The piriformis muscle (PM) inozivikanwa mukurapa semhasuru yakakosha yeiyo yekumashure hudyu. Iyo mhasuru ine basa rekudzora hudyu majoini kutenderera nekutapa, uye zvakare iri mhasuru inoitwa inozivikanwa nekuda kwekuchinja kwechiito mukutenderera. Iyo PM zvakare inoteedzera kutarisisa nekuda kwebasa rayo mupiriformis syndrome, mamiriro anosungirwa seanogona kukonzera shungu uye kusagadzikana.
Piriformis syndrome inogona kurondedzerwa sechiremba munharaunda iyo piriformis muscle, iri munharaunda yemaguta, inokonzera uye inokonzera marwadzo emvura. Iyo Sciatic Nerve inogona kutsamwiswa nekubatana pakati peSN uye PM inobereka marwadzo ekuputika kwepashure shure kwehudyu, zvichiita 'sciatica'.
Zvichemo zvekurwadziwa kwechiuno nekutumirwa kwezviratidzo hazvisi izvo zvePiriformis Muscle. Zviratidzo zvakapararira pamwe nekiriniki yakawanda inooneka yemarwadzo ekudzokera shure. Zvave zvichiratidzwa kuti piriformis syndrome inozvidavirira kune 5-6 muzana yezviitiko zve sciatica. Muzvizhinji zvezviitiko, zvinoitika muvanhu vezera repakati uye zvinonyanya kuwanda muvakadzi.
Mukati
Anatomy: Piriformis
Mutungamiri weMDC anobva pane anterior surface ye sacrum uye anonamirwa nayo nezvisungo zvitatu zvenyama pakati pekutanga, yechipiri, chechitatu uye yechina anterior sacral foramina. Dzimwe nguva mavambo acho angave akareba zvokuti anowanidza capsule yejojo ye sacroiliac kumusoro uye ne sacrotuberous uye / kana sacrospinous ligament pasi apa.
PM imhasuru yakakora uye yakakura, uye sezvainobuda kunze kwechiuno kuburikidza nehukuru sciatic foramen, inoparadzanisa foramen mu suprapiriform uye infra-piriform foramina. Sezvo ichiita anterolaterally kuburikidza nehukuru sciatic foramen, inoputika kuti iite tendon inosungirirwa kune yepamusoro-yepakati pepamusoro peiyo trochanter yakakura, inowanzobatanidza nekatsika tendon ye obturator internus uye Gemelli's muscle.
Mitsipa nemidziyo yeropa mu suprapiriform foramen ndiyo yepamusoro-soro tsinga nemidziyo, uye mu-infra-piriform fossa ndiyo yakaderera gluteal nerve nemidziyo uye sciatic nerve (SN). Nekuda kwehukuru hwayo mune yakakura sciatic foramen, ine mukana wekudzvanya midziyo yakawanda uye tsinga dzinobuda muchiuno.
PM inofambidzana zvakanyanya nemamwe mapfupi ehudyu anotenderera anorara akaderera akadai seyepamusoro gemellus, obturator internus, yakaderera gemellus, uye obturator externus. Musiyano wekutanga pakati pePM uye mamwe mapfupi anotenderera hukama kune SN. Iyo PM inopfuura kumashure kune nerve nepo imwe obturator ichipfuura anterior.
Chikonzero: Piriformis Syndrome
Piriformis Syndrome inogona kukonzerwa kana yakabatana nezvinhu zvitatu zvinokonzera causative;
1. Kubata uye kupfupisa misungo yakasvibiswa yakasvibiswa nemisumbu yakanyanyisa kufanana nekufamba kwema squat uye mhepo mukutenderera kwekunze, kana kushungurudza zvakananga. Izvi zvinowedzera girth yemuMDC munguva yekuputika, uye ingangodaro iyo inobva pakudzvinyirira / kubatwa.
2. Entrapment of the nerve.
3.Sacroiliac Joint Dysfunction (SI Joint Pain) inokonzera PM spasm.
Zviratidzo: Piriformis Syndrome
Zviratidzo zvepiriformis syndrome zvinosanganisira:
- Inonzwa yakasimba kana kuti inogadzika mumatanda uye / kana kuti musasa.
- Kukudzwa kunokudzwa.
- Mhuru yehuru.
- Kuwedzera kwekugara uye kubvarura, kunyanya kana truru iri kutungamira mberi kana gumbo rakayambuka pamusoro pegumbo risingaiti.
- Zvinogona kuitika puropa remvura zvinoratidza marwadzo uye paraesthesia kumashure, kugomera, matope, perineum, kumashure kwehudyu.
Kurapa: Piriformis Syndrome
Apo zvinotendwa izvo piriformis syndrome iripo uye chiremba anonzwa kuti kuongororwa kwakaitwa, kurapwa kunowanzoenderana nemhosva yekufungidzirwa chikonzero. Kana iyo PM iri yakasimba uye inopasm uye pakutanga pakutanga kurapwa kunotarisa kutarisa uye kuisa muviri musungo wakasimba kuti abvise PM semuviri wemarwadzo.
Kana izvi zvisingakwanisi, zvino zvinotevera zvakataurwa:
- Local anesthetic block inoitwa neanesthesiologists vane hunyanzvi hwekugadzirisa marwadzo.
- Steroid injections muMDC.
- Botulinum injections muna PM.
- Nerve Surgery.
Therapist-inotungamirwa kupindira senge kutambanudza PM uye yakananga trigger point massage yagara ichitsigirwa. PM kutambanudza kunoitwa munzvimbo dzehudyu flexion yakakura kudarika 90 degrees, kuderedzwa, uye kutenderera kwekunze kushandisa inversion yezviito zvekuita zvePM kuti iparadzanise kutambanudza kune iyi tsandanyama yakasununguka kune imwe hip yekunze rotators.
Mhedziso: Piriformis Syndrome
The piriformis muscle iri musimba yakasimba uye ine simba inomhanya kubva mu sacrum ichienda kumudzimai. Iyo inomhanya pasi pemakumbo e gluteal iyo nerve inofamba pasi payo. Kana mutsara uyu unopinda mukana, ipapo nharo inouyisa marwadzo anokonzera, kupera, kurira, kana kupisa kubva pamakumbo kusvika kumakumbo netsoka. Vamwe vanhu vanovandudza chirwere ichi pavanenge vachitambura nemarwadzo asingagumi kumashure.
Mabasa uye mafungiro anoita kuti piriformis muscle kuti zvibvumirane zvakare kumanikidzika mutsara, zvichikonzera marwadzo. Iyi tsandanyama inobatirana kana takwenya, kana kumira, kufamba, kukwira nhanho. Inowanzoita kuomesa kana isu takagara pane chero chinzvimbo kweanopfuura 20 kusvika 30 maminetsi.
Vanhu vane nhoroondo yekusagadzikana kwemarwadzo ekudzokera shure vanowanzofunga kuti marwadzo avo e-sciatic anotsvedzerwa kumusana wavo wezasi. Nhoroondo yavo ye disc herniations, kana sprains, sprains yakavadzidzisa kufunga kuti ichaenda seyakajairika uye kuti marwadzo ari kunze kwemusana wavo. Pari pari apo kurwadziwa kusingapindure semazuva ese vanhu vanotsvaga kurapwa, nekudaro vanonoke kupora kwavo.
Sciatica Pain
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Dr. Alex Jimenez DC, Msacp, RN*, CCST, IFMCP*, CIFM*, atn*
email: qeqeshi@elpasofunctionalmedicine.com
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Dr. Alex Jimenez DC, MSACP, RN* CIFM*, IFMCP*, ATN*, CCST
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