Kei te mamae tonu tō kaki, ō pakihiwi, ō ringaringa rānei? Tērā pea ko te Thoracic Outlet Syndrome (TOS) tēnei mate!

Ka rongo koe i ētahi wā i te mamae rerekē, i te ngoikore rānei e rere ana mai i tō kaki me ō pakihiwi ki raro i ō ringaringa? Tērā pea ka piki ake tēnei mamae ina hiki koe i tētahi taumaha, ina hiki rānei i tō ringa. Mēnā he tohu pēnei āu, ko te take pea he mate he ingoa uaua. I tēnei rā ka kōrero tātou mō tētahi mate pēnei, arā, ko te Thoracic Outlet Syndrome (TOS) . Ahakoa he ahua whakamataku te ingoa ina rongo koe, ki te mōhio tika koe ki tēnei mea, ka taea e koe te whakaiti i ngā raruraru maha.

He aha te Mate Putanga o te Uma?

Ki te whakarapopototanga, ko te Thoracic Outlet Syndrome (TOS) he kohinga tohu e puta mai ana i te pēhanga o ngā io, o ngā uaua toto rānei i roto i tō kaki o raro me tō uma o runga. Ko tētahi atu ingoa mō tēnei ko te "thoracic outlet".

Whakaarohia he wāhi iti nei, pērā i te tatau, i waenganui i tō kaki me tō uma. Koinei te mea e kiia nei e ngā tākuta ko te "Thoracic Outlet." Mā roto i tēnei wāhi ka puta ngā io nui e haere ana ki tō ringa, me ngā uaua e kawe ana i te toto ki tō ringa me ngā uaua e whakahoki ana i te toto mai i tō ringa ki tō ngākau. Ko te mea nui o ēnei ko te brachial plexus, he whatunga o ngā io e haere ana ki tō ringa, me te uaua me te uaua subclavian.

I te nuinga o te wā, he nui te wāhi e kiia nei ko te "putanga o te uma" hei whakawhiti mā ēnei io me ngā oko toto, me te kore he ārai. Heoi, i ētahi wā ka whaiti tēnei wāhi nā ētahi rerekētanga hanganga o te tinana, nā ngā whara rānei o te kaki, o te uma rānei. Koinei te wā ka tīmata ai te raruraru. Ina whaiti tēnei wāhi, ka tīmata te pēhi i ngā io, i ngā oko toto rānei e haere ana mā roto i ngā wheua, i ngā uaua rānei i raro. Ka puta mai ngā tohu pēnei i te mamae me te ngoikore o tō ringa, pakihiwi, me tō kaki nā tēnei pēhanga. Kāore e pā ana ēnei tohu, ā, he rerekē hoki, nō reira ka roa pea te wā ka mōhiotia ai tēnei he mate TOS .

Kaua e manukanuka. He maha ngā tāngata ka taea te whakaora mā roto i ngā maimoatanga ngāwari pēnei i te whakaora tinana me ngā rongoā whakamamae mamae. Heoi, ki te kore ēnei e āwhina, ki te mea rānei he aukati nui i te rere o te toto, me mahi pea te pokanga.

He momo TOS kei reira?

Ae, ka wehea e ngā tākuta te TOS kia toru ngā momo matua, i runga i te take o tēnei mamae:

Te TOS Neurogenic (Te TOS i puta mai i te pēhanga io)

Koinei te momo TOS tino noa . Tata ki te 95% o ngā tūroro TOS katoa he momo tēnei. Ko te mea e tupu ana i konei ko te pēhi i te "Brachial plexus", te whatunga io e rere ana mai i tō kaki mā roto i tō kēkē ki tō ringa. Ko te nuinga o te wā ka pā ki te hunga kei roto i ō rātou tau 30. Ko ngā whara ahotea auau - inā koa i roto i ngā hākinakina - me ngā whara ohorere ki te kaki, pērā i te "Whiplash" mai i tētahi aituā motuka, koia ngā tino take.

TOS i puta mai i te pupūnga o ngā uaua (Venous TOS)

Koinei te wāhi e puta ai tō "uaua subclavian". Koinei te uaua toto matua e kawe ana i te toto paru mai i te ringa ki te ngākau. He maha ake te pānga ki ngā tāne , i waenganui i te 20 me te 30 tau te pakeke. He maha ngā wā ka puta ngā tohu i te ringa e whakamahia nuitia ana ('ringa matua').

Te TOS i puta mai i te pēhanga o te uaua (Te TOS o te uaua)

Koinei te momo TOS tino onge . E pāngia ana e te tata ki te 1% o ngā tūroro TOS katoa. Heoi, koinei te tino take o te toto totoka ohorere i roto i ngā ringa i roto i te hunga kei raro iho i te 40 tau te pakeke. Ka puta tēnei momo TOS i roto i tō uaua subclavian, te uaua toto matua e kawe ana i te toto hāora mai i tō ngākau ki ō ringa. He maha ngā wā ka puta mai i tētahi āhuatanga whānau. Hei tauira, he rara tāpiri i roto i te kaki (rara o te kaki). Tata ki te 70% o te hunga whai rara o te kaki he wāhine, nō reira he nui ake te kitea o tēnei momo TOS i roto i ngā wāhine.

I ētahi wā ka whakakotahi ngā tākuta i ngā momo TOS venous me arterial ka kiia ko te "Vascular Thoracic Outlet Syndrome." Ko ngā momo e rua e hiahiatia ana he pokanga hei whakaora i ngā tohu me te ārai i ngā raruraru. Ko te momo TOS e pā ana ki te io (Neurogenic TOS) ka pai te urupare ki te whakaora tinana me te korikori tinana, engari ko ētahi tāngata ka hiahia pea ki te pokanga.

He pēhea te noa o tēnei āhuatanga?

E ai ki ngā kairangahau, i ia tau:

• Ka puta te TOS neurogenic i roto i te kotahi i roto i te 40,000 tāngata.
• Ka puta te TOS uaua i roto i te kotahi i roto i te 1.25 miriona tāngata.

Heoi, nā te uauatanga o te tautuhi tika i tēnei mate, tera pea ka nui ake te tokomaha o te hunga e pāngia ana e tēnei mate.

He aha ngā tohu o te TOS?

Ko ngā tohumate TOS ka puta i te taha kotahi o tō tinana o runga (kaki, uma o runga, pakihiwi, ringa, maihao rānei). Tērā pea ka pāngia koe e ēnei āhuatanga:

• Mamae: Ka piki ake pea tēnei mamae ina ara ake tō ringa.
• Te ngenge, te ahua "ngoki" rānei.
• Te ngenge, te kore e rongo i tetahi mea i roto i te ringa .
• Te ngoikore o te ringa.
• Te pupuhi, te taumaha rānei o te ringa.
• Ka huri te tae o te kiri (ka mā, ka kikorangi rānei te kiri).
• Te mātao ina pā ki te kiri.
• He roa te wā e ora ai ngā patunga o ngā maihao.

Ka rerekē pea ēnei tohu i runga i te momo TOS kei a koe. Nā te mea ka whakawhirinaki ngā tohu ki te mea e pēhia ana (he io, he uaua toto rānei). Hei whakamārama, koia ēnei:

• Ko tō "Brachial plexus" te wāhi e neke ai tō ringa, e rongo ai hoki. Nō reira, ina pāngia tēnei whatunga io e te mamae me te korekore o te tinana, ka puta ngā āhuatanga pēnei i te mamae me te korekore o te tinana.
• Ko tō uaua subclavian te mea e kawe ana i te toto mai i tō ringa ki tō ngākau. Nō reira, ina āraia tēnei uaua, kāore e taea e te toto o tō ringa te rere tika, ka pupuhi, ka taumaha hoki tō ringa.
• Mā tō uaua subclavian e tuku te toto whai hāora ki tō ringa. Nō reira, ina āraia tēnei uaua, ka heke te rere o te toto ki tō ringa me ō maihao. Ka pā mai pea te ngoikore, te ngau, te mamae, me te mātao o tō ringa.

He aha te āhua o te mamae TOS? He rite tonu ki te angina?

Ka mamae pea tō kaki, tō uma o runga, tō pakihiwi, me tō ringa i te TOS. He mamae puhoi tēnei, pērā i te mamae e mau tonu ana, ā, ka kino ake pea ina nekehia tō ringa.

Ka pohehe ētahi tāngata i te mamae TOS me te angina , he mate ngākau. Ko te angina he mamae uma nā te korenga o te hāora e whiwhi ana te uaua ngākau. Engari he rerekētanga nui kei waenganui i ngā mea e rua:

• Kāore te mamae TOS e puta mai, e kino haere rānei i te hikoi. Heoi, ko te mamae angina te tikanga ka puta. Ka taea e te angina te haere tahi me ētahi atu tohu pēnei i te poto o te manawa, te tere o te ngakau, me te whanoke.
• Ka piki ake te mamae o te TOS ina ara ake te ringa e pāngia ana. Kāore tēnei e tupu me te angina.

He mea nui: Kaua e whakapoauautia te TOS me te mate manawa, te whiu rānei!

He mea tēnei hei maumahara māu . Ko ētahi o ngā tohu o te TOS ka rite ki ērā o ngā mate kino pēnei i te mate manawa me te whiu, e hiahia ana kia rongoatia wawetia. Hei tauira:

• Ko te mamae o te uma , ina koa ka puta ohorere, he tohu pea nō te mate manawa. Heoi, i roto i te mate manawa, tera pea ētahi atu tohu, pērā i te poto o te manawa, te mamae o te puku, te werawera, me te mataku kei mate.
• He tohu pea te ngoikore o te taha kotahi o te tinana mō te pararutiki. Heoi anō, ka pā mai pea ētahi atu tohu mō te pararutiki, pērā i te kōrero pōturi, te piko o te taha kotahi, o ngā taha e rua rānei o te mata, me te ngaro ohorere o te tirohanga.

Ki te pāngia koe e ngā tohu o te mate manawa, te whiu rānei, rapua tonutia he awhina hauora. He āhuatanga ohorere ēnei e morearea ana ki te ora. Ka mate pea koe i te whakaroa i te maimoatanga.

He aha ngā take o te TOS?

E toru ngā wāhanga matua o ngā take o te TOS e wehea ana e ngā tākuta:

Ngā take whānautanga

Koinei ētahi o ngā panonitanga kei roto i tō tinana ina whānau koe. Hei tauira, tērā pea ka whānau mai koe me tētahi rara tāpiri (he 'rara kaki') kei roto i tō kaki. He tata tēnei ki te rara tuatahi, ā, tera pea he hononga ki tēnā. Tērā pea he rerekētanga kei roto i ō rara, i ō uaua kaki, i ō hononga rānei. Ka taea e ēnei panonitanga te pēhi i ngā io, i ngā oko toto rānei i roto i te 'putanga o te uma'.

Nā ngā aituā (Ngā āhuatanga kino)

He whara ohorere ēnei ki tō kaki me te uma o runga. Ko ngā whara mai i ngā aituā motuka, inā koa ko te whiu whiu, he tauira pai tēnei. Whakaarohia, mēnā kei te eke koe i tētahi waka wira-toru, ā, ka pāngia koe e tētahi aituā, ā, ka whati whakarere tō kaki, ka tupu pea tēnei.

Nā ngā mahi tonu (Whaihua)

Ko te tikanga o tēnei, ina mahi tonu koe i te mea kotahi, ka pakaru ngā mea o roto i te "putanga o te uma". He take noa tēnei mō tēnei i waenga i ngā kaitākaro (ina koa ko ngā kaitākaro kirikiti - ngā kaiwhiu poi, ngā kaipatu, me ngā kauhoe) nā te tere o ngā nekehanga o te ringa. Ko tētahi atu tauira ko te hiki tonu i ngā mea ki runga ake i te mahunga i roto i ētahi mahi. Ahakoa te tangata e mahi ana i mua i te rorohiko i te rā katoa me te tū kino, ka tūpono pea ki te mōrearea.

Ahakoa i whānau mai ētahi tāngata me ngā āhuatanga mōrearea mō te whakawhanake i te TOS, tērā pea kāore rātou e pāngia e tetahi tohu tae noa ki te whara ohorere o te kaki, ki te mahi tonu rānei i te momo mahi kotahi, ā, ka pakaru.

Ko wai kei te nui ake te mōrearea ki te whakawhanake i te TOS?

Tērā pea ka nui ake tō tūponotanga ki te whakawhanake i te TOS mēnā:

• Mena kei te takaro koe i ngā hākinakina e whakamahi pinepine ana i ngā nekehanga ringa, pakihiwi rānei. Hei tauira: kirikiti, kaukau, korowha, poipapa.
• Ki te hiki taumaha koe.
• Mena he maha ngā wā ka hiki koe i ngā putea taumaha ki runga i ō pakihiwi, ka hiki rānei i ngā mea ki runga ake i tō mahunga (hei tauira, ngā tāngata e mahi ana i te umanga hanga, ngā tāngata e uta ana i ngā taonga)
• Mena kua whara tō kaki, tō tuara rānei, hei tauira, ko te `(Whiplash)`.
• Mena he pukupuku, he kōpuku lymph nui rānei kei te uma o runga, kei te kēkē rānei.
• Mena kāore tō tūnga noho, tū rānei i te pai. (Hei tauira: te hunga e mahi ana i runga i te rorohiko me te piko o ō rātou tuara i te rā katoa)

He mate kino te TOS? He aha ngā raruraru ka pā mai?

Ki te kore e rongoatia, ka arahi pea te Thoracic Outlet Syndrome ki ngā raruraru nui. Ko ētahi o ēnei ko:

• Te toto totoka i roto i te kēkē me ngā uaua e pā ana ('Axillo-subclavian vein thrombosis').
• Te pupuhi me te mamae tonu o te ringa, inā koa mō te hunga he uaua tōngāmimi ('Venous TOS').
• Te mate o ngā kiko (‘Gangrene’).
• Ka puta ngā mate pukupuku ischemic ki ngā maihao nā te heke o te rere o te toto.
• Te kino tuturu o te io.
• Te embolism pūkahukahu - He mate tino morearea tēnei.

Nō reira, ehara i te mea pai te whakaaro noa he raruraru iti noa iho tēnei. He mea tino nui kia kitea wawetia, kia rongoātia hoki.

Me pēhea koe e tino mōhio ai mēnā kei a koe te TOS? (Tauātanga)

Ka tirohia koe e te tākuta, ka pātai atu hoki mō tō hītori hauora hei whakatau mēnā he TOS tōu. I te wā o te whakamātautau tinana, ka tono atu tō tākuta kia whakahaerehia e koe ētahi whakamātautau nekehanga. Hei tauira:

• 'Whakamātautau i te pēhanga o te waewae o runga' (he whakamātautau hei tirotiro mēnā kua pāngia te waewae o runga)
• 'Whakamātautau ahotea ringa teitei'

I roto i ēnei whakamātautau, ka tono tō tākuta kia mahi koe i ngā mea ngāwari pēnei i te hiki i tō ringa, te huri i tō mahunga, me te rūrū i tō ringa. Kātahi ka tirohia e ia ko ēhea nekehanga e puta ai te mamae, te tohu rānei. Ka āwhina pea ngā hua ki te tautuhi i te mate.

Hei tāpiri, ka tono pea tō tākuta i ngā whakamātautau taiwhanga me ngā whakamātautau whakaahua hei whakaū i te mate o te TOS me te whakakore i ētahi atu take o ō tohu.

He aha atu ngā whakamātautau ka mahia e koe?

Me whai koe i tētahi, i ētahi rānei o ēnei whakamātautau:

• Ngā whakamātautau toto .
• He hihi-X o te uma .
• He matawai CT o te uma me/ranei te tuaiwi .
• Whakamātautau EMG (`Electromyography (EMG)`) – Mā tēnei ka tirohia te mahi a ngā uaua me ngā io.
• Te angiography aukume (MRA) o ō uaua toto .
• Whakaahua aukume (MRI) o te uma me/ranei te tuaiwi .
• He rangahau mō te kawe karere – E ine ana tēnei i te tere o te haere o ngā karere mā roto i ngā io.

Ka āwhina ēnei whakamātautau i te tākuta ki te kimi i:

• Tirohia mēnā he āhuatanga kāore i te tika mō te whānautanga (hei tauira, he rara o te kaki).
• Tirohia te rere o te toto i roto i ō uaua me ō uaua toto.
• Me whakakore ngā āhuatanga kē atu e hua ai ēnei tohu.
• Tirohia te mahi a ō uaua me ō io.
• Kimihia te wāhi tika o te pēhanga.

He aha ngā maimoatanga mō te TOS?

Ka rerekē te maimoatanga mō te TOS i runga i te momo TOS kei a koe me ō tohumate. Ko te whāinga matua o te maimoatanga he whakaiti i ngā tohumate me te ārai i ngā raruraru ka pā mai. Mā tō tākuta e whakatau ko tēhea te maimoatanga e pai ana māu.

Anei ētahi maimoatanga ka taea:

• Whakaora tinana: Koinei te rongoā tuatahi mō te mate pūnaha io. Ka taea e te kaiwhakaora tinana te āwhina i a koe ki te whakanui ake i te whānuitanga o te nekehanga i roto i tō kaki me ō pakihiwi, te whakapakari i ō uaua, me te pupuri i te tū tika. He tino whakamarie tēnei mō te tini o te hunga e pāngia ana e te mate pūnaha io.
• Ngā rongoā whakamamae mamae: Tērā pea ka tohua e tō tākuta ngā rongoā whakamamae mamae, pērā i ngā NSAID (ngā rongoā anti-inflammatory kore-steroidal), ka taea e koe te hoko mai i te whare rongoā.
• Ngā rongoā hei ārai, hei whakarewa rānei i ngā toto totoka:Ka taea te āwhina i te hunga whai TOS uaua, uaua rānei mā te 'whakaora thrombolytic' (maimoatanga whakarewa toto). Ko te tikanga o tēnei ko te tuku rongoā mā te raina IV, mā te catheter rānei hei whakarewa i ngā toto kua pakaru, hei ārai hoki i te hanganga o ngā toto hou. Tērā pea ka tohua e tō tākuta he 'rongoā anticoagulant'.
• Pokanga: He maha ngā tāngata whai TOS e pēhi ana i ngā uaua toto, me pokanga. Ko ētahi tāngata whai TOS e pēhi ana i ngā io, me pokanga pea mēnā kāore ētahi atu maimoatanga e āwhina. Ka whakamahia e ngā taote pokanga ngā tikanga pokanga rerekē i runga i te momo TOS me tō momo tinana. Hei tauira, ka tangohia e te pokanga tango pēhi te wheua, te kiko rānei rerekē e puta ai te pēhi. Ka taea e ētahi atu pokanga te whakapai ake i te rere o te toto mā te whakatika i ngā raruraru hanganga i roto i ngā uaua toto. Ma tō tākuta koe e whakamārama mēnā me pokanga koe, me pēhea te mahi, me ngā mōrearea.

Ka pai ake rānei te TOS i a ia anō ?

Kāo, kaua e tatari kia pai ake ngā tohumate. Mena kei a koe ngā tohumate o te TOS , rapua tonutia he awhina hauora. Ahakoa he maha ngā mea ngāwari pēnei i te whakaora tinana ka āwhina i te whakamamae i ngā tohumate, tera pea ka hiahia ētahi tāngata ki te pokanga, ki ētahi atu maimoatanga rānei hei ārai i ngā raruraru nui. Ma tō tākuta koe e kī ko tēhea te mahere maimoatanga pai rawa atu māu.

Ka taea te ārai i te TOS?

Kāore e taea te ārai i ngā TOS i ngā wā katoa. Nā te mea he maha ngā āhuatanga e hua ake ai tēnei mate kei tua atu i tā tātou mana whakahaere (hei tauira, ngā āhuatanga ira), kei reira ētahi mea ka taea e koe te mahi hei whakaiti i tō mōrearea:

• Ki te tākaro koe i tētahi hākinakina e hiahia ana kia nekehia ngā ringa i ngā wā katoa, kōrero ki tō kaiako mō ngā mahi whakakori tinana ka taea te whakapakari i ngā uaua huri noa i ō pakihiwi.
• Mena me hiki e koe ngā taumaha, me mahi rānei i runga i te tinana i tō mahi, kōrero ki te tākuta mō ngā mahi whakakori tinana hei whakaiti i te tūponotanga o te whara.
• Kia tika te tū. Kia tika tō tuara i a koe e noho ana, e tū ana, e mahi ana hoki.
• Kaua e noho tonu i te tūnga kotahi. Whakatika, hikoi haereere i te iti rawa i te kotahi i te hāora, me te totoro i tō tinana.

Mena kei a koe ngā TOS, he aha ngā mea e tika ana kia tumanakohia e koe? / Me pēhea e taea ai e koe te tiaki i a koe anō?

He rerekē te āhua o te tangata whai TOS i runga i te momo TOS kei a rātou. Mā tō tākuta koe e tohutohu pai mō tō āhua.

Mena kei a koe ngā TOS, whai i ngā tohutohu a tō tākuta mō te tiaki i a koe anō. Tērā pea ka tohutohu atu tō tākuta i ētahi mea pēnei i:

• Whakaitihia, kati rānei te amo i ngā peke taumaha i runga i ō pakihiwi, me te hiki i ngā mea i runga i tō mahunga i ngā wā katoa e taea ana.
• Mahi tahi me tētahi kaiwhakaora tinana. Mahia ngā mahi whakakori tinana e hoatu ana e ia ki a koe.
• Mahia ngā mahi whakakori tinana ka taea e koe te mahi ki te kāinga hei whakapakari i ō uaua me te whakapai ake i tō tū.
• Whakawhāitihia, karohia rānei ētahi nekehanga e whakanui ana i ngā tohu.Hurihia tō mahinga o ia rā.

Āhea koe me toro atu ki te tākuta? / Ngā pātai hei pātai atu ki te tākuta

Ki te puta he tohu hou ki a koe, ki te rerekē rānei ō tohu, kōrero ki tō tākuta. Māna koe e kī atu ki te auau o te wā me toro atu koe ki tō tākuta, me te mea hoki me whai whakamātautau koe.

Mena kua kitea tō mate i te Thoracic Outlet Syndrome, anei ētahi pātai ka taea e koe te pātai atu ki tō tākuta:

• He aha te momo mate puku o te uma kei a au?
• He aha te take mō tēnei?
• He aha ngā maimoatanga e taunaki ana koe? Āhea me mahi?
• Me pēhea tātou e mōhio ai mēnā kei te angitu te maimoatanga?
• He aha ngā mōrearea o te maimoatanga?
• He aha ngā huringa me mahi e au i roto i aku mahi o ia rā, i aku tikanga rānei?
• He aha taku e taea ai te mahi i te kāinga hei whakaiti i ngā tohu?
• He aha taku tirohanga?

Ngā mea hei maumahara māu i tēnei tuhinga (Karere hei tango māu i te kāinga)

Ka taea e te Thoracic Outlet Syndrome (TOS) te whakararuraru i tō oranga noa. Ka taea e te whakahōhā te whai wā okioki mai i ō hākinakina, i tō mahi rānei. Engari kia manawanui. Mā te tiaki i a koe anō me te whakaora tinana, me ētahi atu maimoatanga rānei, ka taea e koe te whakahoki mai i tō kaha me te noho ora tonu mō te wā roa.

Ko te mea nui ko te rapu tohutohu hauora mēnā ka pāngia koe e ngā tohu, kaua e warewarehia. Mā te kitenga wawe ka māmā ake te maimoatanga, ā, ka whakaitihia te tūponotanga o ngā raruraru.

Mena he pātai āu mō tō āhua, tō mahere maimoatanga, tō tirohanga rānei, kōrero ki tō tākuta.

` Te Mate Putanga o te Uma, TOS, mamae kaki, mamae ringa, mamae pakihiwi, ngoikore, pēhanga io