The imisipha ye-piriformis (PM) waziwa kakhulu kwezokwelapha njengomsipha obalulekile we-hip yangemuva. Kungumsipha oneqhaza ekulawuleni ukuzungezisa nokuthunjwa kwamalunga e-hip, futhi kuphinde kube yimisipha eyenziwe yaduma ngenxa yokuguquguquka kwayo kwesenzo ngokuzungezisa. I-PM iphinde ithole ukunakwa ngenxa yendima yayo ku-piriformis syndrome, isimo esithintekayo njengomthombo ongase ube nobuhlungu nokungasebenzi.
I-Piriformis syndrome ingachazwa njengesimo sezokwelapha lapho imisipha ye-piriformis, etholakala esifundeni se-buttock, i-spasms futhi ibangela ubuhlungu be-buttock. I-Sciatic Nerve ingase icasulwe ukusebenzisana phakathi kwe-SN kanye ne-PM ekhiqiza ubuhlungu be-hip posterior phansi kwethanga elingemuva, elingisa 'sciatica'.
Izikhalazo zobuhlungu bezinqe ngokudluliselwa kwezimpawu azifani ne-Piriformis Muscle. Izimpawu zisabalele ngama-syndromes abonakala emtholampilo abuhlungu emuva. Kuye kwaboniswa ukuthi i-piriformis syndrome ilandisa ngamaphesenti angu-5-6 wamacala we-sciatica. Ezimweni eziningi, kwenzeka kubantu abaneminyaka ephakathi futhi ivame kakhulu kwabesifazane.
Okuqukethwe
I-Anatomy: I-piriformis
I-PM isuka endaweni engaphambili ye-sacrum futhi igxilwe kuyo ngokunamathiselwe okunenyama okuthathu phakathi kweforamina yokuqala, yesibili, yesithathu neyesine yangaphambili ye-sacral. Ngezinye izikhathi imvelaphi yayo ingase ibe banzi kangangokuthi ijoyina i-capsule ye-joint sacroiliac ngenhla kanye ne-sacrotuberous kanye/noma i-sacrospinous ligament ngezansi.
I-PM iyisiphakeli esiqinile futhi esinamandla, futhi njengoba idlula i-pelvis ngokusebenzisa i-sciatic foramen enkulu, ihlukanisa i-foramen ibe yi-suprapiriform ne-infra-piriform foramina. Njengoba ihamba nge-anterolaterally ngokusebenzisa i-sciatic foramen enkulu, iphuma ukuze yenze i-tendon ehlanganiswe endaweni ephakeme kakhulu ye-trochanter enkulu, evame ukuhlanganisa ne-tendon evamile ye-obturator internus kanye nemisipha ye-Gemelli.
Izinzwa kanye nemithambo yegazi ku-suprapiriform foramen iyinzwa ephakeme kakhulu ye-gluteal nemithambo, futhi ku-infra-piriform fossa yizinzwa eziphansi ze-gluteal nezitsha kanye ne-sciatic nerve (SN). Ngenxa yomthamo wayo omkhulu ku-foramen enkulu ye-sciatic, inamandla okucindezela imikhumbi eminingi kanye nezinzwa eziphuma ku-pelvis.
I-PM ihlotshaniswa eduze namanye ama-hip rotator amafushane angaphansi njenge-gemellus ephakeme, i-obturator internus, i-gemellus ephansi, ne-obturator externus. Umehluko oyinhloko phakathi kwe-PM namanye ama-rotator amafushane ubuhlobo ne-SN. I-PM idlula ngemuva ku-nerve kanti enye i-obturator idlula ngaphambili.
Imbangela: I-Piriformis Syndrome
I-Piriformis Syndrome ingase ibangelwe noma ihlobane nezinto ezintathu eziyinhloko eziyimbangela;
1. Imicu yemisipha eqinile futhi emfushane ebangelwa ukusetshenziswa ngokweqile kwemisipha njengokunyakazisa kwe-squat namaphaphu ekujikelezeni kwangaphandle, noma ukuhlukumezeka okuqondile. Lokhu kwandisa ubukhulu be-PM ngesikhathi sokufinyela, futhi kungase kube umthombo wokucindezelwa/ukubambeka.
2. Ukubanjwa komthambo.
I-3.I-Sacroiliac Joint Dysfunction (I-SI Joint Pain) ebangela i-PM spasm.
Izimpawu: I-Piriformis Syndrome
Izimpawu ezijwayelekile ze-piriformis syndrome zihlanganisa:
- Ukuzwa okuqinile noma okuminyanisa esinqeni kanye/noma umsipha.
- Ubuhlungu be-gluteal.
- Ubuhlungu bethole.
- Ukuhlukunyezwa kokuhlala nokugwaza, ikakhulukazi uma isiqu sithambekele phambili noma umlenze weqa phezu komlenze ongathinteki.
- Izimpawu ezingenzeka ze-peripheral nerve ezifana nobuhlungu kanye ne-paraesthesia ngemuva, i-groin, izinqe, i-perineum, ngemuva kwethanga.
Ukwelashwa: I-Piriformis Syndrome
Lapho kukholakala lokho i-piriformis syndrome likhona futhi nodokotela unomuzwa wokuthi ukuxilongwa sekutholakele, ukwelashwa ngokuvamile kuzoncika kusizathu esisolekayo. Uma i-PM iqinile futhi i-spasm lapho-ke ekuqaleni ukwelashwa okuvamile kuzogxila ekweluleni nasekuhlinzeni umsipha oqinile ukuze kukhishwe i-PM njengomthombo wobuhlungu.
Uma lokhu kwehluleka, khona-ke okulandelayo kuye kwaphakanyiswa:
- I-anesthetic block yendawo eyenziwa odokotela ababulala izinzwa abanobuchwepheshe bokulawula ubuhlungu.
- Imijovo ye-steroid ku-PM.
- Imijovo ye-botulinum ku-PM.
- Ukuhlinzwa Kwezinzwa.
Ukungenelela okuqondiswe kobelaphi njengokwelula kwe-PM kanye ne-direct trigger point massage bekulokhu kukhuthazwa. Ukwelula kwe-PM kwenziwa ezikhundleni ze-hip flexion ezinkulu kune-90 degrees, i-adduction, kanye nokujikeleza kwangaphandle ukuze kusetshenziswe ukuguqulwa komphumela wesenzo we-PM ukuhlukanisa ukwelula kulo mzimba ozimele wezinye i-rotator yangaphandle ye-hip.
Isiphetho: I-Piriformis Syndrome
The imisipha ye-piriformis ingumsipha oqinile futhi onamandla ngempela osuka ku-sacrum uye ku-femur. Igijima ngaphansi kwemisipha e-gluteal inzwa ehamba ngaphansi kwayo. Uma lesi sicubu singena ku-spasm, khona-ke inzwa idala ubuhlungu obukhiphayo, ukuba ndikindiki, ukushoshozela, noma ukushiswa ezinqeni kuya emlenzeni nasenyaweni. Abanye abantu bahlakulela i-syndrome ngenkathi bebhekene nobuhlungu obungapheli obuphansi emuva.
Imisebenzi kanye nokunyakaza okubangela imisipha ye-piriformis ukuze inkontileka iqhubeke icindezela inzwa ye-sciatic, okubangela ubuhlungu. Lesi sisipha siyafinyela uma sishwibeka, noma sima, sihamba, sikhuphuka izitebhisi. Ivamise ukuqina uma sihlezi kunoma iyiphi indawo isikhathi esingaphezu kwemizuzu engama-20 kuya kwengama-30.
Abantu abanomlando wobuhlungu obungapheli obuphansi emuva bavame ukucabanga ukuthi ubuhlungu babo obukhazimulayo be-sciatic bulandeleka emgogodleni wabo ophansi. Umlando wabo we-disc herniations, noma i-sprains, i-sprains ibafundise ukuba bacabange ukuthi izohamba njengokujwayelekile nokuthi ubuhlungu buphuma emgogodleni wabo. Kulapho nje izinhlungu zingasabeli njengokujwayelekile lapho abantu befuna ukwelashwa, ngaleyo ndlela kubambezele ukululama kwabo.
Ubuhlungu be-Sciatica
Imininingwane elapha ku "Ukwelashwa kwe-piriformis" akuhloselwe ukuthatha indawo yobudlelwano bomuntu oyedwa nochwepheshe bokunakekelwa kwezempilo oqeqeshiwe noma udokotela onelayisensi futhi akusona iseluleko sezokwelapha. Sikukhuthaza ukuthi wenze izinqumo zokunakekelwa kwezempilo ngokusekelwe ocwaningweni lwakho kanye nobambiswano nomsebenzi wezempilo oqeqeshiwe.
Ulwazi Lwebhulogi Nezingxoxo Zobubanzi
Ububanzi bethu bolwazi inqunyelwe ku-Chiropractic, ye-musculoskeletal, imithi yenyama, impilo enhle, enikela nge-etiological ukuphazamiseka kwe-viscerosomatic ngaphakathi kwezethulo zomtholampilo, i-somatovisceral reflex Clinical dynamics ehambisanayo, izakhiwo ze-subluxation, izindaba ezibucayi zezempilo, kanye/noma izihloko zemithi esebenzayo, izihloko, nezingxoxo.
Sihlinzeka futhi sethula ukusebenzisana komtholampilo nochwepheshe bemikhakha eyahlukene. Uchwepheshe ngamunye ulawulwa ububanzi bomsebenzi wabo kanye negunya labo lelayisense. Sisebenzisa amaphrothokholi asebenzayo ezempilo nempilo ukuze selaphe futhi sisekele ukulimala noma ukuphazamiseka kwesistimu ye-musculoskeletal.
Amavidiyo ethu, okuthunyelwe, izihloko, izihloko, nemininingwane ihlanganisa izindaba zomtholampilo, izinkinga, nezihloko ezihlobene futhi ezisekela ngokuqondile noma ngokungaqondile ububanzi bethu bomtholampilo.*
Ihhovisi lethu lizame ngokufanelekile ukunikeza izingcaphuno ezisekelayo futhi likhombe ucwaningo olufanele noma izifundo ezisekela okuthunyelwe kwethu. Sinikeza amakhophi ezifundo zocwaningo ezisekelayo ezitholakala kumabhodi okulawula kanye nomphakathi uma uceliwe.
Siyaqonda ukuthi sihlanganisa izindaba ezidinga incazelo eyengeziwe yokuthi ingasiza kanjani kuhlelo oluthile lokunakekelwa noma inqubo yokwelashwa; ngakho-ke, ukuqhubeka nokuxoxa ngendaba engenhla, sicela ukhululeke ukubuza UDkt. Alex Jimenez, DC, noma xhumana nathi 915-850-0900.
Silapha ukuzosiza wena nomndeni wakho.
Izibusiso
UDkt. Alex Jimenez A.D, I-MSACP, RN*, I-CCST, I-IFMCP*, I-CIFM*, I-ATN*
imeyili: qeqeshi@elpasofunctionalmedicine.com
Unikezwe ilayisense njengoDokotela weChiropractic (DC) ku Texas & New Mexico*
Ilayisensi yaseTexas DC # TX5807, Ilayisensi ye-New Mexico DC # I-NM-DC2182
Ilayisensi Njengomhlengikazi Obhalisiwe (RN*) in Florida
Florida License RN License # RN9617241 (Control No. 3558029)
Isimo Esihlangene: Ilayisensi Yezifundazwe Eziningi: Ugunyazwe Ukuzijwayeza I-40 States*
UDkt. Alex Jimenez DC, MSACP, RN* CIFM*, IFMCP*, ATN*, CCST
Ikhadi Lami Lebhizinisi Ledijithali