I kut leh keah vun inthlak danglam rualin tuar theih loh khawpa natna i nei em? CRPS a ni thei! (Complex Regional Pain Syndrome) a ni a, a rilru a hah lutuk a, a rilru a buai em em bawk a.

Hliam tenau i neih hnua, a nih loh leh a chhan hriat loh pawh ni se, kut emaw, ke emawa natna nasa tak, awm reng chu eng ang nge ni ang tih i ngaihtuah ngai em? Mi thenkhat chuan hetiang hi an tawng tawh a ni. Vawiin hian chutiang dinhmun pakhat, `Complex Regional Pain Syndrome (CRPS) chungchang kan sawi dawn a ni. Hlau suh, hei hi hriat chian a pawimawh hle.

CRPS chu eng nge ni? A awlsam zawngin...

`Complex Regional Pain Syndrome`, a tawi zawngin `(CRPS)` tih hi i taksa peng bik, a tam zawkah chuan kut, ke, kutphah, emaw kephah emawa natna nasa tak thlentu natna a ni a, chubakah a lan chhuah dan dang engemaw zat, vun rawng inthlak danglam leh chu hmuna vun rawng a lo hring chhuak te pawh a awm bawk. Ngaihtuah teh, i kut emaw i ke emaw a harsatna a awm chuan i nitin nunah hna a thawk thei lo va, zanah i mut tha thei lo va, i rilru hriselnaah pawh nghawng lian tak a nei bawk.

Doctor-te chuan CRPS hi kan central nervous system ( thluak leh ruhro) emaw, kan peripheral nervous system ( thluak leh ruhro atanga thuchah peng dang, kut leh ke leh kut zungtang dang thlenga thawn chhuaktu system) emaw a thawk tha lo vang niin an ngai. Chutiang a nih chuan kan nervous system chuan natna signal a dawng nasa lutuk a, chu chhanna chu a titawp thei lo.

CRPS hi chi hnih a awm a, chungte chu:

1. Type I: Hemi ah hian , nerve tihchhiat a awm lo. Hei hi eng emaw natna emaw, accident emaw hnuah a thleng tlangpui. Mahse, accident hian direct-in nerve pakhat a tichhe lo. Hei hi a hmain ``Reflex Sympathetic Dystrophy`` tih a ni thin.

2. Type II: Hei hian nerve chhiatna a tilang chiang hle. Hei hi a hmain `Causalgia` an ti thin.

CRPS hi hun rei lote (acute) emaw, chronic (thla ruk aia rei) emaw a ni thei . Vanneihthlak takin enkawl leh tihdam theih a ni fo.

Tute nge CRPS vei tam ber?

CRPS hi naupang aiin puitlingah a tam zawk. Kum 40 vel a ni tlangpui a, mipa aiin hmeichhiain CRPS an vei tam zawk .

Zirna hrang hrangah chuan he natna hi European hnam chhuak zingah hmuh a ni a, 66% leh 80% inkar vel a ni. Mahse, a natna hi a tlem hle. Entîr nân, United States-ah chuan kum tin mi 200,000 vêl chauh an awm a ni.

CRPS natna lan chhuah dante chu engte nge ni? Engtin nge kan hriat theih ang?

CRPS symptoms nasat dan leh hun chhung hi mi hrang hrangah a inang lo.

A tlangpuiin thil engemawCRPS symptoms hi hliam, ruh tliak, a nih loh leh operation hnu kar li atanga kar ruk hnuah a intan tlangpui . Mahse, a chang chuan heng symptoms te hi chhan chiang tak awm lovin a lo lang thei a ni.

CRPS chhinchhiahna ber leh langsar ber chu natna hi a ni. He natna hi a awm reng thei a, a lo thleng thei bawk. A tlangpuiin kang, natna, a nih loh leh mittui tla ang maiin a lang . He natna hi kut emaw ke emaw natna thûk takah hian hriat a ni fo.

Chu bakah, a natna hmunah hian sensitivity inthlak danglamna hmuh tur a awm thei bawk:

• Thil natna thlentu laka sensitivity tihpun: Entirnan, pinch tlemte pawh hian a tlangpui aia na zawkin a hre thei.
• A tlangpuiin natna thlen lo thil atanga natna hriat: Vun khawih mai mai pawhin natna a awm thei.
• I rilru a buai mai thei .

Symptom dang thenkhat chu hetiang hi a ni:

• Vun hring: Vun a lo thleng thei a, a lo awm reng thei bawk.
• Kut emaw ke natna emaw hnathawh a tlahniam: Kut emaw ke natna emaw chu sawn a harsa thei a, a nghet lo hle bawk. Tin, kut/ke natnaah rit dah emaw, ruhkawr chungah rit dah emaw pawh a harsa thei bawk.
• Vun lum leh vawt inthlak danglam: Kut/ke natna chu a dang aiin a lum zawk emaw, a vawt zawk emaw a ni thei.
• Vun rawng danglam: Vun hi hmun thenkhatah chuan a hring, a hring, a sen/a hring, a sen emaw a lang thei.
• Vun rawng inthlak danglam: Vun chu a eng thei a, a hring thei a, a thawkrim lutuk thei bawk.
• Nail leh sam sei dan inthlak danglamna: Chu lai hmuna nail leh sam te chu a thang chak zawk thei a, a thang lo thei bawk.

`CRPS` natna lan chhuah dan hi hun kal zelah a \ha fo \hin avangin, a tir lamah chuan doctor-te tan a awlsam zawk. Chuvangin heng symptoms te hi i neih chuan a rang thei ang bera Doctor pan a pawimawh hle.

Engvangin nge CRPS hi a lo awm? A chhante chu engte nge ni?

Hliam inang nei thenkhatin CRPS an neih a, thenkhatin an vei loh chhan hi zirchiangtute chuan an la hre chiang lo. An ngaihdan chuan peripheral nervous system leh central nervous system a inflammatory emaw immune reaction emaw a awm vang a ni thei .

A tam zawkah chuan 90% aia tam CRPS hi trauma emaw, a hliam emaw, a ke emaw a nerve-a hliam emaw avanga lo awm a ni.Avang. Heng hliamte hian kan taksa chhunga sensory leh autonomic nerve fibers nalh tak tak te chu a tichhe vek a ni. Heng nerve fiber te tak te te hian kan thluak ah natna, hnim hring, leh lumna ang chi hriatna te hi a keng tel a ni. Thisen kalna kawng te tak te leh a chhehvela cell te hriselna zawng zawng thununtu an ni bawk.

CRPS nena inzawm hliam tam ber chu ruh tliak , a bik takin kutphah tliak hi a ni. Ruh a inthlak emaw, a chhe emaw a nih chuan, a nih loh leh tight cast avanga pressure a awm chuan nerve a chhe thei a ni.

CRPS thlen thei hliam chi dangte chu:

• Surgery: Surgery neih laiin incision, stitches, scarring emaw avanga nerve a chhe thei.
• Sprains emaw strains: Connective tissue a chhiat chuan ruh a che nasa lutuk thei a, chu chuan a bula nerve te chu a ti buai lutuk thei a ni.
• Kang, hliam emaw, hliam emaw: Heng zawng zawng hi hmuh theih hliam a ni a, mahse a hnuaia nerve te pawh a tichhe thei bawk.

A chang chuan CRPS hi hliam chiang tak awm lovin a lo awm thei bawk. A nih loh leh hun rei tak immobilization pawh hi a chhan a ni thei bawk.

CRPS vei theihna tipungtu thil engemaw zat a awm a:

• Nerve hriselna tha lo: Diabetes mellitus ang chi natna nei te hian nerve resilience leh recovery an nei tlem zawk. Peripheral neuropathy vei te pawhin nerve cell siam thar leh harsa an ti thei a, chu chu a tlangpuiin harsatna thlen lo tur hliam atang pawhin a ni. Meizial zu thinte leh cancer vanga chemotherapy dawng tawhte pawhin nerve siam thar leh harsa an ti thei bawk.
• Immune system lama harsatna: Kan taksaa inflammation thlentuah hian immune system hian hmun pawimawh tak a chang a. CRPS vei thenkhatah chuan inflammatory chemicals cytokines an tih chu a sang hle a . Hengte hian CRPS natna lan chhuahna thenkhatah a pui a ni. CRPS hi inflammatory leh autoimmune natna dang, asthma ang chi nei te tan pawh a awm fo thin.
• Genetic factors: I genes hian hliam atanga i dam dan pawh a nghawng thei bawk. Zirchiangtute chuan CRPS hi chhungkaw (`family clusters`)-ah a kal tlangpui tih an hmuchhuak. Hei hi a tlem hle nachungin, CRPS hian genetic link a nei thei tih a tilang.

Engtin nge CRPS i nei tih chiang taka i hriat theih ang? (Diagnosis) tih a ni.

A chhan chu CRPS hi thil awm lo tak a nih avangin doctor-te pawhin an hrethiam tawk lo a, a chang chuan a dik lo hle.

`CRPS` tih hriatchhuahTest bik a awm lo. Doctor-te chuan uluk taka medical history lak a, taksa enfiahna leh i natna lan chhuah dan enfiahna hmangin an hriat chian ber a ni. Doctor chuan tun hnaia hliam emaw, surgery emaw i neih leh neih loh a zawt bawk ang.

Doctor chuan heng thilte hi a bik takin a zawng ang:

• A natna hmuna vun hmel, a lum leh a hring (texture) a inthlak danglam thin.
• Hliam avanga beisei aia nasa zawka natna neih.
• I natna emaw, i natna emaw, vun danglamna emaw, chhinchhiahna dang emaw thlen thei natna dang emaw, dinhmun dang emaw a awm emaw pawh ni se.

Imaging test , ultrasound emaw magnetic resonance imaging (MRI) emaw hmangin nerve chhiatna hnuaia awmte chu enfiah theih a ni. Mahse, nerve chhiatna chu hmuh tur a awm ngai lo mai thei.

I doctor chuan test dang a ti thei bawk a, chu chuan natna dang, chutiang bawka natna lan chhuah theihna tur chu a paih chhuak thei a ni. Entirnan, electromyography (EMG) test hian neuropathy thlentu dang a hmuchhuak thei a, chu chuan a chang chuan chutiang natna chu a thlen thei bawk.

CRPS enkawlna tur engte nge ni?

Enkawlna tum ber chu i natna leh natna lan chhuah dan dangte tihziaawm a, kut/ke natna hmuna hnathawh that leh, leh i nunphung tihchak hi a ni.

CRPS kalpui chhung hian enkawl tan hmasak a pawimawh hle. Hei hi a chhan chu hun kal zelah a ke ruh natna chu a nghet (`stiffen`) thei a ni. Enkawl loh chuan a natna chu a zual tlangpui a, a ke ruh natna chu sawn a harsa zual sauh bawk.

A theih chuan CRPS enkawlna lama tawnhriat nei doctor pan a tha ber. Enkawlnaah hian kawng hrang hrang engemaw zat inzawmkhawm a ni a, uluk taka enkawl khawm a ni. Chung zingah chuan:

• Taksa lam enkawlna leh hnathawhna lama enkawlna.
• Nunphung a inthlak danglam thin.
• Psychosocial leh nungchang lama enkawlna.
• Damdawi chi hrang hrang.
• Natna tihdamna atana enkawlna dang.

CRPS vei naupang tê tê tan chuan psychological leh rehabilitation therapies hi enkawlna ber a ni . Natna tihdamna damdawi hi naupang kum upa zawk, enkawlna dang dawng lo symptom nei tan chauh hman a ni tlangpui.

Taksa lam enkawlna leh hnathawhna lama enkawlna

CRPS enkawlna pawimawh tak pakhat chu physical therapy a ni.Physics therapist chuan i kut/ke natna vei te chu a circulation a ti tha thei a, exercise bik hmangin i flexibility, strength, muscle tone leh function te pawh a ti tha thei bawk. Occupational therapist chuan nitin hnathawh dan thar a zirtir thei che a ni.

CRPS tana taksa enkawlna kawng dang thenkhat chu:

• `Graded Motor Imagery`: Hei hi natna tihziaawmna leh taksa peng natna vei te tihchakna tichangtlungtu enkawlna hrang hrang a ni. I kut emaw, i ke emaw a na chuan khawih emaw, chet emaw, hman emaw a harsa thin. Tin, kan thluak hian taksa peng hrang hrang hriatrengna, a nih loh leh ``map`` a nei bawk. An rilru put hmang te, an che vel dan te, nitin hnathawhna atana an hman dan te. I kut/ke natna i khawih loh chuan, i che lo va, i hman loh chuan he map hi a danglam tan a, a bo pawh a ni thei. Mahse he ``Graded Motor Imagery`` method hmang hian he map hi i thlak thei a, i siam thar thei bawk.
• Mirror therapy: Hei hi Graded Motor Imagery chi khat a ni. I kut/ke nghawng lo chu darthlalang-ah i en a. Chumi hnuah chuan mirror image chu a nghawng kut/ke ang chiah chiah a ni ang. Hei hian i thluak chu a "trick" thei a, tunah chuan kut/ke natna chu tunah chuan a pangngaiin a awm tawh a, a che thei tawh bawk.
• `Desensitization`: Hetiang tih dan hian a natna hmun chu thil texture leh rit hrang hrang hmanga khawih a, a nghawng kut/ke chu tui lum leh vawt takah dah a ni. Hun a kal zel a, a natna hmun chu hriatna hrang hrang i hmuhtir chuan i thluak chu chutiang hriatnaah chuan a insiamrem a, a natna chu a tlahniam tan ta a ni.

Nunphung a inthlak danglam thin

I nerve damna tibuaitu thil thenkhat tihbo hian i dam theihna chance leh speed i tipung thei a ni. Chung zingah chuan:

• Meizial zuk bansan: Meizial hi nerve recovery daltu lian tak a ni.
• Hriselna dinhmun awmsa enkawl dan: Thisen kal leh nerve tichhe thei natna, zunthlum ang chi te hi uluk taka enkawl a nih loh chuan nerve te tan a dam harsa thei hle.

I symptoms te tanpui nan in lama i tih theih tur step awlsam dang thenkhat chu hetiang hi a ni:

• Chawlh emaw mut emaw laiin kut/ke natna chu tlem a sang taka dah hian extra fluid chu thinlungah a kir leh theih nan a pui thin.
• Exercise neih reng hi a pawimawh hle a, hei hian nerve chhia a thisen kal a ti tha thei a ni. I doctor emaw physical therapist emaw nen i tana tha tur exercise plan chungchang sawipui rawh.
• Compression stocking emaw sleeve emaw bun hian, a bik takin ding lai hian a hring chhuak tihtlem thei a ni. Hei hi i tan duhthlan tur a nih leh nih loh i doctor zawt rawh.

Psychosocial leh nungchang lama enkawlna

CRPS neih hi lungkhamna, lungngaihna, leh lungkhamna tihpunna nen a inzawm a ni . Hengte hian natna a tizual thei bawk. Psychotherapy hian a pui thei a ni. Psychotherapy (talk therapy tia koh bawk) tih hi a tlangpuiin mi pakhatin rilru hrisel lo, ngaihtuahna leh nungchang hrisel lote hriatchhuah leh tihdanglam theihna tura puitu enkawlna chi hrang hrang sawina a ni.

A theih chuan CRPS enkawl tura trained pain management clinical psychologist hmuh a tha ber. Psychotherapy-ah chuan psychologist nen in inbia a, i natna leh symptom dangte thlentu thilte chu a tha zawka hmachhawn dan tur i zir thin.

Damdawi chi hrang hrang

United States-ah hian CRPS atana damdawi bik phalna pek a awm lo. Mahse, i doctor chuan i natna lan chhuah dân enkawlna tûr damdawi ṭhenkhat a pe thei a ni.

Damdawi chi hrang hrang, natna tihziaawmna nei:

• Nonsteroidal anti-inflammatory drugs (NSAIDs): Entirnan, acetaminophen, ibuprofen, leh naproxen te hi a ni.
• Topical painkiller cream leh patch: Entirnan, Lidocaine.
• Antidepressant thenkhat: Entirnan Amitriptyline leh Duloxetine te hi a ni.
• Seizure damdawi: Entirna atan Gabapentin, Pregabalin, leh Topiramate te hi a ni.
• Bisphosphonates: Entirnan, Alendronate tih hi a ni.
• Botulinum toxin (Botox) injection hmanga tihdam theih a ni.

Damdawi hman tan dan tur thlan dan hi mi hrang hrangah a inang lo. I doctor chuan thil engemaw zat a ngaihtuah ang a, chungte chu:

• i kum zat.
• Hriselna lama harsatna awm tawh dangte.
• Tuna i ei mek damdawi eng pawh.
• Damdawi hian side effect a neih theih dan emaw, tuna i ei mek damdawi nena inzawmna a neih theih dan emaw.

Natna tihdamna atana hmanraw dang (alternative therapies) te

Natna tihziaawmna atana enkawlna dang dangte chu:

• `Biofeedback a ni` tih a ni
• `Acupuncture hmanga tih a ni
• `Hypnosis tih hi a ni`
• `Reiki` tih a ni
• `Chiropractic` tih a ni

Invasive zawka enkawlna

I CRPS dinhmun hian a chunga kan sawi tak enkawlnate hi a lo chhang tha lo a nih chuan, emaw, natna nasa tak emaw, CRPS awm reng emaw i neih chuan, i doctor chuan heng damdawi invasive lo zawkte hi a rawn rawt thei ang:

• Trigger point/tender point injection: CRPS hi i kut chunglam chauh a nih chuan i shoulder girdle muscle-ah trigger point i nei thei. CRPS bul tan tirh lamah chuan trigger point tinah glucocorticoids injection, local anesthetics nen emaw, tel lo emaw pawh hian a pui thei a ni.
• Sympathetic nerve blocks: Heng block te hian mi thenkhat tan natna tihziaawmna nasa tak a pe a ni. Lumbar sympathetic block tih hian i hnungzang hnuai lam, i ruhro bulah anesthetic inject a ni. Hei hian i ke hnuai lam atanga i ruhro leh thluak thlenga natna signal phurtu sympathetic chain chu direct-in a block a ni. Kut chunglam CRPS natna atana block chu stellate ganglion block an ti a . Hei hian i kawr sir lamah anesthetic inject a huam a ni.
• Spinal cord stimulation: He enkawlnaah hian i pum vun hnuaiah emaw, i hnute leh i ruhro bula wire (electrode) emaw hnuaiah pulse generator device surgery hmanga dah a ni. He device hi pacemaker ang chi hian i spinal cord-ah electrical current hniam tak a thawn thin. Heng electrical pulse te hian i thluak lama natna signal kal chu a titawp a, a ti tlem a ni.
• Dorsal root ganglia stimulation: He enkawlna hi spinal cord stimulation nen a inang a. Mahse, wire te te chu dorsal root ganglion chungah direct-in dah a ni. Dorsal root ganglion hi i taksa chhunga nerve zawng zawng i spinal cord atanga chhuahna hmun junction-a awm sensory neurons cluster a ni. Peripheral nervous system (i ke ruh) atanga central nervous system (i ruh leh thluak) thlenga natna signal relay station a ni. He stimulation hi targeted zawk leh effective zawka enkawlna (stimulation tlem zawk mamawh) a ni thei a, a chhan chu heng intermediate point te te hi a ngaih pawimawh vang a ni.
• Peripheral nerve stimulation: He enkawlnaah hian i kut/ke nerve lian tak bulah stimulation wire dahin, chu chuan i natna hmun chu a khuh a ni. Target nerve kal tlanga pain signal kal chu a titawp a, hna a thawk thin.
• IV ketamine infusion: He enkawlnaah hian ketamine dose tlem te chu thisenah (IV infusion) ni 3 atanga ni 5 chhung pek a ni. Ketamine hian i nervous system-a molecule bik (NMDA receptor) block-in hna a thawk a, chu chuan i natna a tizual thei a ni.
• Intrathecal damdawi pump te chu:He enkawlna hian implanted catheter hmangin Ziconotide (Prialt®) ang chi painkillers te chu i spinal fluid ah direct in a rawn lut thin.

CRPS hi ven theih a ni em?

Researcher-te hian CRPS awm chhan dik tak an hriat loh avangin ven dan tur chiang tak a awm lo. Zirna thenkhatah chuan nakin lawka operation neih hmaa vitamin C ei hian CRPS venna kawngah a pui thei tih hmuhchhuah a ni.

CRPS vei hian eng ang hmalam hun nge a neih?

Mi tinin CRPS chungchanga kan tawnhriat hi a inang lo. Mi tam tak tan chuan CRPS hi hun kal zelah a tha chho zel a, a tawpah chuan remission-ah a kal ta a ni.

Mahse, natna khirh tak emaw, hun rei tak emaw (a tlem hle) chuan i nunah nghawng lian tak a nei thei a ni. Mi thenkhat tan chuan CRPS hi a na zual thei a, taksa peng dangah a darh thei bawk. CRPS thlentu hliam i neih lai khan rilru lama harsatna nasa lutuk i tawn hian i natna nasat dan leh i dam leh theihna a nghawng thei a ni.

CRPS vei zinga 10% leh 30% inkar chuan relapse an nei thei a ni. Relapse tam zawk hi a chhan dik tak hriat a la ni lo.

A tum pawimawh ber chu natna tihziaawmna leh kut/ke natna hmuna che leh chakna neih leh hi a ni. Natna laka chhanchhuahna chuan chu hmuna hnathawhna leh i nunphung tihchangtlunna a tipung a ni. Enkawlna ruahmanna uluk taka thlan a nih chuan CRPS vei thenkhat chuan an natna chu hlawhtling takin an enkawl thei a, nun chak tak an hmang thei bawk.

Doctor hmuh hun tha ber berte chu engte nge ni?

He natna hi a buaithlak a, a chang chuan hriat sual a nih avangin, CRPS chungchang hre chiang pain management specialist emaw specialty pain center emaw i zawng tur a ni:

• `CRPS` symptoms i neih i rin chuan.
• I symptoms a na zual zel a nih chuan.
• I dinhmun hian enkawlna dang a la chhang lo a nih chuan.

CRPS hi rualbanlo nge rilru lam natna?

Ni lo, CRPS hi rilru lam hriselna dinhmun a ni lo. Neurological condition a ni. Mahse, CRPS hian lungkhamna, lungngaihna leh lungkhamna a thlen thei a, a tizual thei bawk. A châng chuan Post-Traumatic Stress Disorder (PTSD) pawh a thlen thei a ni.

United States-ah chuan Social Security Administration chuan CRPS hi a nasat dan leh nunah nghawng a neih dan azirin rualbanlo angin a pawm a ni. Eligibility criteria chungchang hrechiang duh tan sorkar official-te i biak theih a ni.

Take-Home Thuchah a ni

He natna `Complex Regional Pain Syndrome (CRPS)` an tih hian i nunah nghawng lian tak a nei thei a ni. Mahse chanchin lawmawm tak chu, enkawl theih a ni.Enkawlna chi hrang hrang a awm a, chu chu a inzawm khawm pawhin i enchhin thei bawk. CRPS i vei tih hmuhchhuah a nih thuai a, enkawl i tan chuan i symptoms te hian enkawlna a dawng nasa zawk ang. CRPS i nei thei nia i hriat chuan i doctor nen inbia ang che. I tanpui turin an awm reng a ni. Hlau suh la, nangmah chauhin hrehawm tuar suh. A pawimawh ber chu damdawi lam thurawn leh puihna dik tak lak hi a ni.

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