I-Radiculalgia ubuhlungu bemvelaphi yezinzwa. Lobu buhlungu bubizwa ngokuthi i-radicular ngoba buthinta impande yemizwa. Lesi simo ngokuvamile sibangelwa ukucindezelwa kwenzwa yomgogodla (enamathiselwe emgogodleni) empandeni yayo. Ukucindezelwa okunjalo kungase kube umphumela we-osteoarthritis yomgogodla, i-disc herniated noma i-tumor yethambo noma yezinzwa. Ngokwe-Etymologically, igama elithi radiculalagie lakhiwa kusukela kwelesiLatini elithi "radicula", elinciphisa i-radix elisho impande, futhi kusukela ku-suffix yemvelaphi yesiGreki "algie" okusho ubuhlungu. Lobu buhlungu buvame ukuba namandla kakhulu. Iziveza yonke indlela ye-nerve. Kusukela emgogodleni, idlulela emilenzeni engaphezulu noma ephansi futhi ivame ukuhambisana nokuphazamiseka kokuzwela.

Ubuhlungu bezinto eziningi

I-Radicuralgia, eqinisweni, i-multifactorial: ihlanganisa kokubili izici zemishini namakhemikhali. Izici ezivame kakhulu zemishini ukukhahlameza, njengokuphakamisa umthwalo osindayo, ukunyakaza okungamanga njengokusonteka komzimba. Ngokuqondene nezici zamakhemikhali ezivame kakhulu, zibandakanya ukuxhumana okulula kwe-nerve nezicubu ezitholakala phakathi kwama-discs, ezikwazi ukubangela ukusabela kokuvuvukala. Lokhu kuzokwehlisa isivinini sokuqhutshwa kwezinzwa.

Ukuxilongwa kobuhlungu obukhulu

Ukuxilongwa kwe-radiculalgia kusekelwe ku-neuroimaging (i-computed tomography noma i-magnetic resonance imaging) yendawo ethintekile. Ngezinye izikhathi kuyadingeka ukwenza ukuhlolwa kwe-electrophysiological kanye. Uma imaging ingazange ibone noma yikuphi ukungahambi kahle kwe-anatomical, ukuhlaziywa koketshezi lwe-cerebrospinal kuzokwenza kube nokwenzeka ukubheka izimbangela ezithathelwanayo noma ezivuthayo. Ngaphezu kwalokho, ushukela wegazi ozila ukudla nawo uzofundelwa isifo sikashukela esingase sibe khona.

Ukuphazamiseka komgudu wezimpande kubangelwa umfutho wegazi ophakeme noma oyingozi kakhulu othinta impande yenzwa phakathi noma eduze nomgogodla. Ngakho-ke ubuhlungu buza, ngokuvamile, kusukela ekucindezelweni kwalesi zimpande zezinzwa ezingeni le-vertebra, futhi kungabangelwa:

• i-herniated intervertebral disc. Lokhu kubonakala kwe-disc ye-herniated ezingeni le-disc etholakala phakathi kwama-vertebrae amabili;
• ukukhubazeka kwamathambo okubangelwa i-rheumatoid arthritis noma i-osteoarthritis, engacindezela izimpande zemizwa ngayinye. Ngakho, ukugqoka kwe-disc intervertebral okubangelwa i-osteoarthritis, isibonelo, kungabangela i-radiculgia;
• ukuncipha komsele womgogodla ophakathi kwe-vertebrae ye-back back, okubangela ukucindezelwa kwezimpande zezinzwa;
• ukuthuthukiswa kwesimila sethambo noma sezinzwa;
• ngaphezu kwalokho, ukubonakala kwe-postoperative radiculgia kungase kwenzeke ngemva kokuhlinzwa kwe-disc.

Isizathu sokuqala se-radiculgia: i-herniated disc

I-herniated disc iyimbangela yokuqala yobuhlungu bezimpande. Incazelo yakudala yileyo yokucindezelwa kwemishini noma ukuwohloka kwezimpande zezinzwa, okuyimbangela eyinhloko yobuhlungu. Kodwa-ke, kufanele futhi wazi ukuthi ngaphezu kwalokho, i-radiculalgia ingabangelwa ingxenye yokuvuvukala noma yokuzivikela engenzeka nge-disc herniated. Imiphumela yocwaningo lwesayensi ibonise ukuthi izinguquko ku-peripheral blood T cell subsets zenzeka ngenxa yokuqhuma kwama-disc lumbar invertebrate. Ababhali bocwaningo baphetha ngokuthi izindlela ze-immunologic kungenzeka zihileleke ebuhlungu obuhlobene ne-disc herniated. Ngaphezu kwalokho, ukwanda kwama-cytokines athile nakho kungabangela ubuhlungu obukhulu.

Izimpawu ezivame kakhulu ze-radiculgia yizi:

• ubuhlungu obukhulu kakhulu obuvame kakhulu;
• ukushoshozela, ukuba ndikindiki, ukukhala;
• ubuthakathaka bemilenze noma ngisho nokukhubazeka;
• i-anesthesia yesikhumba;
• ngaphezu kwalokho, ukukhwehlela, ukuthimula, noma ukusunduza kungenza izinhlungu zibe zimbi nakakhulu.

Ukwelapha ubuhlungu obungapheli kuyinkimbinkimbi, nge-paracetamol kanye nemithi elwa nokuvuvukala e-steroidal ngokuvamile esebenza kancane futhi isikhathi eside ukusetshenziswa kwama-NSAID okumelela ingozi enkulu.

Ukwelashwa kwe-radiculalgia kuhloswe ngakho kokubili ukukhulula ubuhlungu nokunciphisa ukukhubazeka okubangelwayo. Ukwelashwa kusekelwe ngaphezu kwakho konke ekwelashweni kwezidakamizwa, kanye nokuvuselelwa yi-physiotherapist ezokhulula ukungezwani komgogodla.

Izidakamizwa zokwelapha

• Ama-analgesics (ama-painkillers): ngokuvamile, i-paracetamol, isigaba I-analgesic, ayanele. Ngakho-ke ingahlanganiswa ne-caffeine, i-codeine noma i-tramadol. Ngokuqondene nama-morphine (ama-analgesics e-level III), kufanele asetshenziswe kancane, futhi abekelwe i-hyperalgesic radiculgia;
• Izidakamizwa ezingezona ukuvuvukala (ama-NSAID): i-ketoprofen, i-diclofenac, i-naproxen ivame ukunikezwa ngokuhambisana nezinyathelo ze-II zokunciphisa ubuhlungu. Umphumela wabo wokudambisa izinhlungu awudluli ama-analgesics wodwa. Akufanele zisetshenziswe ngaphezu kwezinsuku eziyishumi kuya emavikini amabili. Uma ubuhlungu bubuya ngemva kokumisa izinsuku ezimbalwa, zingabekwa isikhathi eside;
• Ama-Antiepileptics: i-pregabalin, i-gabapentin ne-pregabapentin ama-molecule asetshenziswa ngoba asebenza ku-nerve fiber ngokwayo;
• I-Corticosteroid therapy: i-prednisone ne-prednisolone ama-corticosteroids omugqa wesibili uma izidakamizwa ezilwa nokuvuvukala zingaboniswanga zisebenza ngempumelelo ebuhlungu. Zikhishwa esikhathini esifushane esiyizinsuku eziyisikhombisa kuya kweziyishumi. Zingabuye ziphathwe ngokungeniswa, okwenza kube lula ukuletha ukuhlushwa okuphezulu komkhiqizo osebenzayo ezingeni lobuhlungu. Ziboniswa ngokuyisisekelo kuphela lapho kungabikho ngcono ngemva kwamasonto amathathu okwelashwa kwezidakamizwa.

Ukwelashwa okungezona izidakamizwa

• I-Lombostat: igobolondo eliqinile elenzelwe ukukala uchwepheshe wamathambo. Epulasitiki, isikhumba nensimbi, ngisho ne-plaster noma i-resin, isibalo se-lumbar sivumela ukukhubazeka okuhlobene kwe-lumbar vertebrae, ngendlela yokwesekwa okuvela ohlangothini lwe-pelvis kuya ezimbanjeni zokugcina. Isenzo salo ukufeza ukuvinjelwa kwe-lumbar ngokuvikela i-trunk ku-pelvis. Ngokuqondile, ngaleyo ndlela kwenza kube nokwenzeka ukugwema ukunyakaza okungamanga kanye nokuqinisekisa ukuphumula komhlane. Ngaphezu kwalokho, kunciphisa ukucindezeleka okwenziwa kuma-vertebrae;
• Ukuvuselela: Izikhathi zokuvuselela i-physiotherapist zisiza ukukhulula ukungezwani ku-vertebrae, futhi uvumele ukuqeqeshwa kabusha umzamo ukuze ubuyisele emuva ezinyaweni zawo. Ngisho nasezinhlungwini, kubaluleke kakhulu ukuhlala uhamba futhi usebenza. Inhloso yalokhu kuqeqeshwa ukuqinisa izicubu zayo, ukuthuthukisa amandla ayo omzimba, kanye nokuzivocavoca okwenziwa kusukela ekugibeleni ibhayisikili kuye kokugijima, okuhlanganisa ukushefa, ukuvivinya umzimba kwesisu, njll;
• I-Yoga nokubhukuda: umkhuba wale midlalo emibili uzophumuza umgogodla, kodwa futhi ukhulule ukuqina kwemisipha;
• I-Osteopathy: isiza ukunciphisa ukucindezelwa. Ngakho-ke, le ndlela yokwelapha engajwayelekile ihlose ukukhulula ukuphazamiseka kokusebenza. Isekelwe ekuphathweni ngesandla kwesistimu ye-musculoskeletal kanye namasu okukhululwa kwe-myofascial;
• Ukuhlinzwa: kungasetshenziswa njengendlela yokugcina.

Ukuvimbela i-radiculgia

Ukuze uvimbele i-radiculgia, amathiphu ambalwa kufanele akhunjulwe, njenge:

• gwema ukunyakaza okusontekile kwe-trunk lapho ufuna ukubamba into engemuva kwakho;
• uthanda ojosaka phezu kwezikhwama futhi usebenzise amahlombe womabili ukuphatha ubhaka;
• noma ukuthatha indawo enhle ngenkathi ulele, ikakhulukazi ngokuba nomatilasi onethezekile kanye nomcamelo ongadali i-engeli enkulu ngokwedlulele ezingeni lentamo.

Ezinye izindlela zokwelapha

• Transcutaneous kagesi neurostimulation;
• Thermotherapy;
• I-acupuncture ;
• Ukuphumula nokuzindla: lezi zindlela ezimbili zenza kube lula ukudlala phansi ukwesaba okuholela ekwesabeni ukunyakaza, kodwa futhi ukukhulula ukukhathazeka nokucindezeleka okuhlobene nobuhlungu.