He mamae tō pakihiwi? Tērā pea he Rotator Cuff Tear – Nirogi Lanka

He uaua ki a koe te hiki, te huri rānei i tō pakihiwi? Ka pāngia koe e te mamae nui i a koe e whakamātau ana i ēnei nekehanga? I ētahi wā, ka tino kaha te mamae i te pō, ā, kāore e taea e koe te takoto ki tō taha e pāngia ana? Kāore rānei, kei te rongo koe i te pāorooro, i te hopu rānei i roto i te hononga pakihiwi? Mena koinā, he mea nui ēnei mōhiohio māu. I tēnei rā, i Nirogi Lanka , kei te kōrero mātou mō tētahi āhuatanga noa engari e kore e māramahia: ko te haehae o te Rotator Cuff .

He aha te Rotator Cuff, ā, me pēhea te puta o te roimata?

He whakarāpopototanga noa iho, ko tō poroporo ringa he kohinga o ngā uaua e whā me ō rātou uaua e whakau ana i tō pakihiwi. He rite ēnei hanganga ki te 'poroporo' tiaki, ki te ringaringa rānei e takai ana i tō hononga pakihiwi.

Ko tā rātou mahi matua he āwhina i a koe ki te hapai, ki te whakaheke, me te huri i tō ringa . Hei tāpiri, mā ēnei uaua me ngā uaua e pupuri te tihi poroporo o tō wheua ringa o runga (e mōhiotia ana i roto i te rongoā ko te humerus ) kia mau ki roto i te pūnga papaku o te pakihiwi. Whakaarohia he pōro korowha e noho ana i runga i te tī; pērā tonu, mā te rotator cuff ka whakarite kia noho tika te 'pōro' o tō humerus ki roto i te pūnga me te kore e paheke ki waho.

Ka pakaru te poroporo poroporo ina motu katoa, motu wāhanga rānei tētahi, ētahi rānei o ēnei uaua mai i te humerus. Ka puta pea tēnei nā te whara ohorere (pēnei i te hinganga) nā te pakaru haere rānei i te roanga o te wā.

He rerekē ngā momo roimata?

Āe, e rua ngā momo matua:

1. Haehae Wāhanga: I konei, kāore te uaua i tino wehea mai i te wheua. Kei te hono tonu te uaua, engari kua pakaru, kua pakaru rānei—he rite tonu ki tētahi papanga kua haehaetia engari kāore i tino haehaetia kia rua.

2. Haehae Katoa (Haehae Matotoru): I tēnei wā, ka wehea katoatia te uaua i te wheua. Ko te tikanga, ka puta he kōhao i roto i te uaua, ka wehea rānei te uaua kia rua ngā wāhanga.

He Pēhea te Noa o Tēnei Āhuatanga?

He mea tino noa te pakaru o te ringaringa o te takahurihuri, inā koa i waenga i ngā kaumātua . E ai ki ngā tatauranga e miriona ngā tāngata puta noa i te ao e pāngia ana e ngā raruraru e pā ana ki te ringaringa o te takahurihuri i ia tau.

He mea whakamīharo, tera pea ka haehae ētahi tāngata, ā, kāore he tohu e pā ana ki a rātou, kāore hoki e mōhio kei a rātou te mate. I ētahi wā ka tino wahangu.

He aha ngā tohu, ā, ka pēhea ōu kare ā-roto?

Ka rerekē pea ngā tohu i ia tangata, engari ko ngā tohu noa ko:

• Te mamae, te uauatanga, te ngoikore rānei i te hiki, te whakaheke, te huri rānei i tō ringa. Tērā pea ka kite koe i tēnei mamae i te wā e heru ana i tō makawe, e waru ana i tō tuara, e toro atu ana rānei ki ngā mea i runga ake i a koe.
• He pāorooro, he pakū rānei i roto i te pakihiwi, he kare rānei e huri ana, e mau ana rānei ina nekehia tō ringa.
• Te mamae ka kino haere i te pō. He tino mamae te moe ki te taha e pāngia ana. Mō ētahi, ka mau tonu te mamae ahakoa kei te okioki te ringa.
• Te ngoikore o te pakihiwi, e uaua ai te hiki i ngā mea, te mahi rānei i ngā mahi o ia rā pēnei i te whakatuwhera i te tatau. Tērā pea ka whakaaro koe kāore tō ringa i te kaha pērā i mua.

He aha te āhua o te mamae?

He mamae ā-tangata te mamae. Ko ētahi e whakaahua ana i te mamae puhoi, pumau i roto i te pakihiwi me te taumaha. Ko ētahi ka rongo pea i te mamae koi, kaha pērā i te wero.

• Mena he nui te haehae (nā te whara pēnei i te hinganga), tera pea ka pāngia koe e te mamae pakihiwi ohorere, kaha, me te ngaro tonu o te kaha o te ringa.
• Mēnā he haehae pirau (he pakaru haere), ka tīmata pea koe me te mamae ngawari e tauhohe ana mō te wā poto ki ngā rongoā mamae kore-tohu (OTC). I roto i te wā, ka piki haere te mamae kia kore ra ano e whai hua aua rongoā.
• Ko te mea nui, ehara i te mea ka pāngia te katoa e te mamae. Heoi, ka kite te nuinga o te tangata i te ngoikore o te pakihiwi, o te ringa rānei.

He aha tēnei e tupu ai? He aha ngā take?

He maha ngā āhuatanga ka arahi pea ki te pakaru o te rotator cuff.

1. Whara Whakamataku:

Ka taea e te hinganga, te pānga tika ki te pakihiwi, te nekehanga hiki ohorere rānei, te kaha, te haehae i te uaua. I ētahi wā, ka taea hoki e ngā whara pēnei i te pakihiwi kua motuhia, te whati rānei o te wheua kaki te kino ki te rotator cuff.

2. Ngā Roimata Whakaheke:

Koinei te tino take, inā koa mō te hunga neke atu i te 40 tau te pakeke. He maha ngā āhuatanga e whai wāhi ana ki tēnei:

• Ngā Wheua Wheua: I a koe e pakeke haere ana, ka puta pea ngā tupu wheua iti (ngā wheua wheua) ki te mata o te pakihiwi, ka whakawhāiti i te wāhi mō te uaua. I a koe e hapai ana i tō ringa, ka mirimiri pea ēnei wheua ki te uaua, he āhuatanga e mōhiotia ana ko te Pānga o te Pakihiwi . I roto i te wā, ka rite te mahi a tēnei waku tonu ki te taura e mirimiri ana ki te toka, ka mau te uaua ki raro tae noa ki te haehae.
• Te Rere o te Toto: I te kaumātuatanga, ka heke noa te rere o te toto ki ngā uaua o te pokohiwi. He mea nui te rere o te toto hauora mō te whakaora; ki te kore, kāore e pai te whakatika i ngā whara iti, ā, ka taea te neke haere hei haehae nui.
• Te Whakamahinga Nui me ngā Nekehanga Whakahoki:

Mā te mahi tonu i ngā nekehanga pakihiwi kotahi i te mahi, i te wā rānei e takaro ana, ka pāngia ō uaua me ō uaua e te ahotea roa. Mēnā he maha āu mahi i runga i te tinana—pērā i te peita, te mahi kāmura, ngā takaro pēnei i te whiu kirikiti, te whiu poipapa rānei—tērā pea ka nui ake tō tūponotanga ki te pāngia e ēnei roimata nā te taumahatanga auau.

Ko wai kei te nui ake te mōrearea mō tēnei? (Ngā Take Mōrearea)

Hei te pono, ka taea e te tangata te pāngia e te pakaru o te ringaringa o te ringa. Heoi, tera pea ētahi āhuatanga ka whakanui ake i tō mōrearea. Whakaarohia mēnā e pā ana tētahi o ēnei ki a koe:

• Tau: Ka piki ake te mōrearea mō te hunga neke atu i te 40 tau te pakeke , nā te mea ka ngaro te kaha me te ngāwari o ngā uaua i te roanga o te wā.
• Hītori Whānau: Mena kua pāngia ngā mema o te whānau tata (ngā mātua, ngā tuākana, teina rānei) e ngā raruraru pakihiwi, e ngā pakaru rānei o te pokohiwi, tera pea kei a koe te mate ira.
• Te Momi hikareti: Ka ngoikore ngā uaua i te momi hikareti, ā, ka whakaroa rawa i te tukanga whakaora taiao.
• Te Tūnga Kino: Mā te piko tonu ki runga i te rorohiko, te piko ki runga i tō waea pūkoro, te pupuri rānei i te tūnga kino i a koe e noho ana, e tū ana rānei, ka nui rawa te taumahatanga kāore e tika ana ki tō hononga pakihiwi.
• Ngā Mahi me ngā Hākinakina Motuhake: E ai ki te kōrero, ko ngā nekehanga pakihiwi auau ka arahi pea ki ngā pakaru pirau. Kei roto i ēnei ko:
• Te mahi kāmura
• Te peita
• Te whakatikatika waka
• Ngā mahi e hiahia ana kia hiki taumaha
• Ngā kaitākaro: Ko te hunga e whai wāhi ana ki ngā hākinakina pēnei i te pēhipōro, te whutupōro ngohengohe, te tēnehi, te kaukau, te hoe rānei, he nui ake te mōrearea. Ko ngā hākinakina rongonui o te rohe pēnei i te kirikiti (ina koa mō ngā kaiwhiu poi), te poipapa, me te pēnitimune he nui ake te mōrearea.

Ka aha mēnā ka waihotia kia kore e rongoatia? (Ngā raruraru)

He maha ngā tūroro e pātai mai ana ki a mātou: "He mamae ngawari noa iho, tera pea ka ora ake?" Kāore i te pai te kore aro ki ngā tohu nā te mea ka kino haere ngā pakaru o te poroporo ringaringa mēnā kāore i rongoatia.

• Ahakoa he haehae iti, wāhanga noa, ka taea te huri hei haehae matotoru (katoa) mēnā ka mau tonu te pehi nui rawa o te pakihiwi.
• Ki te haehae katoatia, ka tae pea koe ki te wāhi e kore e taea e koe te neke, te hapai rānei i tō ringa.
• Ki te kore e rongoatia mō te wā roa, ka tūpono koe ki te mamae pakihiwi mau tonu, te ngoikore nui e kore ai koe e mahi i ngā mahi o ia rā, me te whanaketanga pea o ngā raruraru tuarua pērā i te mate pukupuku pakihiwi.

Me pēhea te tautuhi i tōna mate? (Tautuhinga)

Mena kei te pāngia koe e te mamae o tō pakihiwi, te kore rānei e pai ki te noho, ko te mahi tuatahi ko te toro atu ki tētahi tohunga hauora i Nirogi Lanka. Ka arotakehia e mātou tō hītori hauora, ā, ka mahia he aromatawai tinana hōhonu.

1. Whakamātautau Tinana: Ka pā tō tākuta ki tō pakihiwi hei tirotiro mēnā he mamae, he pupuhi rānei. Ka whakamātauhia e rātou tō whānuitanga o te nekehanga, ā, ka aromatawaihia hoki te kaha o tō ringa. Mā ēnei whakamātautau ka taea te tohu tuatahi i te raruraru o te rotator cuff.

2. Ngā Whakamātautau Whakaahua: Hei whakaū i te mate, ka whakamahia pea e mātou:

• X-ray: Ahakoa kāore e taea e te X-ray te tiro tika i te uaua, ka āwhina i te whakakore i ngā wheua, te mate rumatiki, me ētahi atu āhuatanga rerekē o te angaanga.
• MRI (Whakaahua Āhua Aukume): Koinei te paerewa koura mō te tautuhi i ngā pakaru o te pokohiwi. Mā tēnei ka taea e tātou te kite i te rahi tuturu o te pakaru, me te kite rānei mēnā he pakaru wāhanga, he pakaru katoa rānei.
• Matawai Ultrasound: He huarahi whai hua tēnei ki te kite i ngā pakaru o te uaua, i te mumura rānei. He tere ake, he māmā ake hoki te uru atu i te MRI.

He aha ngā kōwhiringa maimoatanga? (Maimoatanga)

Ko te rongo pai, he maha ngā huarahi whai hua hei whakahaere i te pakaru o te hononga o te ringa. Mā tō tākuta e whakatau te huarahi mahi pai rawa atu i runga i tō tau, tō taumata mahi, me te kaha o te pakaru.

Ko te tikanga, ka wehea ngā maimoatanga ki ngā huarahi e rua:

1. Ngā Kōwhiringa Kore-Pokanga

He mea nui kia mōhiotia: Kāore e taea te hono anō, te whakaora rānei i te poroporo poroporo kua pakaru me te kore he pokanga. Heoi, he maha ngā tāngata—ina koa ko te hunga he pakaru wāhanga, ko te hunga kua kaumātua rānei—ka taea te whakamamae nui i te mamae, te whakaora i te mahi a te pakihiwi, me te hoki ki ō rātou oranga o ia rā mā te maimoatanga kore-whakaeke.

E ai ki ngā rangahau , tata ki te 8 i roto i te 10 o ngā tāngata he roimata wāhanga te kite i ngā hua pai mā te maimoatanga kore-pokanga. Heoi, he roa te wā e hiahiatia ana hei whakapai ake, ā, me whakapau kaha pea koe ki tētahi mahere whakaora e roa ana mō ētahi marama, tae atu ki te tau. Ko te manawanui te mea nui.

Ko ngā maimoatanga kore-pokanga ko:

• Te Okiokinga me te Whakarerekētanga o te Mahi: He mea nui te okioki i tō pakihiwi. Me whakarerekē pea koe, me whakamutu rānei i ngā mahi e whakaoho ana i tō mamae mō tētahi wā poto. Ka tūtohu pea tō tākuta kia mau he whitiki ringa mō tētahi wā poto kia okioki ai te kiko.
• Ngā rongoā whakamamae: Hei whakahaere i te mamae me te mumura, ka tūtohu pea tō tākuta i ngā NSAID ka taea te hoko kore-tohu (hei tauira, Ibuprofen, Diclofenac rānei).
• Whakaora Tinana: Koinei te tūāpapa o te whakaoranga kore-pokanga. Mā te kaiwhakaora tinana whai tohu koe e ārahi mā roto i ngā mahi whakapakari tinana me ngā mahi totoro hei whakaora i tō whānuitanga o te nekehanga. Ko te piri tonu ki tēnei kaupapa te huarahi tino whai hua hei whakapai ake i te mahi a tō pakihiwi.
• Werohanga Steroid: Mena he nui te mamae me te mumura, ka tūtohu pea tō tākuta kia werohia he corticosteroid. Ahakoa he tere, he nui hoki te whakaora i tēnei, he otinga rangitahi noa iho, ā, kāore i te tūtohutia hei rautaki maimoatanga mō te wā roa.

2. Ngā Kōwhiringa Pokanga

Ko te tikanga ka whakaarohia te pokanga mēnā:

• Kua pakaru katoa tō kiri (ina koa mēnā he nui).
• He haehae wāhanga tōu, engari kāore e kitea he whakapainga i muri i te 6–12 marama o te whakaora tinana auau.
• He tangata taitamariki koe, he tangata kaha ki te mahi, he tangata rānei e whakawhirinaki ana tō pakihiwi ki tōna kaha ki te mahi.
• I pāngia koe e te pakaru nui nā te whara ohorere.

Ko te nuinga o ngā whakatikatika i te hononga o te pokohiwi ka mahia mā te arthroscopic . Ko te tikanga ka tapahia e tō taote pokanga ētahi tapahi iti ki tō pakihiwi, ka whakauruhia he kāmera iti (arthroscope) me ngā taputapu pokanga. Nā te mea he huarahi iti rawa te whakaekenga o tēnei, tera pea ka iti ake te mamae ka tere ake te ora. Heoi, i ngā wā he nui rawa, he uaua rānei te haehae, ka tūtohu pea tō taote pokanga kia tuwhera te pokanga, kia nui ake te tapahi.

Ko te whāinga matua o te pokanga he whakahoki i te uaua pakaru ki te wheua. Mena he wheua pī kei te rohe, ka tangohia pea e te taote pokanga i te wā e mahia ana.

• Mō ngā haehae wāhanga: Me kuti noa iho pea e te taote pokanga ngā taha pakaru o te uaua. E mōhiotia ana tēnei tikanga ko te tango i te kiri pakaru .
• Ngā haehae kore e taea te whakatika: Ko ētahi haehae he nui rawa, he roa rawa rānei te wā e kore ai e taea te whakatika. I ēnei wā, ka matapaki pea tō tākuta i ētahi atu kōwhiringa pēnei i te whakakapinga pakihiwi whakamuri, te whakawhiti uaua rānei, ka nekehia he uaua hauora hei whakaora i te mahi.

He tikanga tēnei mō te noho ki waho o te hōhipera, he wā poto rānei, arā, ka hoki pea koe ki te kāinga i taua rā anō, i te rā e whai ake nei rānei. Heoi, kia mōhio koe he roa te wā e hiahiatia ana mō te whakaora katoa—he maha ngā wā he tau, he maha atu rānei.

Kia pēhea te roa o te whakaoranga? (Te Wā Whakaora)

He āwangawanga noa tēnei mō te tini o ngā tūroro.

• Kāore he pokanga: Mā te whakaora tinana me ētahi atu maimoatanga ātaahua, ka kite pea koe i te whakaiti i te mamae me te whakapai ake i te mahi i roto i ētahi marama.
• Me te pokanga:
• Whai muri i te tikanga, me mau whitiki koe mō ngā wiki e 4 ki te 6 hei whakau i tō pakihiwi, kia ora ai.
• Kātahi ka tīmata koe i te whakaora tinana . He mea nui tēnei, ā, he mea nui hoki mō te angitu. Ka tīmata koe me ngā mahi whakakori tinana ngāwari, ā, ka neke haere ki ngā mahi whakakaha tinana.
• Ka hoki anō te nuinga o ngā tūroro ki te mahi me te kaha o mua i roto i te 4 ki te 6 marama , ā, ka taea te mahi i ngā mahi o ia rā.
• Heoi, ko te oranga katoa me te hoki ki ngā hākinakina, ki te hiki taumaha rānei, ka roa pea i te 9 ki te 18 marama. Kei te rahi o te pakaru, te momo pokanga, tō tau, me te kaha o tō whai i tō kaupapa whakaora tinana.

He aha te tirohanga? (Matapae/Tirohanga)

He pai te hua o te nuinga o te iwi i muri i te whara o te pokohiwi.

• Maimoatanga kore-pokanga: He maha ngā tūroro e whakahaere pai ana i ō rātou mamae, ā, ka hoki anō ki te taumata teitei o te mahi.
• Maimoatanga pokanga: Ina koa mā ngā tikanga arthroscopic hou, he maha ngā tūroro e whakaora angitu ana i te mahi a te pakihiwi.
• Mōrearea haehae anō: He iti noa te tūponotanga ka haehae anō te uaua. He nui ake tēnei mōrearea mēnā he nui te haehae tuatahi, mēnā kua pakeke koe, mēnā he kaipaipa koe. Mēnā ka pāngia koe e te mamae nui, ka ngaro rānei te nekehanga anō, me toro atu ki tō tākuta tonu nā te mea me mahi pokanga anō pea.

Ka taea te ārai i tēnei? (Te ārai)

Ahakoa e kore e taea te ārai i te roimata i ngā wā katoa, ka taea e koe te whakaiti i tō tupono ki ngā whara tohumate:

• Kia kaha, kia ngāwari hoki ngā uaua o tō pakihiwi: Me mahi ngā mahi totoro me te whakapakari i ngā uaua e ai ki ngā taunakitanga a tō tākuta, a tō kaiwhakaora tinana rānei.
• Kia tika te tū: Kia tūpato ki tō tū i te wā mahi me ngā hākinakina.
• Āta karohia te taumahatanga auau: Mena he maha ngā nekehanga kei roto i tō mahi, me okioki pinepine.
• Hiki tika: Āta karohia ngā nekehanga ohorere, ohorere; hikihia mā ō waewae, ā, kaua e whakararuraru nui i te hononga pakihiwi.
• Kati te kai paipa: Ka whakararu te kai paipa i te rere o te toto me te whakaora.

Āhea te wā me waea atu ki tō kaiwhakarato hauora?

Whakaritea he haerenga ki tō tākuta mēnā ka pāngia koe e:

• Te mamae o te pakihiwi, o te ringa rānei, e mau tonu ana mō ētahi wiki.
• Te mamae e kino haere ana i te pō, e whakararuraru ana i tō moe.
• Te whero, te pupuhi, te mamae nui rānei huri noa i te hononga pakihiwi.
• Te ngoikore ohorere, kāore i te mārama te take o te pakihiwi, o te ringa rānei, inā koa i muri i te whara.
• Te mamae e tino whakawhāiti ana i tō kaha ki te mahi i ngā mahi o ia rā.

Ngā pātai hei pātai atu ki tō tākuta:

Kaua e mangere ki te pātai atu ki tō tākuta i ēnei pātai e whai ake nei:

• He aha te take o te pakaru o taku rotator cuff?
• He roimata wāhanga, he roimata katoa rānei tōku, ā, he pēhea te kaha?
• He aha te mahere maimoatanga pai rawa atu mōku? Me mahi pokanga?
• He aha ngā hua ka taea e au te tumanako mai i ngā maimoatanga kore-pokanga?
• He aha ngā mōrearea o te pokanga, ā, he aha te roanga o te wā whakaora e tumanakohia ana?
• Me pēhea taku ārai i tēnei mea kei puta anō?
• He mahi motuhake kei reira me karo e au, ā, ko ēhea ngā mea haumaru?
• He aha ngā tohu o ngā raruraru me tūpato ahau?

Mena he mahi pukumahi tāu, he kaitākaro rānei, me whai wā okioki mō te wā poto mō tēnei whara mai i ō mahi o ia rā—engari kāore e tika kia mutu tō mahi, tō hākinakina rānei. Kōrerohia te huarahi pai ki tō tīma hauora i Nirogi Lanka. Mā te manawanui, te maimoatanga tika, me tō whakapau kaha ki te whakaora, ka taea te whakaora. Ko te auau me te whai i ngā tohutohu hauora te mea nui ki tō whakaoranga.

Ngā Kaupapa Matua (Karere hei Whakahoki ki te Kāinga)

He mate noa te haehae o te ringaringa takahuri, engari he mate kino pea, ka arahi pea ki te mamae nui o te pakihiwi me te ngoikore.

• Ngā Take: Te whara ohorere, te pakaru me te haehae o te tinana nā te koroheketanga, ngā mahi auau o runga, te whanaketanga rānei o ngā koiwi.
• Ngā Tohu: Mamae te pakihiwi (ina koa i te pō, i te wā rānei e hiki ana i tō ringa), he uaua ki te hiki i tō ringa, he ngoikore whānui, me te pāorooro, te pakū rānei o te pakihiwi.
• Tātaritanga: He whakamātautau tinana e tō tākuta, ā, i muri mai ka whai i te hihi-X, te MRI, te ultrasound rānei.
• Maimoatanga: Okiokinga, rongoā ārai-mumura (NSAID), whakaora tinana, werohanga corticosteroid, ā, mēnā e tika ana, te pokanga (pēnei i te pokanga arthroscopic).
• He Tuhipoka Hira: Mena kei te mamae tonu tō pakihiwi, kei te uaua rānei te nekeneke, tēnā whakapā atu ki tētahi tohunga hauora. Mā te tātaritanga wawe me te maimoatanga ka pai ake te putanga o tō whakaoranga. Kaua e ngana ki te rongoā i a koe anō, kaua hoki e wareware ki ō tohumate. He mea nui tō nekehanga, ā, i Nirogi Lanka, kei konei mātou hei tautoko i tō whakaoranga.

Ngā Kupumatua: mamae pakihiwi, rotator cuff, haehae uaua, whara pakihiwi, whakaora tinana, pokanga pakihiwi, haehae rotator cuff