kuburikidza nezviito zveagonist pa alpha-2 delta subunit ye ​​calcium channel, inozivikanwawo kuti inobudirira pakurwadziwa kweuropathi. Zvisinei, gabapentin inoshanda mukati uye inogona kukonzera kuneta, kuvhiringidzika uye kunyarara.

 

Kwete-Opioid Analgesics

 

Pane kushaikwa kwemashoko akasimba anotsigira kushandiswa kwemishonga isina-steroidal anti inflammatory, kana kuti NSAIDs, mukuzorora kwekutambudzika kweuropati. Izvi zvingave zvakakonzerwa nokushayikwa kwechirwere chekuvhiringidza pakuderedza marwadzo. Asi zvakashandiswa zvakasiyana-siyana neapioid sevanokurudzira mukurapa kurwadziwa kwekenza. Izvo zvakambove zvichirondedzerwa, kunyange zvakadaro, kunyanya mune zvakanyanya kuora mwoyo varwere.

 

Opioid Analgesics

 

Opioid analgesics ndeyekukakavadzana kukuru mukuderedza marwadzo europathic. Vanoita kuburikidza nekudzivisa hukuru hukwira hunova nemarwadzo ekurwadza. Nenzira, marwadzo europathic akamboonekwa kuti ane opioid-resistant, umo maopioid ndiyo yakakodzera nzira dzekodonary uye somatic nociceptive marwadzo emarudzi. Vanachiremba vazhinji vanodzivisa kushandisa maopioid kurapa marwadzo europathic, muchikamu chikuru nekuda kwekunetseka pamusoro pekushandisa zvinodhaka, kukanganisa uye nyaya dzekutonga. Asi, pane mimwe miedzo yakawana maangeso opioid kuti abudirire. Oxycodone yaive yakakwirira pane placebo yekudzivirira marwadzo, allodynia, kuvandudza kurara nekuremara. Opioids inodzorwa-yakasunungurwa, maererano nehurongwa hwakarongerwa, inorumbidzwa kune varwere vane marwadzo anogara achikurudzira kuti varambe vachiwedzera maitiro ealgesia, kudzivirira kuchinja kwehutachipa reropa uye kudzivirira zviitiko zvakashata zvine chokuita nepamusoro dosing. Kazhinji kazhinji, kugadzirira muromo kunoshandiswa nekuda kwekusununguka kwavo kwekushandisa nekudhura-kubudirira. Kutenda-dermal, parenteral uye kugadziridza kwemashure kunowanzoshandiswa kune varwere vasingagoni kubvumira zvinodhaka zvemuromo.

 

Local Anesthetics

 

Pedyo nekuita anesthetics inofadza nokuti, nekuda kwekuita kwavo kwemuganhu, vane minda yakaipa. Vanoita nekugadzirisa miviri ye sodium pamakwikoni emakona ekutanga-neurons. Vanoshanda zvakanakisisa kana paine kungoerekana kusarura musungo uye kupfurikidza nemigero ye sodium yakaunganidzwa. Nyaya dzepamusoro lidocaine ndiye mumiririri anonyatsodzidza wedzidzo yekutambudzika kweuropati. Kunyanya, kushandiswa kweiyi 5 yeputi lidocaine patch ye-post-herpetic neuralgia yakakonzera kugamuchirwa naRFA. Chigamba chinoratidzika sechishanda zvakanaka kana chichikuvadzwa, asi chakachengetedzwa, purogiramu yenherera system nociceptor basa kubva kune iyo inobatanidza dermatome inoratidza sa allodynia. Inofanirwa kuiswa zvakananga munzvimbo ine chiratidzo chemaawa e12 uye yakabviswa kune imwe nguva yama12 uye inogona kushandiswa kwemakore nenzira iyi. Kunze kwekuita kweganda remukati, zvinowanzomirirwa zvakanaka nevarwere vakawanda vane marwadzo europathic.

 

Zvimwe zvinodhaka Zvinodhaka

 

Clonidine, an alpha-2-agonist, yakaratidzwa kuti inoshanda mune imwe sarudzo yevarwere vane chirwere cheshuga chinoputika neuropathy. Zvinyorwa zvinogona kuwanika kuti zvinobatsira pakuedza kuenzanisa marwadzo emhuka mumhando yezvipfuwo uye uchapupu hwehubudirira huri kuunganidza. CB2-selective agonists inoparadza hyperalgesia uye allodynia uye kuisa pasi maitiro ekudzivirira pasina kukanganisa marwadzo.

 

Interventional Pain Management

 

Mishonga inogadziriswa inogona kuonekwa kune varwere vane chirwere chisingaiti chinonzi neuropathic. Izvi zvinosanganisira zvipembenene zvepidural kana pineinural yeanesthetics yepanyika kana corticosteroids, kuiswa kwepidural uye intrathecal zvinoshandiswa pakushandisa zvinodhaka uye kuiswa kwemutsipa wepelinha stimulators. Iyi nzira yakachengeterwa varwere vane marwadzo asingagoneki neuropathic avo vasina kukanganisa kurapwa kwekuchengetedzwa kwezvokurapa uyewo vakave nekuongororwa kwakakwana kwepfungwa. Mune chidzidzo chaKim et al, zvakaratidzwa kuti muspinha tsvimbo stimulator yakashanda mukurapa marwadzo europathic emutsipa midzi.

 

Dr. Alex Jimenez's Insight

Nemarwadzo europathic, zvirwere zvisingaperi zvinosuruvara zvinoitika nekuda kwehutachiona hwehutano pachahwo huri kukuvadzwa, husina basa kana kuti hukuvara, kazhinji hunoendeswa nekukuvadza kwemavara kana kukuvara. Somugumisiro, izvi zvinokonzera mutsara zvinogona kutanga kutumira zviratidzo zvisina kunaka kune dzimwe nzvimbo dzomuviri. Migumisiro yemarwadzo europathy anokonzerwa nekukuvara kwehutachiona inosanganisira kugadziriswa kwehutano hunoshanda panzvimbo yekukuvadzwa uye munzvimbo dzakapoteredza kukuvara. Kunzwisisa pathophysiology yekutambura kwepfungwa kwave kuri chinangwa chevashandi vazhinji vehutano, kuitira kuti vaone zvakajeka nzira yekurapa kubatsira kubatsira nekugadzirisa zviratidzo zvayo. Kubva kushandiswa kwezvinodhaka uye / kana mishonga, kuchipatractic kuchengetedza, kurovedza muviri, kuita zvekuita uye kudya kunovaka muviri, nzira dzakasiyana-siyana dzokurapa dzinogona kushandiswa kubatsira kubvisa marwadzo europathic kune zvinodiwa nomunhu mumwe nomumwe.

 

Zvimwe Zvinyorwa Zvitsva Neuropathic Pain

 

Vakawanda vevarwere vane marwadzo europathic vanotevera kuwedzera pamwe uye mamwe maitiro ekurapa maitiro ekurapa marwadzo europathic. Zvimwe zvirongwa zvinoshandiswa pakurapa marwadzo europathic zvinosanganisira kugadziriswa, kushandiswa kwemagetsi emagetsi ekusimudzira, kutengesa magetsi emagetsi ekusimudzira, kufungidzira kwekuita maitiro, kurapa motokari yemifananidzo uye kutsigira kurapa, uye kurovedza muviri. Pakati pavo, chiropractic ndeye nzira inozivikanwa yekurapa inowanzoshandiswa kubatsira kubata marwadzo europathic. Chiropractic kuchengetedza, pamwe nekurapa kwepanyama, kurovedza muviri, kudya kunovaka muviri uye kugadzirisa mararamiro eupenyu kunogona kupedzisira kunopa rubatsiro rwezviratidzo zvekurwadziwa kweuropathic.

 

Chiropractic Care

 

Izvo zvinozivikanwa ndezvokuti kushandiswa kwakakwana kwekushanda kunokosha mukurwisana nemigumisiro yekutambudzika kwepfungwa. Nenzira iyi, chiropractic kutarisira chirongwa chakakwana chekurapa chinogona kubudirira mukudzivirira nyaya dzehutano dzakabatana nehutano hwehutano. Chiropractic inopa rubatsiro kuvarwere vane mamiriro mazhinji akasiyana, kusanganisira avo vane marwadzo europathic. Vanorwara nehutano hweuropathy vanowanzoshandisa mishonga isina-steroidal-anti-inflammatory, kana kuti NSAIDs, dzakadai se ibuprofen, kana kuti nzara inorayirirwa pazvinillers kuti vabatsire kunetsa marwadzo europathic. Izvi zvinogona kupa chirongwa chenguva pfupi asi chinoda kushandiswa nguva dzose kugadzirisa marwadzo. Izvi zvinogara zvichiita kuti zvive nemigumisiro yakaipa uye mumamiriro ezvinhu akaipisisa, kushandiswa kwechirongwa chekushandisa zvinodhaka.

 

Chiropractic kuchengetedza inogona kubatsira kuvandudza zviratidzo zvehutano hwepfungwa uye kusimbisa kugadzikana kunze kwezvikonzero izvi. Imwe nzira yakadai sechiropractic inotarisira inopa purogiramu yakasiyana-siyana yakagadzirirwa kuti ione kuti chii chinokonzera nyaya yacho. Nokushandiswa kwemagunha uye magwaro, chiropractor inogona kunyatsogadzirisa chero upi noupi hwepelinha, kana kuti kuwedzerwa, kunowanikwa pamwe nehupamhi hwepamusoro, iyo inogona kuderedza migumisiro yeropa wracking kuburikidza ne realigning yemasana. Kudzorera kutenderera kwepelinha kunokosha kuti uchengetedze hurongwa hwepamusoro hwehutano hwemagetsi.

 

A chiropractor anogonawo kuva kwenguva yakareba kurapwa pakunatsiridza hupenyu hwako hwose. Kunze kwekugadziriswa kwemusana uye nzira dzekushandisa, chiropractor inogona kupa mazano ekudya, zvakadai sokurondedzera kudya kwakachengetedzeka mune antioxidants, kana kuti inogona kugadzira chirwere chepanyama kana chirongwa chekurovedza muviri kurwisa kurwadziwa kwemitsipa flair-ups. Chirwere chemazuva mazhinji chinoda chirongwa chemazuva mazhinji, uye mune izvi, mudzidzisi wehutano anonyanya kuisa mukukuvara uye / kana mamiriro ezvinhu anokonzera musishungurudzo uye manzwiro emagetsi, akadai sachiremba wechiropractic kana chiropractor, angave anokosha sezvaanoshanda kuti kuenzanise kuchinja kunofadza kwenguva.

 

Kurapa kwepanyama, maitiro uye mafambiro ekumiririra maitiro ave akaratidzwa kuti anobatsira kurapa kurwadziwa kweukama. Chiropractic kuchengetedza inopawo mamwe maitiro ekurapa angangobatsira kune vatungamiri kana kuvandudza marwadzo europathic. Low level laser therapy, kana LLLT, somuenzaniso, yakave yakakurumbira sekurapa kwekutambudzika kweuropathi. Maererano nekutsvakurudza kwakasiyana-siyana, zvakagadziriswa kuti LLLT yakava nemigumisiro yekudzora marwadzo ekurwadziwa kweuropathic, zvisinei, zvidzidzo zvekare zvinowanzotarisirwa kurondedzera zvirongwa zvekurapa zvinopfupikisa migumisiro yepamusoro yezinga laser therapy muhutano hwehutano hwehutano.

 

Chiropractic kuchengetedzawo inosanganisira mazano ekudya, izvo zvinogona kubatsira kudzora zvirwere zvinokonzerwa nechirwere cheshuga neuropathy. Munguva yekutsvakurudza kwekutsvakurudza, kudya kwakaderera kwemafuta kunokonzerwa nekudyara kwakaratidzwa kuvandudza glycemic control muvarwere vane chirwere chechirwere cheshuga 2. Mushure memavhiki e20 echidzidzo chekutsvaga, avo vaibatanidzwa vakazivisa kuchinja muhutano hwavo hwemagetsi uye electrochemical skin conductance mutsoka yakanzi yakagadziridzwa nekupindira. Tsvakurudzo yakatsvakurudza yakaratidza kuti inogona kukosha mune zvakaderera-miti inogadziriswa mishonga yekupindira kwechirwere cheshuga neuropathy. Uyezve, zvidzidzo zvekuchirapa zvakawana kuti kunyora kushandiswa kwe magnesium L-threonate kunogona kudzivirira pamwe nekudzorera kukanganwa kwepfungwa kunobatanidza nehupenzi hwepfungwa.

 

Chiropractic kuchengetedza inogona kupawo mamwe maitiro ekurapa ekukurudzira kushandiswa kwemishonga. Nenzira imwecheteyo, kukurudzira kushandiswa kwemasikoni kwakarongedzwa kubatsira kubatsira kuvandudza kushandiswa kwehutano mushure mekurwa kwehutano hwemagetsi. Kukurudzira magetsi, pamwe chete nekurovedza muviri kana mabasa epanyama, zvakawanikwa kukurudzira kushandiswa kwemishu mushure mekurumidza kunonoka kugadziriswa kwevanhu nemakonzo, maererano neongororo dzechangobva kuitwa. Zvose zvekugadzirisa magetsi uye yekurovedza muviri zvakagadziriswa kuva nekupikira kurapa kwekuedza kweropa rekushaya mungozi rinoratidzika kugadzirira kuendeswa kuchipatara. Zvimwe zvidzidzo zvekutsvaga zvinogona kudiwa kuti zvigadzirise zvakakwana mhinduro dzeizvi kune varwere vane marwadzo europathic.

 

mhedziso

 

Kurwadziwa kweNeuropathic chinhu chakasiyana-siyana chisina mirau yekutarisira. Izvo zvakanaka zvinogoneswa uchishandisa nzira dzakasiyana siyana. Kurapa manejimendi kunoda kuenderera kwekuongorora, dzidzo yemurwere, kuverengera kuteedzera kwevarwere uye kuvimbiswa. Kurwadziwa kweNeuropathic chiitiko chisingaperi chinoita kuti sarudzo yekurapa kwakanyanya kuome. Kuzvimiririra kurapwa kunosanganisira kufunga nezve maratidziro ekurwadziwa pahupenyu hwemunhu, kushushikana uye hurema pamwe nekuenderera mberi nedzidzo uye kuongorora. Neuropathic marwadzo ekudzidza, ese ari maviri mamorekuru uye mumhando dzemhuka, iri nyowani asi inovimbisa zvikuru. Kugadziridza kwakawanda kunotarisirwa mune yekutanga uye yekiriniki minda yekurwadziwa kweuropathic nekudaro kuvhura madhoo ekuvandudzwa kana nyowani marapirwo maitiro eiyi mamiriro ekuremadza. Chiyero cheruzivo rwedu chinogumira kuchiropractic pamwe nekukuvara kwepamuviri nemamiriro. Kuti ukurukure nyaya yacho, ndapota inzwa wakasununguka kubvunza Dr. Jimenez kana kuti tibate isu pa 915-850-0900 .

 

Yakarongedzwa naDkt Alex Jimenez

 

 

Zvimwe Zvinyorwa: Kubva Painini

 

Kutambudzika shure ndechimwe chezvikonzero zvakakosha zvikuru zvekuremara uye mazuva asina kukwana kubasa pasi rose. Sezvakangoitika, kurwadziwa kwekudzokera shure kwave kuchiitwa sechipiri chikonzero chikuru chechiremba chekushanyira, chakanyanya kupfurikidza nehutachiona hwepamusoro-kuporesa. Inenge 80 muzana yevanhu vanozoona rumwe rudzi rwemarwadzo emutsipa kamwechete kamwe chete muupenyu hwavo hwose. Iyo musana inorongwa yakaoma yakaumbwa nemapfupa, mafundo, magirasi nemasumbu, pakati pezvimwe zvinyoro zvishoma. Nemhaka yeizvi, kukuvadzwa uye / kana mamiriro ezvinhu akawandisa, akadai herniated discs, zvinogona kutungamirira kune zviratidzo zvekurwadziwa shure. Kukuvara kwemitambo kana kukuvara kwepamberi yemotokari kazhinji kunowanzokonzera kukonzera kurwadziwa, zvisinei, dzimwe nguva kufamba kwakanyanya kunogona kuva nemigumisiro inorwadza. Nenzira yakanaka, nzira dzakasiyana dzokurapa, dzakadai sechiropractic, dzinogona kubatsira kuderedza marwadzo shure kuburikidza nekushandurwa kwepelinha nekugadzirisa maitiro, pakupedzisira kunatsiridza marwadzo ekurwadziwa.

 

 

 

NHAURWA INOKOSHA INOKOSHA: Low Back Pain Management

 

DZIMWE NYAYA: DZIMWE DZIMWE DZIDZISO: ronicKusingaperi Kurwadziwa & Marapirwo