Ubume bePathophysiology ye-Pauropathic Pain

Iintlungu ze-Neuropathic ziimeko ezinzima, ezingapheliyo zentlungu zihlala zihamba kunye nokulimala kwezicubu ezithambileyo. Intlungu ye-Neuropathic ixhaphake kuqhelaniso lweklinikhi kwaye ikwabangela ucelomngeni kwizigulana nakwabahlengikazi ngokufanayo. Ngeentlungu ze-neuropathic, imithambo ngokwayo inokuba yonakele, ingasebenzi okanye ilimele. Intlungu ye-Neuropathic sisiphumo somonakalo ovela kwintlungu yesifo okanye kwisifo ukuya kwipripalal or central system system, apho lesion inokuthi ivele nakweyiphi na indawo. Ngenxa yoko, le micu ye-nerve eyonakalisiweyo ingathumela imiqondiso engalunganga kwamanye amaziko entlungu. Iziphumo zokulimala kwentsinga ye-nerve kubandakanya ukutshintsha kokusebenza kwe-neural, zombini kwindawo yokulimala kunye nokujikeleza ukulimala. Iimpawu zeklinikhi zentlungu ye-neuropathic ihlala iquka imvakalelo yenzwa, ezinje ngeentlungu ezizenzekelayo, i-paresthesias kunye ne-hyperalgesia.

 

Intlungu ye-Neuropathic, njengoko ichazwe yi-International Association of the Study of Pain okanye i-IASP, yintlungu eqaliswe okanye ibangelwa sisilonda esentloko okanye ukungasebenzi kakuhle kwenkqubo yethambo. Isiphumo sisiphumo somonakalo naphi na kwi-neuraxis: inkqubo ye-peripheral nervous, ye-spinal okanye ye-supraspinal system. Iimpawu ezihlukanisa iintlungu ze-neuropathic kwezinye iintlobo zentlungu zibandakanya iintlungu kunye neempawu zenzwa ezihlala zingaphaya kwexesha lokufumana. Luphawulwa ebantwini ziintlungu ezenzekelayo, i-allodynia, okanye amava okukhuthaza un-noxious njengentlungu, kunye ne-causalgia, okanye intlungu eqhubekayo evutha. Iintlungu ezizenzekelayo zibandakanya ukuziva "ngeepini kunye neenaliti", ukutshisa, ukudubula, ukugwaza kunye nentlungu yeparoxysmal, okanye ukungcangcazela kombane njengentlungu, edla ngokunxulunyaniswa ne-dysesthesias kunye ne-paresthesias. Ezi mvakalelo azitshintshi kuphela izixhobo zokwenza iimvakalelo zesigulana, kodwa kwimpilo-ntle yesigulana, imvakalelo, ingqalelo kunye nokucinga. Iintlungu ze-Neuropathic zenziwa zimpawu zombini “ezingalunganga”, ezinje ngokuphulukana nemvakalelo kunye nokuziva uthandabuza, kunye neempawu "ezintle"

 

Iimeko ezihlala zihambelana nentlungu ye-neuropathic inokuhlelwa ibe ngamaqela amabini aphambili: iintlungu ngenxa yomonakalo kwinkqubo ye-nerve yangaphakathi kunye nentlungu ngenxa yomonakalo kwinkqubo ye-peripheral system. Imivimbo ye-cortical and sub-cortical stroke, i-traumatic spinal cord, i-syringo-myelia kunye ne-syringobulbia, i-negegias ye-trigeminal kunye ne-glossopharyngeal neuralgias, i-neoplastic kunye nezinye izilonda ezithatha indawo yimo yeemeko zeklinikhi zeqela langaphambili. Ukunyanzelwa kwengqondo okanye ukubamba imithambo-luvo, ischemic neuropathy, i-polyipur ye-peripheral, i-plexopathies, ukunyanzeliswa kweengcingo, isiphumlisi sasemva kokuphuma kunye nentlungu ye-phantom, isifo se-postherpetic neuralgia kunye ne-neuropathies ezinxulumene nomhlaza.

 

I-pathophysiology ye-Neuropathic Pain

 

Iinkqubo ze-pathophysiologic kunye neengqondo ezingaphantsi kweentlungu ze-neuropathic zininzi. Ngaphambi kokugubungela ezi nkqubo, ukuphononongwa kwezinto ezijikelezayo zentlungu kubalulekile. Ukujikeleza kwentlungu rhoqo kubandakanya ukubandakanyeka kwe-nociceptor, ekwabizwa ngokuba sisamkeli seentlungu, ekuphenduleni ekukhuthazeni kabuhlungu. Amaza okuhanjiswa kwesidumbu ahanjiswa kwii-neurons zodidi lokuqala, kunye nokuhamba ngokungxamisekileyo kwe-sodium kwiindlela zesodium kunye nokuphuma ngokukhawuleza kwe potaziyamu. I-Neurons iphela kwi-stem yobuchopho kwi-nucleus ye-trigeminal okanye kwi-dorsal uphondo lomgogodla. Kulapha apho umqondiso uvula iitshaneli ze-calcium-gated calcium kwimolela yangaphambili ye-synaptic, ivumela i-calcium ukuba ingene. I-calcium ivumela i-glutamate, i-neurotransmitter evuthayo, ukuba ikhutshwe kwindawo ye-synaptic. I-glutamate ibophelela kwii-receptors ze-NMDA kwii-neurons ze-oda yesibini, ebangela ukudodobala.

 

Ezi zi-neurons zinqumla kwintambo yomgogodla kwaye zihambe de kube yi-thalamus, apho zihlala kunye ne-neurons ye-oda yesithathu. Ezi ke ziqhagamshela kwinkqubo ye-limbic kunye ne-cortex yecereal. Kukho indlela yokuthintela engathinteli ukuhanjiswa kwesiginali yeentlungu ukusuka kwiphondo le-dorsal. I-anti-nociceptive neurons isuka kwingqondo yengqondo kwaye ihambe iyehla kumqolo wentambo apho ihambelana khona kunye ne-interneurons emfutshane kwiphondo le-dorsal ngokukhulula i-dopamine kunye ne-norepinephrine. I-Intneurons ziguqula ukuvumelanisa phakathi kwe-neuron ye-oda yokuqala kunye ne-neuron ye-odolo yesibini ngokukhupha i-gamma amino butyric acid, okanye i-GABA, i-inhibitory neurotransmitter. Ngenxa yoko, ukupheliswa kwentlungu sisiphumo sothintelo lwee-synapses phakathi kwee-neurons zokuqala kunye ne-oda ezimbini, ngelixa ukuphuculwa kwentlungu kunokuba sisiphumo sokucinezelela kokunxibelelana kwe-inhibitory synaptic.

 

 

Amachiza asisiseko se-neuropathic pain, nangona kunjalo, awacacanga. Izifundo ezininzi zezilwanyana zatyhile ukuba iindlela ezininzi zinokubandakanyeka. Nangona kunjalo, umntu kufuneka akhumbule ukuba oko kusebenza kwizidalwa akunakuhlala kusebenza kubantu. I-neurons yoku-oda yokuqala inokunyusa ukudubula kwabo ukuba yonakaliswe ngokwengxenye kwaye yonyuse inani leendlela zesodium. Ukukhutshelwa kwe-Ectopic sisiphumo sokonyusa amandla kwiindawo ezithile kwifibre, okukhokelela kwintlungu engazinzanga kunye nentlungu ehambelana nokushukuma. Imijikelezo ye-inhibitory inokuncitshiswa kwinqanaba lempondo ye-dorsal okanye iiseli zengqondo, kunye zombini, ukuvumela ukunyanzeliswa kwentlungu ukuhamba kungavalwanga.

 

Ukongeza, kunokubakho inguqu kulungelelwaniso oluphambili lweentlungu xa, ngenxa yentlungu engapheliyo kunye nokusetyenziswa kwesiyobisi esithile kunye / okanye amayeza, i-neurons yesibini kunye neyesithathu inokudala "inkumbulo" yentlungu kwaye ibe novakalelo. Kukho ukuphakama kokuziva kwe-neurons yomgogodla kunye nemibandela yokunciphisa ukusebenza. Enye ithiyori ibonakalisa umba wentlungu egcinwe ngovelwano. Olu luvo lubonakaliswe yi-analgesia kulandela ukulandela uvelwano kwizilwanyana nakubantu. Nangona kunjalo, umxube we-mechanics ungabandakanyeka kwiimeko ezininzi ze-neuropathic ezingapheliyo okanye umxube we-somatic kunye ne-neuropathic. Phakathi kwemiceli mngeni kwintlungu, kwaye kakhulu ngakumbi ngokubhekisele kwintlungu ye-neuropathic, kukukwazi ukuyijonga. Kukho icandelo eliza kubakho koku: okokuqala, kuvavanyo lomgangatho, ubukhulu kunye nokuqhubela phambili; kwaye okwesibini, ukufumanisa ngokuchanekileyo iintlungu ze-neuropathic.

 

Kukho, nangona kunjalo, ezinye izixhobo zokuxilonga ezinokunceda abagqirha ekuvavanyeni iintlungu ze-neuropathic. Kwabaqalayo, izifundo zenzululwazi yokuveliswa kwemithambo luvo kunye nezinto ezinokubangela ukuba babe namandla okuchonga kunye nokuchaphazela ubungakanani bomonakalo kwiimvakalelo, kodwa kungabi njalo, iindlela ngokujonga iimpendulo ze-neurophysiological kukhuthazo lombane. Ukongeza, amanyathelo okuvavanya uvakalelo lokubona kwindlela ekuphendula ngayo isikhuthazo sangaphandle samandla ahlukeneyo ngokusebenza okukhuthaza ulusu. Uvakalelo lobuxhakaxhaka bokuvuselela okubonakalayo lilinganiswa ngezixhobo ezikhethekileyo, ezinje ngeenwele ze-V Frey, ipinki ngenaliti zokunxibelelana, kunye nokuva kokuhamba kunye nokudibana kunye ne-vibrameter kunye nentlungu eshushu ene-thermode.

 

Kubaluleke kakhulu ukwenza uvavanyo olupheleleyo lwe-neurological ukuchonga ukungasebenzi kwemoto, imvakalelo kunye nokungasebenzi kakuhle. Ekugqibeleni, kukho imibuzo emininzi esetyenziselwa ukwahlula intlungu ye-neuropathic kwintlungu ye-nocicepts. Ezinye zazo zibandakanya imibuzo yodliwano-ndlebe kuphela (umzekelo, i-Neuropathic Questionnaire kunye ne-ID Pain), ngelixa ezinye ziqulathe imibuzo yodliwanondlebe kunye novavanyo lomzimba (umz., Uvavanyo lweLeeds of Neuropathic Symbols and Signs wadogo) kunye nesixhobo esikhethekileyo senoveli Intlungu, edibanisa imibuzo emithandathu yodliwanondlebe kunye novavanyo lweshumi lomzimba.

 

 

Iindlela zoNyango kwiNhlungu ye-Neuropathic

 

Iirejimeni zonyango ezijolise kwiindlela zentlungu ye-neuropathic. Nangona kunjalo, zombini unyango lwe-pharmacologic kunye nolwe-non-pharmacologic lunika isiqabu esipheleleyo okanye isahlulo nje kwisiqingatha sezigulana. Ubungqina obuninzi obusekelwe kubungqina bucebisa ukusebenzisa umxube wamachiza kunye / okanye amayeza ukusebenza ngeendlela ezininzi kangangoko kunokwenzeka. Uninzi lwezifundo ziphande kakhulu kwi-post-herpetic neuralgia kunye ne-neuropathies yesifo seswekile kodwa iziphumo zinokungasebenzi kuzo zonke iimeko zentlungu ye-neuropathic.

 

Ukuxhatshazwa

 

Ii-Antidepressants zonyusa i-syaptonin ye-synaptic kunye namanqanaba e-norepinephrine, ngaloo ndlela kuphuculwe umphumo wehla we-analgesic system ehambelana nentlungu ye-neuropathic. Bayeyona nto iphambili kunyango lwentlungu ye-neuropathic. Izenzo zohlalutyo zinokuthi zibekho ngenxa ye-ad -alrenaline kunye ne-dopamine ukuphinda i-blockade, ekhuthaza ngakumbi ukuthintela, i-NMDA-receptor antagonism kunye ne-sodium-channel blockade. I-Tricyclic antidepressant, ezinje ngee-TCAs; Umzekelo, i-amitriptyline, imipramine, inortriptyline kunye ne-doxepine, zinamandla ngokuchasana nokuqaqanjelwa okungapheliyo okanye ukutsha kwentlungu kunye nentlungu ezenzekelayo.

 

I-Tricyclic antidepressants iye yangqinwa inempumelelo kakhulu kwintlungu ye-neuropathic kune-serotonin reuptake inhibitors, okanye ii-SSRIs, ezinje ngeFluoxetine, iparoxetine, isertraline kunye ne-citalopram. Isizathu kukuba banokuthi baphinde baphinde baphinde bathathe i-serotonin kunye ne-epinephrine, ngelixa i-SSRIs inhibitake i-serotonin. I-Tricyclic antidepressants inokuba neziphumo ebezingalindelekanga ezimbi, kubandakanya isicaphucaphu, ukudideka, iibhlokhi zentliziyo zokuhambisa, i-tachycardia kunye ne-ventricular arrhythmias. Zinokubangela ukuzuza kwesisindo, isithsaba esinciphileyo kunye ne-orthostatic hypotension. Ii-Tricyclics kufuneka zisetyenziswe ngononophelo kubantu abadala, abasesichengeni ikakhulu kwiziphumo zabo ezimbi. Uxinzelelo lwechiza kwigazi kufuneka lubekwe esweni ukuze kugwetywe ubuthi kwizigulana ezisebenzisa amayeza okucoca umzimba ngokukhawuleza.

 

I-Serotonin-norepinephrine reuptake inhibitors, okanye i-SNRIs, iklasi entsha ye-antidepressants. Njengee-TCA, zibonakala ngathi zisebenza ngakumbi kunee-SSRIs zokunyanga iintlungu ze-neuropathic ngenxa yokuba zikwathintela ukuphinda zibuye zombini i-nor-epinephrine kunye ne-dopamine. I-venlafaxine iyasebenza ngokuchasene ne-polyneuropathies eyonakalisayo, efana ne-neuropathy yesifo seswekile, njenge-imipramine, xa kukhankanywa i-TCA, kwaye zombini zikhulu kakhulu kune-placebo. Njengee-TCAs, ii-SNRIs zibonakala ngathi zibonelela izibonelelo ezizimeleyo kwiziphumo zabo zokungahambi kakuhle. Iziphumo ezibi zibandakanya ukudumba, ukudideka, uxinzelelo lwegazi kunye nesifo sokurhoxa.

 

Iziyobisi zeAntiepileptic

 

Amachiza e-antiepileptic anokusetyenziswa njengonyango lomgca wokuqala ngakumbi kwiintlobo ezithile zentlungu ye-neuropathic. Basebenza ngokumodareyitha i-voltage-gated calcium kunye neesodium sodium, ngokuphucula iimpembelelo ze-GABA kunye nokuthintela ukuhanjiswa kwe-glutaminergic transmit. Amayeza okulwa ne-epileptic awakhange abonakaliswe ukuba asebenza kwintlungu eqaqambileyo. Kwiimeko zentlungu engapheliyo, iziyobisi ze-antiepileptic zibonakala zisebenza kuphela kwi-neuralgia ye-trigeminal. I-Carbamazepine iqashwa rhoqo le meko. UGabapentin, osebenza ngokuthintela umsebenzi we-calcium channel ngokusebenzisa iintshukumo ze-agonist kwi-alpha-2 delta subunit yesitayile se-calcium, ikwabizwa ngokuba isebenza kwintlungu ye-neuropathic. Nangona kunjalo, i-gabapentin isebenza ngokuthe ngqo kwaye inokubangela ukukhathala, ukudideka kunye nokuzonwabisa.

 

Uhlalutyo lwe-non-Opioid

 

Kukho ukunqongophala kwedatha eyomeleleyo exhasa ukusebenzisa amayeza okunyanga angekhoyo kwi-steroidal, okanye i-NSAIDs, ekukhululeni kwintlungu ye-neuropathic. Oku kungabangelwa kukunqongophala kwento edakumbisayo ekunciphiseni iintlungu. Kodwa zisetyenziswe ngokuchaseneyo kunye nee-opioids njengee-adjuvants ekunyangeni iintlungu zomhlaza. Kuxelwe iingxaki, nangona kunjalo, ngakumbi kwizigulana ezinengxaki kakhulu.

 

Uhlalutyo lweOpioid

 

Ii-analgesics ze-Opioid zingumxholo wengxoxo enkulu yokuphelisa iintlungu ze-neuropathic. Benza ngokungathinteli kwintloko ukunyuka kweempembelelo zentlungu. Ngokwemveli, iintlungu ze-neuropathic ziye zabonwa ngaphambili ukuba zinganyangeki i-opioid, apho ii-opioids ziindlela ezifanelekileyo ngakumbi kwiintlobo ezithile zentlungu e-coronary kunye ne-somatic. Oogqirha abaninzi bathintela ukusebenzisa ii-opioids ukunyanga iintlungu ze-neuropathic, kwinxalenye enkulu ngenxa yokuxhalaba malunga nokusebenzisa iziyobisi, iziyobisi kunye nemicimbi elawulayo. Kodwa, zininzi iimvavanyo eziye zafumana i-opioid analgesics ukuba iphumelele. I-Oxecodone yayinamandla kune-placebo yokunciphisa iintlungu, i-allodynia, ukuphucula ukulala kunye nokukhubazeka. I-opioids ezikhutshiweyo ezikhutshiweyo, ngokwesiseko esicwangcisiweyo, ziyacetyiswa kwizigulana ezinentlungu engapheliyo ukukhuthaza amanqanaba e-analgesia rhoqo, thintela ukuguquguquka kwiglucose yegazi kunye nokukhusela izigulo ezichasene ne-dosing ephezulu. Eyona nto ixhaphakileyo, amalungiselelo omlomo asetyenziswa ngenxa yokusebenzisa lula kunye nokusebenzisa iindleko. Amalungiselelo e-trans-dermal, parenteral and rectal asetyenziswa ngokubanzi kwizigulana ezingakwaziyo ukunyamezela iziyobisi zomlomo.

 

I-Anesthetics yendawo

 

I-anesthetics esondeleyo iyabukeka kuba, ngenxa yesenzo sabo sengingqi, baneziphumo ebezingalindelekanga ezincinci. Basebenza ngokuzinzisa amashaneli e-sodium kwi-axons ye-neurons yecala lokuqala loku-odola. Basebenza ngcono ukuba kukho kuphela ukulimala kwenxalenye yenzalo kunye neziteshi ze-sodium ezigqithisileyo eziqokelelweyo. I-lidocaine yodidi oluphezulu lolona mmeli ufundwayo obalaseleyo wezifundo zentlungu ye-neuropathic. Ngokukhethekileyo ukusetyenziswa kwale 5 yepesenti ye-lidocaine patch ye-post-herpetic neuralgia kubangele ukuvunywa kwayo yi-FDA. I patch ibonakala isebenza kakuhle xa yonakele, kodwa igcinwe, umsebenzi we-nociceptor we-neripheror ovela kwimithambo echaphazelekayo ebonakalisa njenge-allodynia. Kufuneka isethwe ngokuthe ngqo kwindawo enophawu kwiiyure ze-12 kwaye isuswe kwenye iiyure ze-12 kwaye inokusetyenziswa iminyaka ngale ndlela. Ngaphandle kokuphazamiseka kolusu lwengingqi, ihlala inyamezeleka kakuhle kwizigulana ezininzi ezinentlungu ye-neuropathic.

 

Iziyobisi ezichanekileyo

 

I-Clonidine, i-alpha-2-agonist, yaboniswa ukuba iyasebenza kwi-subset yezigulana ezine-diabetesic peripheral neuropathy. I-Cannabinoids ifunyenwe idlala indima yokuvavanywa kweentlungu kwiimodeli zezilwanyana kunye nobungqina bokusebenza ngokuqokelelwa. Ii-agonists ezikhethiweyo ze-CB2 zanyanzela i-hyperalgesia kunye ne-allodynia kwaye zilungelelanise nemibandela ye-nocicilos ngaphandle kokuphembelela i-analgesia.

 

Ulawulo lobuhlungu oluqhubekayo

 

Unyango olungenakunyangwa lungathathelwa ingqalelo kwizigulana ezinentlungu engenakuphazamiseka. Olu nyango lubandakanya inaliti yokuqunjelwa sisifo okanye i-perineural ye-anesthetics yendawo okanye i-corticosteroids, ukufakwa kweendlela zokuhanjiswa kwamachiza okubulala intsholongwane kunye nokufakelwa kwezixhobo zokunyusa umgogodla. Ezi ndlela zigcinelwe izigulana ezineentlungu ezinganyangekiyo ze-neuropathic ziye zangaphumeleli kulawulo lwezonyango olongeziweyo kwaye ziye zafumana uvavanyo olupheleleyo lwengqondo. Kuphononongo olwenziwa nguKim et al, kwaboniswa ukuba i-spinal intambo yokunyusa intsholongwane yayisebenza kakuhle kunyango lwentlungu ye-neuropathic yemvelaphi ye-nerve.

 

Insight of Dr. Alex Jimenez

Ngeentlungu ze-neuropathic, iimpawu zentlungu ezingapheliyo zenzeka ngenxa ye-nerve fibers ngokwazo eyonakalisiweyo, engasebenziyo okanye eyenzakeleyo, ngokubanzi ehamba kunye nokulimala kwezicubu okanye ukwenzakala. Ngenxa yoko, le micu yemithambo-luvo inokuqalisa ukuthumela imiqondiso engalunganga yentlungu kwezinye iindawo zomzimba. Iziphumo zentlungu ye-neuropathic ebangelwa kukulimala kwentsholongwane ye-nerve kubandakanya ukulungiswa komsebenzi we-nerve zombini kwindawo yokulimala kunye nakwiindawo ezijikeleze ukulimala. Ukuqonda i-pathophysiology ye-neuropathic pain ibe yinjongo yabaninzi bezonyango, ukuze kumiselwe ngokufanelekileyo indlela efanelekileyo yokunyanga ukunceda ukuphatha kunye nokuphucula iimpawu zayo. Ukusuka ekusetyenzisweni kweziyobisi kunye / okanye amayeza, ukuya kukhathalelo lwe-chiropractic, ukuzivocavoca, ukwenza umthambo kunye nesondlo, iindlela ngeendlela zonyango zinokusetyenziselwa ukunceda ukunciphisa intlungu ye-neuropathic kwiimfuno zomntu ngamnye.

 

Ungenelelo olongezelelweyo lweNeuropathic Pain

 

Uninzi lwezigulana ezinentlungu ye-neuropathic zigcina zilungiselelwe kunye nezinye iindlela zonyango zokunyanga iintlungu ze-neuropathic. Ezinye iirejimeni ezaziwayo ezisetyenziselwa ukunyanga iintlungu ze-neuropathic zibandakanya ukunyanzelwa, ukukhuthazeka kombane, ukunyusa isimilo sentsimbi yombane, unyango lokuziphatha okubonakalayo, imifanekiso eqingqiweyo yeemoto kunye nonyango oluxhasayo, kunye nokuzivocavoca. Phakathi kwezi, nangona kunjalo, ukhathalelo lwe-chiropractic yindlela eyaziwayo yonyango esetyenziselwa ukunceda ukunyanga iintlungu ze-neuropathic. Ukunyamekelwa kwe-Chiropractic, kunye nonyango lomzimba, ukuzivocavoca, ukondla kunye nokuguqulwa kwendlela yokuphila kunokubonelela ngokuphumla kwiimpawu zentlungu ye-neuropathic.

 

Ukhathalelo lweChiropractic

 

Yintoni eyaziwayo kukuba isicelo esipheleleyo sokuphatha sibalulekile ukulwa nefuthe leentlungu ze-neuropathic. Ngale ndlela, ukhathalelo lwe-chiropractic yonyango olupheleleyo olunokusebenza ngempumelelo ekuthinteleni imiba yezempilo enxulumene nomonakalo wezinyo. Ukunyangwa kwe-Chiropractic kubonelela ngoncedo kwizigulana ezineemeko ezininzi ezahlukeneyo, kubandakanya nezo zinentlungu ye-neuropathic. Iintlungu zentlungu ye-neuropathic ihlala isebenzisa amayeza angenayo i-steroidal-anti-immune, okanye i-NSAIDs, njenge-ibuprofen, okanye i-painkillers enzima yokufumana unyango ukunceda ukunciphisa intlungu ye-neuropathic. Oku kunokubonelela ngokulungiswa okwethutyana kodwa kufuna ukusetyenziswa rhoqo ukulawula intlungu. Oku kungenisa njalo kwimiphumo emibi nakwiimeko ezixhalabisayo, ukuxhomekeka kugqirha ngamachiza.

 

Ukunyamekelwa kwe-Chiropractic kunokunceda ukuphucula iimpawu zentlungu ye-neuropathic kunye nokuphucula ukuzinza ngaphandle kwezi zihla. Indlela efana nokhathalelo lwe-chiropractic inikezela ngenkqubo eyenzelwe ngokukodwa ukukhangela ingcambu yomba. Ngokusebenzisa uhlengahlengiso lomgogodla kunye nokuxhaphaka ngesandla, i-chiropractor inokulungisa ngononophelo naluphi na ugwenxa lomgogodla, okanye ukuthambeka, okufunyanwa kunye nobude bomgogodla, onokuthi unciphise iziphumo zokulimala kwemithambo-luvo ngokulungelelanisa umqolo. Ukubuyisela ingqibelelo yomgogodla kubalulekile ekugcineni inkqubo yokusebenza yovalo oluphezulu.

 

I-chiropractor inokuba lonyango lwexesha elide ekwenzeni ngcono impilo yakho iyonke. Ngaphandle kohlengahlengiso lomgogodla kunye nokuxhaphaka ngesandla, i-chiropractor inokubonelela ngengcebiso yesondlo, njengokuchonga ukutya okutyebileyo kwi-antioxidants, okanye banokuyila unyango lomzimba okanye inkqubo yokuzivocavoca ukulwa nentlungu ye-nerve flair-ups. Imeko yexesha elide ifuna unyango lwexesha elide, kwaye kule nqanaba, ochwepheshe bezempilo abagxile ekulimaleni kunye / okanye iimeko ezichaphazela inkqubo ye-musculoskeletal and system, efana nogqirha we-chiropractic okanye i-chiropractor, banokubaluleka njengoko besebenza ukulinganisa utshintsho olufanelekileyo ngokuhamba kwexesha.

 

Unyango ngokwasemzimbeni, ukuzivocavoca kunye neendlela zokumela intshukumo zibonakalisiwe ziluncedo kunyango lwentlungu ye-neuropathic. Unonophelo lweChiropractic lubonelela kwezinye iindlela zonyango ezinokuba luncedo kulawulo okanye ukuphuculwa kwentlungu ye-neuropathic. Unyango lwe-laser olukumgangatho ophantsi, okanye i-LLLT, umzekelo, luye lwafumana ukuvelela okukhulu njengonyango lweentlungu ze-neuropathic. Ngokwezifundo ezahlukeneyo zophando, kwagqitywa ekubeni i-LLLT ineempembelelo ezilungileyo kulawulo lwe-analgesia kwintlungu ye-neuropathic, nangona kunjalo, uphando olongezelelweyo luyafuneka ukuchaza iiprotocol zonyango ezishwankathela imiphumo yonyango lwe-laser ephantsi kunyango lwentlungu ye-neuropathic.

 

Ukunyamekelwa kwe-Chiropractic kukwabandakanya nengcebiso yesondlo, enokunceda ukulawula iimpawu ezinxulumene neswekile yengqondo. Ngexesha lophando, isityalo esisezantsi esisekwe emafutheni saboniswa ukuba siphucule ulawulo lweglycemic kwizigulana ezinesifo seswekile se2. Emva kweeveki ze-20 zesifundo somqhubi, abantu ababandakanyekayo baxela utshintsho kwimilinganiselo yomzimba kunye nokuziphatha kwesikhumba ezinyaweni kuye kwathiwa kuphuculwe ngongenelelo. Isifundo sophando siphakamise ixabiso elinokubakho kungenelelo lokutya olusekwe ngamafutha asezantsi kwisifo seswekile yengqondo. Ngaphezu koko, izifundo zeklinikhi zifumanise ukuba ukusetyenziswa komlomo we-magnesium L-threonate iyakwazi ukuthintela kunye nokubuyisela ukukhubazeka kwenkumbulo okunxulumene nentlungu ye-neuropathic.

 

Ukunyamekelwa kwe-Chiropractic kunokubonelela ngeendlela ezongezelelweyo zonyango lokukhuthaza ukuvuselelwa kwe-nerve. Ngomzekelo, ukuphucula ngokutsha kwe-axons kuye kwacetyiswa ukunceda ukuphucula ukubuyela kwimeko yesiqhelo emva kokulimala kwemithambo yengozi. Ukuvuselelwa kombane, kunye nokuzivocavoca okanye imisebenzi yomzimba, kwafunyanwa ukukhuthaza ukuvuselelwa kwemithambo-luvo emva kokulibaziseka kolungiso lwezinyo ebantwini nasezirheni, ngophando lwamva nje. Zombini zokuvuselelwa kombane kunye nokuzivocavoca okokugqibela zazimisele ukuthembisa unyango lokunyanga ukulimala kwemithambo yegazi okubonakala kulungele ukuhanjiswa kusetyenziso lweklinikhi. Izifundo ezongezelelweyo zophando zingadingeka ukufumanisa ngokupheleleyo iziphumo zezi zigulana ezineentlungu ze-neuropathic.

 

isiphelo

 

Intlungu ye-neuropathic liqumrhu elineenkalo ezininzi elingenazikhokelo ezithile zokunyamekela. Ilawulwa ngcono kusetyenziswa indlela yee-multidisciplinary. Ukulawulwa kweentlungu kufuna ukuvavanywa okuqhubekayo, imfundo yesigulane, ukuqinisekisa ukulandelwa kwesigulane kunye nokuqinisekiswa. Intlungu ye-neuropathic yimeko engapheliyo eyenza ukuba ukhetho lonyango olungcono lube ngumngeni. Unyango lomntu ngamnye lubandakanya ukuqwalaselwa kwempembelelo yentlungu kwintlalontle yomntu, ukudakumba kunye nokukhubazeka kunye nemfundo eqhubekayo kunye novavanyo. Izifundo zeentlungu ze-neuropathic, zombini kwinqanaba le-molecular kunye nemodeli yezilwanyana, zintsha kodwa zithembisa kakhulu. Uphuculo oluninzi lulindelwe kwiinkalo ezisisiseko kunye neekliniki zeentlungu ze-neuropathic kungoko kuvula iingcango zokuphucula okanye iindlela zonyango olutsha lwale meko yokukhubaza. Ububanzi bolwazi lwethu bukhawulelwe kwi-chiropractic kunye nokulimala komgogodla kunye neemeko. Ukuxoxa ngalo mbandela, nceda uzive ukhululekile ukubuza uGqr. Jimenez okanye uqhagamshelane nathi apha915-850-0900 .

 

Ikhutshwe nguDkt. Alex Jimenez

 

 

Imixholo eyongezelelweyo: Ubunzima bokubuyisela

 

Umqolo obuhlungu enye yezona zizathu ezibangeleko zokukhubazeka kunye neentsuku eziphosakeleyo emhlabeni wonke. Njengokuba kunjalo, iintlungu zenziwa emva kweyona sibini isizathu esivakalayo sokutyelela iofisi yee-dkt. Ngokumalunga neepesenti ze-80 zabemi ziya kuba nolunye uhlobo lweentlungu zentlungu ubuncinane kanye kanye ebomini babo. Umgudu uyisakhiwo esiyinkimbinkimbi esakhiwa ngamathambo, amajoyina, iigaments kunye nezihlunu, phakathi kwezinye iifomthi ezithambileyo. Ngenxa yoko, ukulimala kunye / okanye iimeko ezihlaziyiweyo, ezifana disni, ekugqibeleni unokukhokelela kwiimpawu zentlungu. Ukulimala kwezemidlalo okanye ukulimala kwengozi yeemoto ngokuqhelekileyo kubangelwa yintlungu yokubuhlungu, kodwa ngamanye amaxesha ukuhamba kwezinto ezilula kunokuba neziphumo ezibuhlungu. Ngethamsanqa, ezinye iindlela zokhathalela unyango, ezifana nokunyamekelwa kwe-chiropractic, kunokunceda ukubuyisela intlungu emva kokusetyenziswa kwemilenze kunye nokunyanzeliswa kwemigaqo, ekugqibeleni ukuphucula intlungu.

 

 

 

ISIHLOKO ESIBALULEKILEYO: Ulawulo oluPhantsi lwePain Pain

 

IINKCUKACHA NGOKUGQITHISILEYO: UKONGEZA KWEZINTLOKO: PainUbuhlungu obungapheliyo kunye nonyango