Radiculgia ndi ululu wamanjenje woyambira. Ululu umenewu umatchedwa radicular chifukwa umakhudza mizu ya mitsempha. Matendawa nthawi zambiri amayamba chifukwa cha kukanikizana kwa mitsempha ya msana (yolumikizidwa ku msana) pamizu yake. Kupanikizika kotereku kungakhale chifukwa cha osteoarthritis ya msana, diski ya herniated kapena ngakhale fupa kapena chotupa cha mitsempha. Etymologically, mawu akuti radiculalagie amapangidwa kuchokera ku Chilatini "radicula", diminutive of radix kutanthauza muzu, ndi kuchokera ku chiganizo cha chiyambi cha Chigriki "algie" chomwe chimatanthauza kupweteka. Ululu umenewu nthawi zambiri umakhala waukulu kwambiri. Imadziwonetsera yokha panjira yonse ya mitsempha. Kuyambira pamsana, imafikira kumtunda kapena kumunsi kwa miyendo ndipo nthawi zambiri imatsagana ndi kusokonezeka kwa chidziwitso.

Multifactorial ululu

Radicuralgia ndi, kwenikweni, multifactorial: imaphatikiza zonse zamakina ndi mankhwala. Zomwe zimachitika kwambiri zamakina ndizovuta, monga kukweza katundu wolemera, kuyenda kwabodza monga kupotoza thupi. Ponena za zinthu zomwe zimachitika pafupipafupi, zimaphatikizapo kulumikizana kosavuta kwa mitsempha ndi minofu yomwe ili pakati pa ma disc, omwe amatha kuyambitsa kutupa. Izi zipangitsa kuchepetsa kuthamanga kwa mitsempha.

Kuzindikira kupweteka kwakukulu

Kuzindikira kwa radiculgia kumachokera ku neuroimaging (computed tomography kapena magnetic resonance imaging) ya dera lomwe lakhudzidwa. Nthawi zina ndikofunikira kuchita mayeso a electrophysiological. Ngati kujambula sikunapeze vuto lililonse la anatomical, kusanthula kwa cerebrospinal fluid kumapangitsa kuti athe kuyang'ana zomwe zimayambitsa matenda kapena kutupa. Kuphatikiza apo, shuga wamagazi osala kudya adzaphunziridwanso za matenda omwe angakhalepo.

Matenda a mitsempha ya mizu amayamba chifukwa cha matenda oopsa kwambiri kapena oopsa omwe amakhudza mizu ya mitsempha mkati kapena pafupi ndi msana. Kupweteka kotero kumabwera, nthawi zambiri, chifukwa cha kukanikiza kwa muzu wa minyewa pamlingo wa vertebra, ndipo zimatha chifukwa:

• herniated intervertebral disc. Ichi ndi maonekedwe a diski ya herniated pamlingo wa diski yomwe ili pakati pa ma vertebrae awiri;
• mafupa opunduka chifukwa nyamakazi nyamakazi kapena osteoarthritis, amene akhoza compress munthu minyewa mizu. Choncho, kuvala kwa intervertebral disc chifukwa cha osteoarthritis, mwachitsanzo, kungayambitse radiculgia;
• kuchepa kwa msana wa msana womwe uli pakati pa vertebrae kumunsi kumbuyo, zomwe zimayambitsa kukanikiza kwa mizu ya mitsempha;
• kukula kwa fupa kapena minyewa chotupa;
• kuonjezera apo, maonekedwe a postoperative radiculgia amathanso kuchitika pambuyo pa opaleshoni ya disc.

Chifukwa choyamba cha radiculgia: herniated disc

Dongosolo la herniated ndilomwe limayambitsa kupweteka kwa mizu. Kufotokozera kwachikale ndi kujambulira kwa makina kapena kusinthika kwa mizu ya mitsempha, yomwe ndi chifukwa chachikulu cha ululu. Komabe, muyenera kudziwa kuti kuwonjezera apo, radicuralgia ikhoza kuyambitsidwa ndi gawo lotupa kapena chitetezo cha mthupi chomwe chingachitike ndi disc ya herniated. Zotsatira za kafukufuku wa sayansi zinasonyeza kuti kusintha kwa maselo a T cell ozungulira magazi kumachitika chifukwa cha kuphulika kwa ma lumbar invertebrate discs. Olemba maphunzirowo adatsimikiza kuti njira za immunological zikhoza kukhala zowawa zomwe zimagwirizanitsidwa ndi diski ya herniated. Kuonjezera apo, kuwonjezeka kwa ma cytokines kungapangitsenso kupweteka kwakukulu.

Zizindikiro zodziwika bwino za radiculgia ndi:

• pafupipafupi kwambiri kupweteka pachimake;
• kuyabwa, dzanzi, kumva kuwawa;
• kufooka kwa miyendo kapena ngakhale ziwalo;
• opaleshoni ya khungu;
• kuonjezera apo, kutsokomola, kuyetsemula, kapena kukankha kungapangitse ululuwo kukulirakulira.

Kuchiza kupweteka kosalekeza kumakhala kovuta, ndi paracetamol ndi steroidal anti-inflammatory drugs nthawi zambiri zimakhala zothandiza pang'ono komanso kugwiritsa ntchito nthawi yayitali NSAID zomwe zimayimira chiopsezo chachikulu.

Chithandizo cha radiculgia chimafuna kuthetsa ululu komanso kuchepetsa kulumala komwe kumayambitsa. Mankhwalawa amachokera pamwamba pa chithandizo chamankhwala, komanso kukonzanso ndi physiotherapist yemwe adzathetsa kupsinjika kwa msana.

Mankhwala osokoneza bongo

• Ma analgesics (ochepetsa ululu): nthawi zambiri, paracetamol, siteji yoyamba ya analgesic, sikwanira. Choncho, zikhoza kuphatikizidwa ndi caffeine, codeine kapena tramadol. Ponena za morphine (level III analgesics), iyenera kugwiritsidwa ntchito mochepa, ndikusungidwa kwa hyperalgesic radiculgia;
• Nonsteroidal anti-inflammatory drugs (NSAIDs): ketoprofen, diclofenac, naproxen nthawi zambiri amaperekedwa limodzi ndi ma analgesics a sitepe II. Zotsatira zawo zochepetsera ululu siziposa ma analgesics okha. Asamagwiritsidwe ntchito kwa masiku opitilira khumi mpaka milungu iwiri. Ngati ululu ubwereranso pambuyo posiya kwa masiku angapo, akhoza kulembedwa kwa nthawi yaitali;
• Antiepileptics: pregabalin, gabapentin ndi pregabapentin ndi mamolekyu omwe amagwiritsidwa ntchito chifukwa amagwira ntchito pa mitsempha yokha;
• Thandizo la Corticosteroid: prednisone ndi prednisolone ndi njira yachiwiri ya corticosteroids ngati mankhwala osagwiritsidwa ntchito poletsa kutupa sanasonyezedwe kuti ndi othandiza polimbana ndi ululu. Amaperekedwa kwa nthawi yochepa ya masiku asanu ndi awiri mpaka khumi. Zitha kuperekedwanso ndi kulowetsedwa, zomwe zimapangitsa kuti zikhale zotheka kupereka mankhwala okhudzidwa kwambiri ku mlingo wa ululu. Iwo anasonyeza kwenikweni kokha pakalibe kusintha pambuyo milungu itatu mankhwala mankhwala.

Mankhwala osagwiritsa ntchito mankhwala

• Lombostat: ndi chipolopolo cholimba chomwe chimapangidwa kuti chiyezedwe ndi katswiri wa mafupa. Mu pulasitiki, zikopa ndi zitsulo, ngakhale pulasitala kapena utomoni, chiwerengero cha lumbar chimalola kuti chiuno cha msana chisasunthike, pogwiritsa ntchito chithandizo chomwe chimachokera kumbali ya pelvis kupita ku nthiti zomaliza. Zochita zake ndikukwaniritsa kutsekeka kwa lumbar poteteza thunthu ku pelvis. Mwachindunji, zimapangitsa kuti zikhale zotheka kupewa kusuntha kwabodza komanso kuonetsetsa kuti msana wina umakhalapo. Kuphatikiza apo, imachepetsa kupsinjika komwe kumachitika pa vertebrae;
• Kubwezeretsanso: Magawo okonzanso ndi physiotherapist amathandizira kuthetsa kupsinjika kwa vertebrae, ndikulola kuyambiranso kuyesayesa kuti mubwezeretse msana wanu pamapazi ake. Ngakhale mukumva zowawa, ndikofunikira kwambiri kuti mukhalebe oyenda komanso achangu. Cholinga cha maphunzirowa ndikulimbitsa minofu yake, kuwongolera mphamvu zake, komanso zolimbitsa thupi zomwe zimayambira panjinga mpaka kuthamanga, kuphatikiza masewera olimbitsa thupi, masewera olimbitsa thupi am'mimba, ndi zina zambiri;
• Yoga ndi kusambira: mchitidwe wa masewera awiriwa kumasuka msana, komanso kuthetsa contractures minofu;
• Osteopathy: imathandizira kuchepetsa kupsinjika. Choncho, njira iyi ya mankhwala osagwirizana ndi cholinga chothetsa vuto la ntchito. Zimakhazikitsidwa ndi kuwongolera pamanja kwa minofu ndi mafupa komanso njira zotulutsa myofascial;
• Opaleshoni: itha kugwiritsidwa ntchito ngati njira yomaliza.

Kupewa kwa radiculgia

Pofuna kupewa radiculgia, malangizo angapo ayenera kukumbukiridwa, monga:

• pewani kusuntha kwa thunthu pamene mukufuna kugwira chinthu chomwe chili kumbuyo kwanu;
• konda zikwama kuposa zikwama zam'manja ndikugwiritsa ntchito mapewa onse kunyamula chikwama;
• kapena kukhala ndi malo abwino pogona, makamaka pokhala ndi matiresi abwino komanso pilo yomwe simapanga ngodya yaikulu kwambiri pamtunda wa khosi.

Njira zina zochiritsira

• Transcutaneous magetsi neurostimulation;
• Thermotherapy;
• Acupuncture;
• Kupumula ndi kusinkhasinkha: njira ziwirizi zimapangitsa kuti zitheke kuchepetsa mantha omwe amachititsa mantha akuyenda, komanso kuthetsa nkhawa ndi nkhawa zokhudzana ndi ululu.