Ischialgia yog Latin rau mob hauv plab. Sciatica yog ib tug pinched sciatic paj hlwb nrog tom qab o. Pathology tsis yog ib qho kev cais nosology thiab suav hais tias yog ib qho kev tshwm sim ntawm cov kab mob ntawm tus txha nqaj qaum, nyob rau hauv uas kev hloov pauv pathological tshwm sim hauv cov ntaub so ntswg, pob txha thiab cov leeg nyob ze ntawm lub paj hlwb sciatic. Lawv tso siab rau lub paj hlwb, ua rau mob. Ntev npaum li no, qhov mob hnyav dua yuav dhau mus.
Anatomy excursion
Cov hlab ntsha sciatic yog qhov loj tshaj plaws, ntev thiab tuab tshaj plaws, ncav cuag 1 cm ntawm txoj kab uas hla ntawm cov txiv neej. Nws pib nyob rau hauv lub lumbar cheeb tsam los ntawm lub sacral paj hlwb plexus, tawm ntawm tus txha nraub qaum, los ntawm lub coccyx thiab lub pelvic nto nyob rau sab nraum qab mus rau ob txhais ceg. Ntawm no, ntawm sab ceg, nws muab faib ua 2 pawg, thiab txhua tus mus rau ib ceg mus rau taw. Yog li, nws cov paj hlwb kov ntau qhov chaw, thiab qhov mob thaum nws o yog hnov nyob rau hauv ntau qhov chaw ntawm lub cev. Nws txoj haujlwm yog muabsensory thiab lub cev muaj zog innervation ntawm qis extremities.
Ua rau thiab yam tseem ceeb rau kev loj hlob ntawm sciatica
feem ntau ua rau sciatica yog:
- Osteochondrosis, osteoarthritis ntawm cov pob qij txha intervertebral. Nyob rau hauv cov ntaub ntawv no, spikes daim ntawv ntawm lub vertebrae, uas provoke o.
- Intervertebral hernia. Nrog rau lawv, ib tug protrusion ntawm lub disc tshwm sim thiab cov hauv paus hniav uas ua rau cov hlab ntsha yog pinched.
- Tunnel neuropathies.
- Piriformis Syndrome (nws yog cov leeg lub luag haujlwm rau kev txav ntawm lub duav). Peb yuav tsum tham txog nws vim nws nyob ze rau ntawm cov hlab ntsha sciatic.
- Stenosis ntawm tus txha caj qaum.
- hlav thiab neoplasms.
- Kab mob sib kis. Cov paj hlwb raug cuam tshuam los ntawm co toxins los ntawm cov kab mob xws li TB, typhoid, malaria, syphilis. Tom qab ntawd, nws yuav mob.
- Hypothermia tuaj yeem dhau los ua qhov tshwm sim thaum lub cev tiv thaiv tsis muaj zog.
Symptomatic manifestations
Kev tshwm sim ntawm cov hlab ntsha pinched sciatic - cov tsos mob ntawm cov hlab ntsha ntawm qhov kawg. Lawv pib los ntawm sab nraub qaum, nqes mus rau hauv lub pob tw, thiab tom qab ntawd nrog rau sab nraub qaum mus rau ko taw, lawv ua kom nruj nrog kev txav thiab thauj khoom txhua yam, txham, hnoos, luag. Thaum tsaus ntuj, ib tug neeg raug yuam kom sawv los hloov txoj haujlwm. Tom qab ntawd, qhov mob tuaj yeem thaiv kev txav mus los.
Tus yam ntxwv tshaj plaws yog qhov tshwm sim ntawm kev nruj. Thaum khoov ob txhais ceg ntawm lub duav sib koom, qaij lub taub hau, lub cev, qhov mob nce ntxiv.
Lwm cov cimmob:
- daim tawv nqaij loog thiab kub hnyiab, goosebumps ntawm sab nraub qaum.
- Txhob tactile rhiab heev thiab ua rau mob.
- Hloov hauv gait (taug kev ncaj nraim).
Qhov tseem ceeb yog txawm li cas los xij, cov tsos mob ntawm sciatica zoo ib yam, tab sis kev kho mob ib txwm txawv.
Tus yam ntxwv ntawm qhov mob
Kev hnov mob tuaj yeem muab faib raws li cov yam ntxwv hauv qab no:
- Localization. Qhov mob feem ntau yog unilateral. Lwm sab tsuas tingles los yog loog me ntsis.
- Kev siv zog. Nyob ntawm qhov degree ntawm o thiab pinching. Nyob rau hauv thawj theem, qhov mob tsis muaj zog, nws raug tshem tawm nrog cov pa analgesics. Lub sijhawm ntev ntawm tus kab mob ua rau atrophy ntawm cov leeg ntawm qhov cuam tshuam. Sab laug tsis kho, qhov mob kis mus rau cov ntaub so ntswg uas nyob ib sab thiab cuam tshuam rau cov hlab ntsha tshiab.
Yog tias koj tau txheeb xyuas cov tsos mob ntawm sciatica kom raug thiab nws tsim nyog los kho nws, nws yuav tsum tau ua los ntawm tus kws kho mob tshwj xeeb, vim ntau yam yuav tsum tau kho ntau yam.
ntsuas ntsuas
Yog qhov mob tsis ploj hauv 2-3 hnub, tab sis tsuas yog nce ntxiv, koj yuav tsum tau mus ntsib kws kho mob. Hauv sciatica, reflexes ua txawv txav thiab tsis muaj zog.
Cov tsos mob ntawm lub paj hlwb ntawm kev kuaj pom qhov tseem ceeb:
- Txog Achilles tendon reflex. Thaum ntaus hauv cov leeg nqaij saum pob taws, ko taw flexes tsis muaj zog lossis tsis hnov tsw;
- txo qis hauv caugreflex.
- Kev txo qis lossis tsis tuaj yeem cog qoob loo.
Thaum tsa ceg, qhov mob nce nrawm heev vim cov leeg nro. Tsis tas li ntawd, qhov mob hnyav yog xav tau thaum nias ntawm qee cov ntsiab lus hauv qab pob tw, ntawm tus ncej puab (Valle cov ntsiab lus).
Rau qhov kev kuaj mob tag nrho, koj yuav tsum tau kuaj ntshav, X-ray, MRI, CT.
X-ray tso cai rau koj los txiav txim qhov xwm txheej ntawm cov pob qij txha intervertebral thiab cov xwm txheej ntawm cov discs intervertebral. Ua li no, cov duab raug coj mus rau hauv 2 qhov projections - nyob rau hauv txoj hauj lwm ntsug thiab kab rov tav. MRI tshuaj xyuas cov kev hloov pauv hauv cov ntaub so ntswg (qhov no tsis pom ntawm x-ray).
Txoj Cai Kho Mob
Kev kho mob ntawm sciatica tsuas yog nyuaj - dav dav thiab hauv zos. Nws yog ua tiav los ntawm kev kho tsis yog tshuaj. Nws yuav tsum tau muab sau tseg tias kev kho mob ntawm lumbago thiab sciatica yog yuav luag zoo tib yam. Ua li no, cov hom phiaj hauv qab no tau ua raws:
- Restore mobility thiab elasticity ntawm cov leeg cuam tshuam.
- pab mob.
- Txhim kho cov kev coj ua ntawm cov hlab ntsha.
- Txhim kho cov khoom noj khoom haus ntawm cov ntaub so ntswg neuromuscular.
Rau kev kho mob sciatica, nws yog qhov zoo dua los siv cov tshuaj txhaj, cov tshuaj tsis zoo.
Kev kho mob algorithm
Ua ntej, hom yog qhov tseem ceeb. Nws txhais tau tias muaj kev thaj yeeb tiav. Koj yuav tsum tau pw ntawm ib lub txaj nrog ib qho nyuaj, txawm tias lub txaj pw, ces qhov load ntawm tus txha nraub qaum thiab lub siab ntawm cov hlab ntsha yog tsawg.
Nyob rau hauv cov ntaub ntawv ntawm exacerbation, non-steroidal thiab steroidal anti-inflammatory tshuaj, cov leeg nqaij relaxants yog siv los kho sciatica. Kuj pom tau tias yog tshuaj antispasmodics, opioid analgesics, epiduralKev kho thiab vitamin complexes.
Rau kev kho mob ntawm sciatic paj hlwb sciatica thiab mob nyem, cov teebmeem hauv zos kuj tau siv: gels, tshuaj pleev, thaj ua rau thaj, daim ntaub ntawv. Kev kho mob yog ua tiav los ntawm kev kho lub cev, homeopathy, kev tawm dag zog, zaws.
Non-steroidal anti-inflammatory tshuaj (NSAIDs)
Lawv qhov kev txiav txim yog raws li qhov tseeb tias kev tsim cov prostaglandins, cov tshuaj muaj lub luag haujlwm rau qhov mob, raug thaiv.
Thaum cov tsos mob ntawm sciatica tshwm sim, ntau cov tshuaj tiv thaiv kab mob yog qhov zoo tshaj rau kev kho mob. Lawv muab faib ua ceev thiab qeeb ua yeeb yam. Qee qhov muaj nyob rau ntawm lub tsev muag tshuaj, lwm tus yog cov tshuaj nruj me ntsis.
Feem ntau siv: "Ibuprofen", "Voltaren", "Diclofenac", "Aspirin", "Ketoprofen", "Motrin", "Anseid", "Seraktil" thiab lwm yam. khoom - irritate lub plab mucosa, yog li nws yog zoo dua mus noj lawv tom qab noj mov. Lawv kuj txo cov ntshav txhaws.
Contraindications rau NSAIDs
NSAIDs raug txwv nyob rau hauv cov xwm txheej hauv qab no:
- Peptic ulcer.
- Anemia.
- Nyob los ntshav.
- ntshav siab.
- Heart, raum, siab mob.
Steroid Anti-Inflammatory Drugs (SAIDs)
Lwm qeb ntawm kev kho mob rau cov tsos mob ntawm sciatica yog kev kho mob nrog tshuaj steroid. Cov tshuaj hormonal no yog tsim los tsim cov tshuaj hormones hauv lub cevhydrocortisone thiab zoo txo qhov o thiab mob. Cov tshuaj no muaj kev phiv:
- Nyob qhov hnyav.
- plab ulcer.
- Osteoporosis.
- Edema ntawm lub ntsej muag.
- Ntshav ntshav khov.
- Immune tsis muaj zog.
Cov kev kho mob ntawm ischialgia ntawm cov hlab ntsha sciatic nrog cov tshuaj steroid yog muab rau ntau tshaj 2 lub lis piam. Qhov no yog ua kom tsis txhob muaj kev phiv.
Kev kho mob ntawm sciatica nrog tshuaj ntawm ntau pab pawg yog ntxiv nrog cov tshuaj epidural. Lawv tau siv txij li xyoo 1952. Cov tshuaj tau txhaj rau hauv tus txha caj qaum - cov kab noj hniav uas cov hauv paus hniav ntawm cov hlab ntsha nyob.
Cov koob tshuaj yuav tsawg dua li qhov kho tau, vim tias cov tshuaj tam sim ntawd nkag mus rau ntawm qhov chaw tsom. Yog li ntawd, qhov kev pheej hmoo ntawm kev mob tshwm sim yog txo. Qhov mob no sai sai, tab sis tsis ntev.
Opioids
Tshuaj kho mob sciatica tuaj yeem nqa nrog tshuaj, uas suav nrog cov ntsiab lus ntawm cov tshuaj narcotic. Cov no yog cov muaj zog tshaj plaws. Lawv nqus qhov mob, huab kev nkag siab.
Opioids kuj tseem siv tau niaj hnub no hauv daim ntawv thaj ua rau thaj. Lawv qhov kev ua tau zoo dua los ntawm qhov no. Feem ntau siv "Tramadol" lossis "Ultram". Kev mob tshwm sim ntawm opiates yog lethargy, delusional disorders, lethargy thiab tsaug zog.
Miorelaxants - Mydocalm, Relanium, Sirdalud, Baclofen.
Kev pab thawj zaug rau sciatica
Thaum lub sijhawm tawm tsam, kev kho mob sciatic paj hlwb sciatica tom tsev yog ua kom tiavtus neeg mob immobility. Koj yuav tsum tau pw ntawm koj nraub qaum, ntawm lub txaj tawv. Koj khoov tsis tau koj tus txha nraub qaum. Ib yam dab tsi yuav tsum tau muab tso rau hauv qab ntawm lub hauv caug - qhov no yuav txo qis qhov nro ntawm cov hlab ntsha sciatic thiab txo qhov mob. Tsis txhob nqa qhov hnyav, zaum ntawm qhov chaw mos.
Koj tuaj yeem haus "Ibuprofen", "Aspirin" thiab lwm yam NSAIDs yog tias tus neeg mob tsis noj cov ntshav thinner rau kev kho mob. Pab tau "Pentalgin" lossis "Analgin". Txias yuav tsum tau siv rau hauv zos. Ice cubes tuaj yeem kneading.
Rau kev kho mob sciatic paj hlwb sciatica tom tsev, cov cai hauv qab no yuav tsum ua raws li:
- Zaum tsis tshaj 2 teev.
- Tsis txhob hnav heels siab.
- noj zaub mov ntau nrog cov vitamins B.
- Pw nrog mob sab hauv fetal txoj hauj lwm.
- Tsis txhob dag koj nraub qaum.
Nyob hauv tsev, koj tuaj yeem siv cov tshuaj pleev tshuaj tiv thaiv kab mob lossis cov gels raws li muv lossis nab venom: Apizartron, Sofya, Nyatoks, Ketoprofen, Voltaren.
Los ntawm cov kev kho mob pej xeem, cov txiaj ntsig zoo hauv kev kho mob sciatica hauv tsev yog muab los ntawm dais thiab badger rog, cov roj yam tseem ceeb - fir, camphor, tshuaj yej tsob ntoo, kua txob liab. Thaum nres qhov mob, koj tuaj yeem hloov mus rau chondroprotectors. Nws yog ib qho tseem ceeb uas yuav tsum nco ntsoov tias tsis muaj kev kho mob sciatica hauv tsev tsis thim rov qab mus rau tus kws kho mob.
Physiotherapy
Nws yog ib qho yuav tsum muaj tshuaj ntxiv. Physiotherapy yog siv thaum mob hnyavlub sij hawm. Nws qhov kev txiav txim yog txhawm rau txo qhov o thiab txo qhov mob, ua kom sov cov hlab ntsha, txhim kho cov ntshav ncig, thiab so cov leeg.
Cov txheej txheem hauv qab no feem ntau tau sau tseg:
- Diadynamic tam sim no.
- Magnetotherapy.
- UHF.
- Electrophoresis thiab phonophoresis.
- kev kho mob Paraffin.
- Ozokerite.
Massage ntawm cheeb tsam lumbar
Massage tsuas yog ua tau sab nraud ntawm exacerbations ntawm cov txheej txheem o. Nws tsuas yog ua los ntawm tus kws tshaj lij xwb. Kev zaws tuaj yeem ua rau kom muaj qhov ua tau zoo ntawm cov paj hlwb, txhim kho cov qog ntshav thiab cov ntshav ntws, thiab tiv thaiv cov leeg ntawm hypotrophy. Cov leeg nqaij muaj zog yuav muaj peev xwm tswj tau lub zog ntawm tus txha caj qaum thiab txhawb nqa qhov hnyav ntawm lub cev, thiab qhov no yuav tshem tawm cov vertebrae.
kev kho mob phais
Kev phais tsuas yog siv rau qhov mob hnyav tshaj plaws, thaum txhua txoj kev kho mob tsis zoo. Kev phais txha caj qaum yog suav tias yog qhov nyuaj tshaj plaws thiab yuav tsum tsuas yog ua los ntawm cov kws phais neeg paub txog hauv cov chaw loj.
Gymnastics thiab qoj ib ce kho mob
Sab nraud ntawm qhov exacerbation ntawm tus txheej txheem, kev tawm dag zog kho mob thiab gymnastics yog siv tau. Kev tawm dag zog yuav pab txhawb cov metabolism thiab txo qhov mob.
Contraindications rau kev tawm dag zog:
- theem ntawm exacerbation ntawm sciatica.
- Kev cev xeeb tub.
- Cawv lossis yeeb tshuaj.
- kuaj mob qog noj ntshav.
- Internal los ntshav.
- Kev ua txhaum ntawm daim tawv nqaij.
Hirudotherapy
Leech qaub ncaug muaj ntau yam tshuaj lom neeg uas tuaj yeem txhim kho cov ntshav ncig hauv thaj tsam ntawm qhov mob thiab muab cov ntaub so ntswg nrog cov khoom noj zoo. Lawv qhov kev cuam tshuam tsis yog hauv zos xwb, tab sis kuj yog dav dav - cov phab ntsa ntawm cov hlab ntsha tau tshem tawm cov roj cholesterol, o raug tshem tawm.
YHomeopathy
Cov tshuaj homeopathic qeeb dua, tab sis feem ntau siv tau zoo dua. Tsis tas li ntawd, cov tshuaj no muaj ib tug natural muaj pes tsawg leeg.
Qee cov tshuaj homeopathic:
- RhusToxicodendron. Nws yog noj rau sciatica nyob rau hauv lub supine thiab zaum.
- Aesculushippocastanum. Muab tshuaj rau qhov mob ntev ntev.
- Colocynthis. Tawm nrog mob, rub qhov mob, hnyav los ntawm kov.
- Nuxvomica. Siv tau rau qhov mob thiab tua hauv cheeb tsam sacral, nrog paresthesia.
- Berberis vulgaris. Ua rau sawv ntxov mob.
tshuaj ntsuab
Y Phytotherapy yog siv cov compresses, decoctions, mixs, tshuaj pleev. Ntawm cov zaub mov txawv:
- Cov ntaub qhwv sov nrog cov ntawv so hauv cov kua txiv hmab txiv ntoo thiab ntsev, nrog rau daim pam wool rau saum. dag qhwv rau 1.5 teev.
- Decoction ntawm aspen nplooj. 1 st. l. tshuaj ntsuab hauv 200 ml dej, boil thiab haus 3 zaug ib hnub twg.
- Decoction of St. John's wort. Siv raws li compresses thiab ntxiv rau da dej. Rau kev ua noj, 2 tbsp. l. brew tshuaj ntsuab nyob rau hauv 1 liter dej. Koj tseem tuaj yeem ntxiv cov kua txiv hmab txiv ntoo tuab rau hauv da dej.
- Npaj cov tshuaj pleev kom zoo los ntawm zib ntab, vodka thiab kua txiv hmab txiv ntoo tshiab. Tag nrho cov Cheebtsam yog coj nyob rau hauv sib npaug proportions thiab sib tov. Siv cov kev kho mob rau sab uas cuam tshuam.
- Fir roj, eucalyptus roj yog siv los txhuam. Sciatica tsis suav nrog kev siv mustard plasters.
- Ntsev. Nws yog rhuab mus rau 37.5 degrees thiab siv rau hauv lub hnab mus rau qhov chaw cuam tshuam kom txog thaum nws txias.
- YWax yog tov nrog propolis 1:10. Thov nyob rau hauv daim ntawv ntawm lub ncuav mog qab zib rau ib teev thiab ib nrab.
- qos yaj ywm nyoos yog rubbed, horseradish ntxiv. Daim ntawv thov no khaws cia rau 30 feeb.
- Kalanchoe thiab Aloe. Cov kua txiv hmab txiv ntoo ntawm cov nroj tsuag no ntxiv rau kev sib xyaw ntawm rye hmoov thiab zib mu. Thov nyob rau hauv daim ntawv ntawm ib lub ncuav mog qab zib, sov nrog ib tug woolen daim ntaub rau saum. Tuav 30 feeb.
- Cawv cawv ntawm cov paj dawb acacia kuj siv los txhuam - insist rau ib lub lim tiam thiab rub 2 zaug ib hnub.
- Koj tuaj yeem ua compresses nrog kua txiv radish thiab zib ntab - feem 3: 1.
- Daim ntawv thov ntawm turpentine thiab qe dawb. Tuav kom txog thaum tsis xis nyob tshwm. Koj tuaj yeem rov ua cov txheej txheem tom qab 6 teev.
- Compresses kuj yog tsim los ntawm scalded nplooj ntawm cabbage, burdock los yog birch.
Y Rau qhov ncauj siv, decoctions ntawm aspen nplooj, viburnum, Kalanchoe (diluted kua txiv), calendula, horsetail, thyme.
Baths
Da dej nrog qhov kub tsis tshaj 38 degrees Celsius muaj txiaj ntsig zoo. Coj lawv tsis pub dhau 15 feeb. Cov ceg ntoo thuv hluas, ib lub decoction ntawm horsetail, grated horseradish nyob rau hauv ib lub hnab yog ntxiv rau da dej.
Kho mob kerosene. Sib tov 100 ml nrog horseradish thiab radish, tawm rau 9 hnub, thov nyob rau hauv daim ntawv thov rau ib teev 2 zaug ib hnub twg.
Qe dawb yog ntxiv rau qhov hnyav ntawm ib nrab ntawm cov xab npum ntxhua khaub ncaws. Cov khoom yuav tsum tau sivcompress rau 2 teev.
Cov txheej txheem rau kev ua tau zoo ntawm kev kho mob
cov qauv kev ua tau zoo yog:
- Txoov qhov mob hnyav, ces lawv ploj mus.
- Txo cov tsos mob paj hlwb.
Rau cov tsos mob ntawm sciatica, kev kho zoo tshaj plaws (raws li cov neeg mob) yog:
- NSAIDs - Ibuprofen thiab Arcoxia.
- Miorelaxants - "Mydocalm".
- YHomeotherapy.
- Defanotherapy.
- As tshuaj loog - "Thiodin", vitamin B1, dorsaplast.
Kev Tiv Thaiv
Yog tias sciatica ploj mus, nws yog ib qho tseem ceeb kom tiv thaiv tsis txhob rov tshwm sim dua. Txhawm rau ua qhov no, ua raws li cov cai hauv qab no:
- Lub txaj yuav tsum nyuaj me ntsis thiab txawm.
- Tsis txhob zaum ntev.
- Qhov chaw ua haujlwm yuav tsum tau nruab nrog cov rooj tog zoo.
- Yog tias tsim nyog, siv orthopedic corsets, nws raug nquahu kom hnav khau orthopedic.
Nws tseem yog ib qho tseem ceeb rau kev kho cov menyuam yaus scoliosis, articular pathologies, thiab ntxiv dag zog rau tus txha nraub qaum. Ib ntus, rov qab zaws thiab kho lub cev yuav tsum tau ua los tiv thaiv tus txha caj qaum.
Kho gymnastics yuav tsum ua tsis tu ncua. Rau kev tiv thaiv, noj cov vitamins, immunostimulants. Yuav tsum tso tus cwj pwm phem.
Thaum zaum ntawm lub computer, koj yuav tsum tau sawv txhua teev kom sov thiab ncab. Yog tias tsim nyog, siv rau hauv qabtshwj xeeb hauv ncoo. Thaum lub caij txias, hypothermia yuav tsum zam.
