Kwa anthu ambiri, mankhwala ochiritsira amalephera kuthandizira kuthetsa ululu. Izi zikhoza kukhala chifukwa chimodzi chomwe kugwiritsa ntchito njira zochiritsira zosagwiritsidwe ntchito ndi mankhwala opitirirabe kukupitirira ku United States.
Anthu a ku America ali ndi ululu wopweteka kwambiri. Ndipotu, ndi chimodzi mwa zifukwa zomveka zoyendera maofesi a dokotala ndikusowa masiku ogwira ntchito, komanso chifukwa chofala kwambiri chokhudzana ndi ntchito, malinga ndi National Institute of Neurological Disorders ndi Stroke.
Kuwonjezera apo, National Center for Complementary and Integrative Health, bungwe la National Institutes of Health, lomwe liri gawo la boma, limatchula kuti minofu ndi ululu wammbuyo monga mwina zoyendetsa kwambiri njira zochiritsira zosagwiritsa ntchito mankhwala.
Mankhwala Osakaniza Amuna ku United States
Komabe, mbali zambiri zachipatala zimakhazikitsidwa m'zochiritsira zowonjezereka monga mankhwala.
Mndandanda wa mankhwala ochiritsira amene amadokotala amapereka kwa odwala omwe amamva ululu amapezeranso mankhwala osokoneza bongo. Popanda kudziwika ngati opioids, mankhwalawa akhoza kutsitsa njira ngati inu, dokotala wanu ndi wamasitolo musamala.
Nkhani yabwino ndi yakuti ululu wammbuyo umachokera ndekha kapena mwa kutsatira mokhulupirika pulogalamu yabwino yochita masewera olimbitsa thupi. Nkhani zoipa (mwinamwake) ndikuti chinthu choyamba chomwe dokotala wanu angachichite ndikumakupatsani opioid chifukwa cha ululu wanu-ngakhale ngati mphamvu ndi yofatsa kapena yochepa.
Koma CDC imati madokotala ayenera kulingalira mosamala phindu la mankhwala aliwonse pokhudzana ndi mavuto omwe angakhale nawo. Pankhani ya ululu wa mankhwala osokoneza bongo, ngati dokotala akuyembekeza zabwino zomwe mankhwalawa adzakuchitirani-potsitsimutsa zowawa zonse ndi ntchito ya tsiku ndi tsiku-zidzakhala zazikulu kusiyana ndi chiopsezo cha kuledzera, kudzimbidwa, ndi zina zowonongeka , kenako opioids zingakhale zoyenera kulingalira.
Koma kumbukirani kuti opioidsyi yatsimikizirika kuti imathandiza kwambiri pakanthawi kochepa, kupweteka kwambiri. Kwa ululu wa nthawi yayitali kapena wofatsa, palinso zina zomwe mungasankhe.
Ngati mukugwiritsa ntchito opioids kupweteka, muyenera kudziŵa kuti dokotala wanu ayenera kuyang'anitsitsa zomwe mukuchita pa chithandizo chonsechi. Mphamvu zanu komanso luso lanu lochita masewera olimbitsa thupi tsiku ndi tsiku liyenera kusintha, ndipo kuchepa kwanu kukuyenera kuchepa. Apo ayi, zingakhale bwino kuthetsa mankhwala opioid, CDC imati.
Ndipo potsiriza, CDC imalimbikitsa madokotala kuti asanayambe kuchipatala, akuyankhula nanu za kuopsa ndi phindu la kutenga opioids.
Mankhwala ena opatsirana omwe amavomerezedwa kwa odwala akudandaula za ululu wammbuyo ndi opaleshoni, machitidwe opatsirana opweteka, komanso pang'ono, mankhwala opatsirana.
Kuchita chilungamo, kumayambitsa mphutsi za msana zimakonda kupeza ndemanga zabwino kuchokera kwa odwala omwe amatha kupwetekedwa msanga kwambiri omwe ali ndi zipangizozi. Ndipo chifukwa cha kupweteka kochepa, njira yothandizira thupi nthawi zambiri imakhala yothandiza-kwa iwo omwe amapanga homuweki, kuti ndi.
Kodi Dokotala Wanu Amadziwa Zomwe Amalimbikitsa M'njira ya Chithandizo?
Nthawi zambiri, opereka mankhwala amapanga ndalama zambiri pazochiritsira zotere, komabe ziwerengero zimasonyeza kuti odwala msana samakhala bwino nthawi zonse.
Ndalamayi ingakhale yomwe imayendetsa kayendetsedwe kake komwe zipatala zamphamvu zachipatala ndi zapadera zikupitiliza mpikisano wopita kuchipatala chowopsa, chotheka, chosachiritsika chomwe chimakhudzitsa odwala paokha.
Ndiye madokotala amatha bwanji kusankha mankhwala omwe angakulimbikitseni? Chokhazikitsira chimodzi chikhoza kukhala wopereka mwapadera. Ngati mumapita ku chipatala kuti mukambirane, mwachitsanzo, mukhoza kupeza njira zokhudzana ndi matenda opatsirana pogonana ngati chinthu chomwe chidzasokoneze zizindikiro zanu. Koma zosankha zina zingakhalepo zomwe mungasankhe.
Kuwonjezera apo, uwu ndi zaka za niche.
Udokotala wanu akhoza kukhala ndi luso lapadera mu njira imodzi ya msana, koma ndipakati pafupipafupi kapena kuposa pamwamba pa luso la ena omwe ali ofanana. (Izi zikhoza kuti chifukwa dokotala wa opaleshoni amachita izi mobwerezabwereza.) Izi zati, njira yeniyeni (kapena filosofi ya opaleshoni) imene dokotala akuposa mwina sangakhale yabwino yoyenera kuti mupereke zaka zanu, chikhalidwe, zokonda zanu , ndi mtundu wa vuto lakumbuyo lomwe muli nalo.
Tiyeni titenge opaleshoni ya disc monga chitsanzo. Madokotala ena opaleshoni agwiritsira ntchito ndalama zambiri kuti adziwe momwe angagwiritsire ntchito mawotchi , omwe ndi njira yatsopano. Ena, mwinamwake iwo omwe akhala ali mu malonda kwa nthawi yayitali, amamatira ndi kuyesera kokhala ndi kuyesedwa kwa msana. Ngakhalenso kupweteka kwa msana kapena kusinthanitsa bwino kumakhala kosavuta ponena za chitetezo ndi zogwira mtima, kotero m'malo movomereza malingaliro a munthu mmodzi yekha pa zomwe mankhwala anu ayenera kukhala, zingakhale zofuna kuti mufufuze zosankha zanu bwino kwambiri musanachite.
Ndipo potsiriza, mabungwe apamwamba azachipatala ali ndi chizoloŵezi chopereka malangizo kwa madokotala kuti asankhe (posankha) kutsatira. Inu, monga wodwalayo, mukhoza (kapena ayi) kupindula ndi malangizidwewa mu njira yowonongeka. Malangizo a mavuto a mmbuyo ndi a misana amafalitsidwa ndi mabungwe monga American Physical Therapy Association, American Society of Interventional Pain Physicians, American College of Physicians, ndi ena. Malingana ndi vuto lenileni la msana, komanso yemwe ali wofalitsa, malangizowa amasonyeza mankhwala, opaleshoni, mankhwala opangira jekeseni, ndi / kapena mankhwala opatsirana. Mwachizoloŵezi, iwo sanapereke pang'ono kuvomereza kuchipatala chokwanira.
Senti Yophatikizira Kupweteka Kwambiri Kungakhale Patsogolo
Kuyambira kumayambiriro kwa 2017, kusintha kungakhale kukubwera.
Phokoso lalikulu pa intaneti komanso pa TV pulogalamuyi inakhazikitsidwa mu February ndi March 2017 pamene American College of Physicians inafotokoza malangizo omwe, mwazinthu zina, adalimbikitsa njira zambiri zochizira monga mankhwala opweteka kwambiri. Izi zimaphatikizapo kupaka minofu, kutemera thupi, kupweteka kwa msana, tai chi, yoga, ndi kutentha. Chitsogozocho ndi umboni wozikidwa pambali, kutanthauza kuti malingalirowo adapangidwa kuchokera ku ndondomeko yowonongeka ya zotsatira zapamwamba zapamwamba (maphunziro apamwamba) omwe amafufuza chithandizo. Ochita kafukufuku ankafuna kudziŵa kuti ndi mankhwala ati omwe amachititsa zotsatira zabwino zowononga ululu, kumatha kugwira ntchito, kuwongolera umoyo wa moyo, kuchepetsa kulemala ndi kubwerera kuntchito, ndi zina.
Ofufuzawa adafunanso kudziwa za zotsatira zake komanso mavuto omwe amakumana nawo, komanso momwe odwala analiri okhutira ndi chithandizo chilichonse.
Zotsatirazi zimaphimba mitundu yonse ya mankhwala-osati mankhwala okhazikika-chifukwa cha ululu wovuta, wodwalayo komanso wopweteka kwambiri. Malingaliro ake a zochitika zosiyanasiyana zapadera zimasiyana malinga ndi mtundu wa ululu. Olemba a chitsogozo adanena kuti iwo alibe umboni wokwanira kuti adzalankhulana mwa njira iliyonse pa ululu umene umatchulidwa kuchokera msana, womwe umatchedwa kupweteka kwambiri ndipo kawirikawiri umayambitsidwa ndi disc.
Tsopano musanayambe kuchita zachiwerewere (ngati mulidi munthu amene angasamalire chisamaliro chonse pazomwe mukuchita), kumbukirani kuti izi ndizovomerezedwa ndi gulu limodzi lachipatala. Mwa kuyankhula kwina, mankhwala opatsirana monga opaleshoni ochiritsira opaleshoni omwe mungathe kuuzidwa ndi dokotala wanu sikutanthauza.
Zowonjezera Zowonjezereka Zophatikizapo Zomwe Zimaphatikiza Zaumoyo Wosungira
Mabungwe ena, monga American Medical Association ndi Joint Commission (bungwe lovomerezeka lomwe limapereka ndondomeko zamankhwala kuchipatala) nawonso, m'mbuyomo, anapereka mawu.
Mankhwala achilengedwe pakudziŵika mu malipoti awa ndi ofanana sangakhale osadziŵika. Nthawi zina, mankhwala omwe mumadziŵa bwino ( chiropractic , massage, acupuncture, mindfulness, yoga, mwachitsanzo) amatchulidwa mwachindunji, koma lipoti limasiya kufunsa kapena kulimbikitsa kwambiri ngati mankhwala oyamba omwe angagwiritsidwe ntchito. Nthawi zina, mndandanda wa mitundu yonse yochiritsira ndi yaying'ono kwambiri, koma ntchito yawo imalimbikitsidwa kwambiri.
"Chilankhulochi chimasintha nthawi zambiri pamene mapepala ovomerezekawa amapangidwa, ndipo mndandanda wa mankhwala othetsera onsewa ndi okhudzana ndi zosankha, pamene chomaliza sichikutchulidwa pang'ono," akutero John Weeks, wofalitsa wa Integrator Blog News & Report .
Mwachitsanzo, mu November 2014, bungwe la Joint Commission linapereka "Kufotokozedwa kwa Mavuto Oyenera" omwe, m'mawu a Masabata, "adakweza kufunika kwa njira zopanda mankhwala. Mankhwala opangira mankhwala, mankhwala odzoza minofu, mankhwala othandizira anthu, mankhwala othandiza kuti azidziŵa bwino, komanso matenda otupa mtima anali ena mwa njira zomwe zimatchulidwa bwino, "akutero.
Kenaka, mu 2017, Joint Commission inapanga ndondomeko yotsatira ya Standard Pain. Mungaganize kuti kungakhale kupitiriza kwa chidziwitso chofotokozera kuyambira zaka zitatu zapitazo, zomwe zikuphatikizapo, komanso kulimbitsa mndandanda wa zochitika zonse zapakati pa 2014. M'malo mwake, ngakhale kuti njira zambiri zothandizira mankhwalawa zinkalimbikitsidwa, chiwerengero cha mankhwala onse omwe atchulidwawo ndi ochepa.
Pa chifukwa ichi, ndemanga za masabata, zolemba zaposachedwa ndi zosokoneza. Iye anati: "Mwachitsanzo, kutsekemera kapena kupaka minofu sikunatchulidwe. Masabata amatsimikizira kuti ngati mankhwala asanatchulidwe mwatsatanetsatane, madokotala ochepa adzakhala ndi chizoloŵezi chochizoloŵera kuchizoloŵezi chawo kapena kuwalimbikitsa iwo kwa odwala awo.
Chitsanzo china cha kusintha kwachinenero ichi, malinga ndi Masabata, ndi ma CDC a 2016 othandizira malemba okhudza mankhwala opweteka a opioid. (Chotsatira chatsopano chimasulidwa.) Iye akuti, "Langizoli likuphatikizapo chilankhulo chosasintha chotere: 'Mankhwala osagwiritsa ntchito mankhwala komanso mankhwala osagwiritsa ntchito opioid amakonda kupweteka kosatha.'"
Koma, monga milungu imatchulidwa mu zolembera, njira zothandizira komanso zochiritsira zosagwiritsidwa ntchito (mwachitsanzo, kupweteka kwa msana, kupaka minofu, ndi kupopera mankhwala) zinatchulidwa kuti ndi zofunika, osati mankhwala omwe angayesedwe kuti amve ululu m'malo mwa mankhwala ozunguza bongo. "Kugwiritsiridwa ntchito kwa mawu oti 'zokonda' kumasonyeza kuika patsogolo," akutero, "Izi zokha zikusonyeza kusintha kosasintha kuchokera ku chizolowezi chamakono."
Koma pamene CDC inasindikiza buku lomalizira patapita miyezi ingapo, njira zowonjezereka zothandizira ndi zina zomwe zatchulidwa zinali zitapita. Mndandanda womwewo tsopano umati: "Kuchita masewera olimbitsa thupi, madzi, madzi, aubongo, maganizo, chidziwitso, komanso zokhudzana ndi bio-psycho."
Ndi anthu ambiri a ku America akukhala ndi ululu kuposa matenda a shuga, matenda a mtima, ndi khansa pamodzi (molingana ndi American Academy of Pain Medicine), kuyang'anira kupweteka mwa njira yotsika mtengo, yogula ogula n'kofunika kwambiri. Ndipo izi zimangopindulitsa kwambiri chifukwa chakuti anthu ambiri sakupeza mpumulo umene amawapeza kuchokera kwa madokotala awo ochiritsira.
> Zotsatira:
> ACP. American College of Physicians amapereka chitsogozo chochiza > nonradicular > kupweteka kwa msana. American College of Physicians. Feb 2017. https://www.acponline.org/acp-newsroom/american-college-of-physicians-issues-guideline-for-treating-nonradicular-low-back-pain.
> Zolinga za Kuletsa ndi Kuteteza Matenda. Kuchiza ndi Kufa Sabata Sabata. Mndandanda wa CDC wolembera opioids for Chronic Pain - > United States >, 2016 > Zotani > ndi Malipoti. March 2016. https://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm.
> Quseem > A., MD, > PhD >, MHA, Wilt T., MD, MPH, McLean, R, MD, Othandizira, M, MD, Opaleshoni, Odwala, ndi Matenda Osatha: Kuchokera ku American College of Physicians. Annals of Internal Medicine. Feb 2017. http://annals.org/aim/article/2603228/noninvasive-treatments-acute-subacute-chronic-low-back-pain-clinical-practice