Coccygodynia
Mabala a tailbone, omwe amadziwika bwino kuti amatchedwa coccygodynia, sali pikisnicini pamphepete mwa nyanja.
Coccygodynia ingabwere chifukwa cha kugwa kapena zoopsa zina pamtunda wa msana wanu. Zovuta zoterezi zingathe kuvulaza periosteum (minofu yolumikizana yomwe imayandikana fupa), yopweteka. Kugwera pamsana pakhosi kumatha kuphwanya fupa, kusasuntha (palimodzi la sacroccygeal, komwe kumalo komwe khosi ndi sacrum zimasonkhana,) kapena zonse ziwiri.
Zonse zomwe zimachitika chifukwa cha vutoli, nthawi zambiri zimakhala zopweteka kwambiri kuti munthu amve kupweteka kwa mchira.
Ndipotu, chifukwa chokhala-ntchito yaikulu ya ambiri a ife, ndi imodzi yomwe imakhudza mwachindunji - kumakhala kovuta kwambiri ngati muli ndi coccygodynia, matendawa ndi otchuka chifukwa chosokoneza khalidwe la moyo.
Zimayambitsa
Ngakhale kuti nthawi zambiri matendawa amachokera ku mtundu wina wa zoopsa kwa mchira, pali zifukwa zina.
Mavuto ndi fupa lanu la coccyx limene lingabweretse vutoli limaphatikizapo kuvulazidwa (kuphatikizapo osati kugwa, monga momwe tafotokozera pamwambapa), kutaya kwa disk ku sacrococcygeal (kutchulidwa pamwambapa) ndi / kapena mapangidwe amodzi (mapangidwe pakati pa zidutswa zazing'ono zomwe zimaphatikiza pamodzi chiphalaphala), fupa limathamanga pamtambo (wotchedwa coccygeal spicule), matenda m'mphongo (otchedwa osteomyelitis) kapena chotupa pamphuno.
Chinthu chinanso choyambitsa matendawa (mwa mayi) ndi kubala kwa amayi.
Coccygodynia ingakhalenso chifukwa cha kupweteka kwamtundu, mwachitsanzo, ululu umene umachokera ku ziwalo zomwe zimakhalapo. Zitsanzo zingaphatikizepo mikhalidwe kapena mavuto mu sigimoid colon, system urogenital ndi / kapena rectum.
Osati kokha, kupweteka mu mchira mafupa m'deralo nthawi zina kungayambane ndi mavuto omwe akuchitika, kapena pafupi.
Zitsanzo zikuphatikizapo: Mavuto omwe ali mumtambo wanu wa msana, sacrum ndi sacroiliac , matenda a piriformis, matenda a ziwalo za m'mimba, zotupa, ndi zina zambiri.
Zofanana: Piriformis Syndrome
Pomalizira, mayendedwe anu angakhale a "chifukwa chosadziwika." Mu kafukufuku wa maphunziro omwe amatchedwa "Coccygodynia: etiology, pathogenesis, zizindikiro zachipatala, matenda ndi matenda," mu nyuzipepala ya zamankhwala ku Croatia ya Lijec Vjesn , ya Jan-Feb 2012, akuti, 30% ya coccygodynia ndi idiopathic; mwa kuyankhula kwina, chifukwa cha kupweteka kwa mchira kwa mchira sikukanapezeke.
Hypermobile Mchira Bone
Ndiko kunena kuti, kusagwirizana kwamtundu wa coccyx (kuthamanga kumatanthawuza kuti mafupa amatha kugonjetsa) ndimadokotala omwe amapezeka kupweteka kwa mchira. Grgić akunena kuti odwala 70 peresenti yokhala ndi coccygodynia amasonyeza zizindikiro zowonjezera mafupawa pamene X-rays anatengedwa.
Kuwonjezera pa kuvulala (monga tafotokozera pamwambapa), kulemetsa kwambiri phokosoli panthawi yoyendayenda komanso pamene malo otha kuyambitsa amatha kuyambitsa matenda osokoneza bongo. Zochita ndi zigawo za kukhala zomwe zingakulowetseni kuti mutenge katundu wanu zikuphatikizapo kukhala olemera komanso / kapena kukhala kwa nthawi yaitali (kutaya kwambiri), ndi njinga yamoto, kuthamanga kapena kukwera.
Mu kafukufuku wawo wa 2014 wofalitsidwa mu Ochsner Journal , ofufuza amanena kuti kunenepa kwambiri ndi kukhala akazi ndizifukwa ziwiri zoopsya za ululu wa tailbone.
Zizindikiro za Coccygodynia
Zisonyezero za katemera wochuluka zimaphatikizapo kupweteka ndi kupweteka pamunsi pa msana wanu (apa ndi pamene fupa la coccyx lilipo). Zitha kuphatikizapo kupweteka kumbuyo kwanu ndi / kapena m'chiuno. Mungapeze kuti mukupweteka kupweteka pansi miyendo yanu, inunso.
Kukula kwa coccygodynia kumasiyana pakati pa munthu ndi munthu. Kulemera kwa ululu wanu wa coccygodynia kungapitirire kuwonjezereka pakapita nthawi.
Monga ndanenera kale, kugwiritsira ntchito mankhwala osokoneza bongo kungasokoneze kwambiri moyo wanu. Zingathe kusokoneza tulo ta usiku ndikusokoneza luso lanu lochita zinthu zomwe kukhala ndi / kapena kugwedeza n'kofunika.
Zingapangitsenso kusamalira ntchito za thupi mopambanitsa.
Izi zikutanthauza kuti zinthu zomwe mumakonda kuchita - ndipo mwinamwake mutenga zochepa - monga kugwira ntchito pa kompyuta yanu kapena kuyendetsa galimoto zingakhale zopweteka kwambiri. Chowonadi ndi chakuti pamene muyeza kulemera kwa fupa lanu lamkati, ngakhale ngati pansi panu muli phokoso lofewa kapena mpando, kupweteka kwanu kudzawonjezeka. Mungapezenso kuti kudzuka pamalo ovuta kumakhala kovuta.
Kudziwa
Madokotala amadziwika kuti coccygodynia mwa kutenga mbiri yachipatala, kuchita kafukufuku wamthupi (zomwe zimaphatikizapo kutentha kwa dera lanu) ndi kutenga zida zowonongeka. Mwinamwake, dokotala wanu adzakufunsani kuti mukhale ndi / kapena kuti mupange njinga, kuti muyesere kuberekana ululu ndi zizindikiro zanu.
Zofanana: Kulankhulana Zizindikiro Zanu Kwa Dokotala Wanu
Kafukufuku wochulukirapo nthawi zambiri amatsimikiziridwa ndi jekeseni. Pachifukwa ichi, mankhwala amadzimadzi amalowa m'malo amodzi kapena kumalo amtundu wa mchira, omwe amachokera pa zomwe mumanena zokhudzana ndi zizindikiro zanu ndi zotsatira za kuyesedwa kwanu, komanso x-ray komanso mwinamwake MRI (onani m'munsimu kuti mudziwe zambiri), dokotala wanu akukayikira kuti ululu umachokera.
Kafukufuku wa MRIs
Nthaŵi zambiri MRI sichigwiritsidwe ntchito mu ndondomeko ya matenda. Koma mu 2012, akatswiri a ku France adapeza kuti MRIs ikhoza kupereka mfundo zomwe zingagwiritsidwe ntchito pofuna kudziwa chomwe chimayambitsa mchira wopweteka. Kafukufuku wawo adawonetsa kuti pamene chikhalidwe cha mtundu wa coccyx chikudziwika, MRI ingathandize kupitiriza kufotokoza chithunzi cha zomwe zikuchitika. Mwachitsanzo, mu phunziroli, kuchokera pa mayesero 172 omwe anali kuyesedwa, 105 anawonetsa mofulumira. Mwa awa, ambiri amasonyeza discs zachilendo; Pa odwala 67 omwe ali ndi vuto lopanda kanthu, zosaoneka bwino zimapezeka pansi pa fupa, lotchedwa nsonga.
Kuchiza ndi Mpumulo Wopweteka
Sizowonjezereka kuti mukhale ndi mpumulo wopwetekedwa chifukwa cha mankhwala osokoneza bongo.
Mofanana ndi mavuto ambiri a msana, mankhwala amagawanika kukhala mitundu iwiri ikuluikulu: Conservative (osati-invasive) ndi opaleshoni (yomwe imatchedwanso invasive). Kuchita opaleshoni kwa mchira kupweteka kwa mafupa kumatchedwa coccygetectomy. Zingakhale zopanda phindu kapena kuchotsa kwathunthu kwa mchira; opaleshoniyi kawirikawiri imasungidwira nthawi pamene china chirichonse chayesedwa popanda kupambana. Kawirikawiri, zotsatira zimakhala zocheperapo bwino, ndipo pakuchita opaleshoni, mumayambitsa mavuto.
Mankhwala opatsirana omwe amamva kupweteka kwa mchira amaphatikizapo kupumula, mankhwala, monga NSAIDs (makamaka poyamba), atakhala pamtambo ndi dzenje lodulidwa pakati (nthawi zambiri modzudzulidwa amatchedwa "whoopie mtsuko"), mankhwala opangira thupi ndi mankhwala. Mukakhala mukudwala, mankhwala opatsirana angaphatikizepo manja pa njira zowonjezera kusintha kwapansi pazitsulo - makamaka mthunzi wa nyama, womwe ukhoza kutulutsa fupa la coccyx ngati lakhala.
Ofufuza omwe tawatchula pamwambapa omwe maphunziro awo a 2014 adafalitsidwa mu Ochsner Journal amati njira yothandizira mankhwala ambiri imayamba kugwira bwino ntchito. Amanenanso kuti mankhwala osagwiritsa ntchito opaleshoni amagwira ntchito pafupifupi 90%.
Zokhudzana: Njira Zopangira Thupi
Dokotala wanu angakuuzeni kupeza jekeseni wa steroid , kapena jekeseni wamagetsi, kuti akuthandizeni kuthana ndi ululu. (Kugwiritsanso ntchito mankhwala kumathandizanso ndi izi, komanso.) Nthawi zina njira yowononga kupweteka yotchedwa ablation yamagetsi imagwiritsidwa ntchito kwa coccygodynia, koma izi sizikuvomerezedwa kawirikawiri.
Zotsatira:
Grgić V. [Coccygodynia: etiology, pathogenesis, zizindikiro zachipatala, matenda ndi matenda]. Lijec Vjesn. 2012 Jan-Feb; 134 (1-2): 49-55. http://www.ncbi.nlm.nih.gov/pubmed/22519253
Lirette, L., MD. Coccydynia: Chidule cha Anatomy, Etiology, ndi Chithandizo cha Mavuto a Coccyx Ochsner J. Spring 2014. Kupezeka: June 2016. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3963058/
Maigne JY, Pigeau I, Roger B. Magnetic zojambula zojambula zojambula m'kati mwa anthu akuluakulu ovuta. Eur Spine J. 2012 Oct; 21 (10): 2097-104. lembani: 10.1007 / s00586-012-2202-6. Epub 2012 Feb 22. http://www.ncbi.nlm.nih.gov/pubmed/22354690
Moore, K., Dalley, A. Kachilombo ka Anatomy. Chachisanu. Kusindikiza. Lippincott, Williams & Wilkins. 2006. Baltimore. Pool-Goudz.
Patijn J, Janssen M, Hayek S, Mekhail N, Van Zundert J, van Kleef M. Coccygodynia. Kupweteka Kwambiri. 2010 Nov-Dec; 10 (6): 554-9. lembani: 10.1111 / j.1533-2500.2010.00404.x. Epub 2010 Sep 6.
Vacarro, A. Spine: Chidziwitso Chachikulu mu Orthopedics. Elsevier Mosby 2005. Philadelphia, PA.