ꯅꯍꯥꯛꯅꯥ ꯅꯣꯔꯃꯦꯜ ꯑꯣꯏꯕꯥ ꯑꯅꯥꯕꯥ ꯐꯥꯎꯕꯥ ꯌꯥꯕꯥ ꯉꯃꯗꯕꯥ ꯑꯣꯏꯅꯥ ꯎꯕ꯭ꯔꯥ? ꯍꯥꯏꯄꯔꯑꯦꯂꯖꯦꯁꯤꯌꯥꯒꯤ ꯃꯇꯥꯡꯗꯥ ꯋꯥꯔꯤ ꯁꯥꯁꯤ!

ꯀꯤꯆꯦꯅꯗꯥ ꯊꯕꯛ ꯇꯧꯔꯤꯉꯩꯗꯥ ꯅꯍꯥꯛꯀꯤ ꯈꯨꯠꯇꯥ ꯈꯔꯥ ꯁꯣꯀꯄꯥ ꯌꯥꯏ ꯍꯥꯌꯅꯥ ꯈꯅꯕꯤꯌꯨ꯫ ꯅꯠꯔꯒꯥ ꯀ꯭ꯔꯤꯀꯦꯠ ꯁꯥꯟꯅꯔꯤꯉꯩꯗꯥ ꯑꯗꯣꯃꯒꯤ ꯑꯄꯤꯀꯄꯥ ꯈꯣꯡꯎꯞ ꯑꯃꯥ ꯂꯩ꯫ ꯑꯁꯤꯒꯨꯝꯕꯥ ꯃꯇꯝ ꯑꯁꯤꯗꯥ ꯈꯔꯥ ꯁꯣꯀꯄꯥ ꯍꯥꯌꯕꯁꯤ ꯅꯣꯔꯃꯦꯂꯅꯤ꯫ ꯑꯗꯨꯕꯨ ꯀꯔꯤꯒꯨꯝꯕꯥ ꯑꯗꯨꯒꯨꯝꯕꯥ ꯑꯄꯤꯀꯄꯥ ꯑꯋꯥꯕꯥ ꯑꯗꯨ ꯌꯥꯝꯅꯥ ꯋꯥꯅꯥ ꯊꯣꯛꯂꯕꯗꯤ, ꯑꯁꯨꯛ ꯌꯥꯝꯅꯥ ꯁꯥꯊꯤꯅꯥ ꯁꯣꯀꯄꯥ ꯌꯥꯕꯥ ꯑꯣꯏꯔꯕꯗꯤ ꯀꯔꯤ ꯑꯣꯏꯒꯅꯤ? ꯉꯁꯤ ꯑꯩꯈꯣꯌꯅꯥ ꯋꯥꯔꯤ ꯁꯥꯔꯤꯕꯥ ꯀꯟꯗꯤꯁꯟ ꯑꯗꯨꯅꯤ, ꯍꯥꯏꯄꯔꯑꯦꯂꯖꯦꯁꯤꯌꯥ꯫ ꯃꯁꯤ ꯂꯥꯌꯅꯥ ꯑꯃꯗꯒꯤ ꯍꯦꯟꯅꯥ ꯂꯥꯏꯑꯣꯡ ꯑꯃꯅꯤ꯫ ꯃꯁꯤꯒꯤ ꯃꯇꯥꯡꯗꯥ ꯈꯔꯥ ꯍꯦꯟꯅꯥ ꯑꯀꯨꯞꯄꯥ ꯃꯔꯣꯂꯗꯥ ꯋꯥꯔꯤ ꯁꯥꯁꯤ .

ꯍꯥꯏꯄꯔꯑꯦꯂꯖꯦꯁꯤꯌꯥ ꯍꯥꯌꯕꯁꯤ ꯁꯨꯞꯅꯒꯤ ꯀꯔꯤꯅꯣ?

ꯑꯅꯥꯕꯥ ꯍꯥꯌꯕꯁꯤ ꯇꯁꯦꯡꯕꯗꯤ ꯑꯩꯈꯣꯌꯒꯤ ꯍꯀꯆꯥꯡꯒꯤ ꯍꯀꯁꯦꯜ ꯐꯕꯥ, ꯅꯣꯔꯃꯦꯜ ꯑꯣꯏꯕꯥ ꯁꯔꯨꯛ ꯑꯃꯅꯤ꯫ ꯃꯁꯤ ꯋꯥꯔꯅꯤꯡ ꯕꯦꯜ ꯑꯃꯒꯨꯝꯕꯅꯤ꯫ ꯑꯋꯥꯕꯥ ꯑꯁꯤꯅꯥ ꯑꯩꯈꯣꯌꯗꯥ ꯀꯔꯤꯒꯨꯝꯕꯥ ꯈꯔꯥ ꯑꯁꯣꯌꯕꯥ ꯂꯩꯔꯦ, ꯑꯩꯈꯣꯌꯒꯤ ꯍꯀꯆꯥꯡꯗꯥ ꯀꯔꯤꯒꯨꯝꯕꯥ ꯑꯃꯥ ꯑꯁꯣꯌꯕꯥ ꯂꯩꯔꯦ ꯍꯥꯌꯅꯥ ꯍꯥꯌꯔꯤ꯫ ꯑꯩꯈꯣꯌꯅꯥ ꯑꯋꯥꯕꯥ ꯐꯥꯑꯣꯔꯀꯄꯥ ꯃꯇꯃꯗꯥ, ꯑꯩꯈꯣꯌꯅꯥ ꯃꯁꯥ ꯃꯊꯟꯇꯥ ꯃꯗꯨꯒꯤ ꯄꯥꯎꯈꯨꯝ ꯄꯤꯖꯩ, ꯑꯋꯥꯕꯥ ꯑꯗꯨ ꯊꯤꯡꯅꯕꯥ ꯍꯣꯠꯅꯩ꯫ ꯀꯔꯤꯒꯨꯝꯕꯥ ꯑꯩꯈꯣꯌꯅꯥ ꯑꯋꯥꯕꯥ ꯅꯪꯂꯃꯗ꯭ꯔꯕꯗꯤ ꯑꯩꯈꯣꯌꯅꯥ ꯀꯌꯥ ꯌꯥꯝꯅꯥ ꯁꯥꯊꯤꯕꯥ ꯈꯨꯗꯣꯡꯊꯤꯕꯥ ꯊꯣꯀꯄꯥ ꯌꯥꯕꯒꯦ ꯍꯥꯌꯕꯗꯨ ꯈꯟꯗꯨꯅꯥ ꯌꯦꯡꯕꯤꯌꯨ꯫

ꯍꯥꯌꯄꯔꯑꯦꯂꯖꯦꯁꯤꯌꯥ ꯍꯥꯌꯕꯁꯤ ꯅꯣꯔꯃꯦꯂꯗꯒꯤ ꯌꯥꯝꯅꯥ ꯍꯦꯟꯅꯥ ꯁꯥꯊꯤꯕꯥ ꯊꯥꯛ ꯑꯃꯗꯥ, ꯃꯗꯨ ꯑꯣꯏꯒꯗꯕꯥ ꯃꯇꯃꯗꯁꯨ ꯁꯣꯀꯍꯜꯂꯀꯄꯥ ꯌꯥꯕꯥ ꯀꯟꯗꯤꯁꯟ ꯑꯃꯅꯤ꯫ ꯌꯥꯝꯅꯥ ꯂꯥꯏꯅꯥ ꯍꯥꯌꯔꯕꯗꯥ, ꯑꯅꯥꯕꯒꯤ ꯔꯦꯁꯄꯣꯟꯁ ꯑꯁꯤ ꯍꯦꯅꯒꯠꯂꯀꯏ꯫ ꯃꯁꯤ ꯃꯈꯜ ꯀꯌꯥꯒꯤ ꯃꯔꯃꯁꯤꯡꯅꯥ ꯊꯣꯀꯍꯅꯕꯥ ꯌꯥꯏ, ꯑꯃꯁꯨꯡ ꯑꯌꯥꯝꯕꯥ ꯃꯇꯃꯗꯥ ꯃꯑꯣꯡ ꯆꯨꯝꯅꯥ ꯂꯥꯏꯌꯦꯡꯗꯨꯅꯥ ꯀꯟꯠꯔꯣꯜ ꯇꯧꯕꯥ ꯌꯥꯏ꯫

ꯍꯥꯏꯄꯔꯑꯦꯂꯖꯦꯁꯤꯌꯥ ꯑꯃꯁꯨꯡ ꯑꯦꯂꯣꯗꯥꯏꯅꯤꯌꯥꯒꯤ ꯃꯔꯛꯇꯥ ꯀꯔꯤ ꯈꯦꯠꯅꯕꯥ ꯂꯩꯕꯒꯦ?

ꯋꯥꯍꯩ ꯑꯅꯤ ꯑꯁꯤ ꯈꯔꯥ ꯃꯥꯟꯅꯔꯕꯁꯨ, ꯐꯤꯚꯝ ꯑꯅꯤ ꯑꯁꯤꯒꯤ ꯃꯔꯛꯇꯥ ꯃꯌꯦꯛ ꯁꯦꯡꯕꯥ ꯈꯦꯟꯅꯕꯥ ꯂꯩ꯫ ꯃꯁꯤ ꯃꯌꯦꯛ ꯁꯦꯡꯅꯥ ꯈꯪꯅꯕꯒꯤꯗꯃꯛ, ꯃꯈꯥꯗꯥ ꯄꯤꯔꯤꯕꯥ ꯇꯦꯕꯜ ꯑꯁꯤ ꯌꯦꯡꯕꯤꯌꯨ꯫

ꯈꯦꯟꯅꯕꯥ ꯑꯗꯨ ꯑꯗꯣꯝꯅꯥ ꯈꯉꯕꯤꯔꯤꯕꯔꯥ? ꯍꯥꯏꯄꯔꯑꯦꯂꯖꯦꯁꯤꯌꯥꯗꯥ, ꯑꯅꯥꯕꯥ ꯑꯁꯤ ꯁꯣꯀꯍꯅꯒꯗꯕꯥ ꯄꯣꯠꯁꯛ ꯑꯃꯗꯒꯤ ꯂꯥꯀꯏ, ꯑꯗꯨꯕꯨ ꯃꯁꯤ ꯌꯥꯝꯅꯥ ꯁꯥꯊꯤꯅꯥ ꯊꯣꯀꯏ꯫ ꯑꯦꯂꯣꯗꯥꯏꯅꯤꯌꯥꯗꯥ, ꯑꯅꯥꯕꯥ ꯑꯁꯤ ꯁꯣꯀꯍꯟꯗꯕꯥ ꯄꯣꯠꯁꯛ ꯑꯃꯗꯒꯤ ꯂꯥꯀꯏ꯫

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ꯍꯥꯌꯄꯔꯑꯦꯂꯖꯦꯁꯤꯌꯥ ꯀꯧꯕꯥ ꯄꯣꯠꯁꯛ ꯑꯁꯤ ꯑꯩꯈꯣꯌꯒꯤ ꯍꯀꯆꯥꯡꯗꯥ ꯀꯔꯝꯅꯥ ꯊꯣꯛꯂꯤꯕꯅꯣ?

ꯍꯥꯏꯄꯔꯑꯦꯂꯖꯦꯁꯤꯌꯥꯅꯥ ꯑꯩꯈꯣꯌꯒꯤ ꯍꯀꯆꯥꯡꯅꯥ ꯄꯦꯟ ꯁꯤꯒꯅꯦꯂꯁꯤꯡ ꯁꯦꯃꯒꯠꯄꯒꯤ ꯃꯑꯣꯡ ꯑꯃꯁꯨꯡ ꯄ꯭ꯔꯣꯁꯦꯁ ꯇꯧꯕꯒꯤ ꯃꯑꯣꯡ ꯍꯣꯡꯍꯜꯂꯤ꯫ ꯃꯁꯤ ꯃꯔꯨꯑꯣꯏꯕꯥ ꯃꯑꯣꯡ ꯀꯌꯥꯗꯥ ꯊꯣꯀꯄꯥ ꯌꯥꯏ:

• ꯑꯅꯥꯕꯥ ꯐꯥꯎꯕꯒꯤ ꯊ꯭ꯔꯦꯁꯍꯣꯜꯗ ꯑꯗꯨ ꯍꯟꯊꯔꯀꯏ: ꯃꯍꯧꯁꯥꯅꯥ ꯅꯨꯡꯉꯥꯏꯇꯕꯥ ꯐꯥꯎꯕꯥ ꯌꯥꯕꯥ ꯄꯣꯠꯁꯛ ꯑꯃꯅꯥ ꯑꯁꯣꯛ-ꯑꯄꯟ ꯊꯣꯀꯍꯅꯕꯥ ꯌꯥꯕꯥ ꯑꯅꯥꯕꯒꯤ ꯊ꯭ꯔꯦꯁꯍꯣꯜꯗ ꯑꯗꯨ ꯀꯟꯗꯤꯁꯟ ꯑꯁꯤꯗꯥ ꯌꯥꯝꯅꯥ ꯍꯟꯊꯔꯀꯏ꯫ ꯃꯁꯤꯅꯥ ꯇꯥꯀꯄꯗꯤ ꯈ꯭ꯕꯥꯏꯗꯒꯤ ꯄꯤꯀꯄꯥ ꯄꯣꯠꯁꯛ ꯑꯃꯅꯥ ꯐꯥꯑꯣꯕꯥ ꯑꯋꯥꯕꯥ ꯊꯣꯀꯍꯅꯕꯥ ꯌꯥꯏ꯫
• ꯔꯦꯁꯄꯣꯟꯁ ꯑꯁꯤ ꯌꯥꯝꯅꯥ ꯀꯅꯈꯠꯂꯀꯏ: ꯑꯩꯈꯣꯌꯒꯤ ꯍꯀꯆꯥꯡꯒꯤ ꯄꯦꯟ ꯔꯤꯁꯦꯞꯇꯔꯁꯤꯡ ꯑꯁꯤ ꯅꯣꯔꯃꯦꯂꯗꯒꯤ ꯍꯦꯟꯅꯥ ꯃꯁꯤꯡ ꯌꯥꯝꯅꯥ ꯑꯃꯁꯨꯡ ꯑꯦꯛꯇꯤꯕ ꯑꯣꯏꯔꯀꯏ꯫ ꯃꯁꯤꯅꯥ ꯑꯅꯥꯕꯥ ꯑꯗꯨ ꯌꯥꯝꯅꯥ ꯍꯦꯟꯅꯥ ꯁꯣꯀꯍꯜꯂꯤ꯫
• ꯄꯦꯏꯟ ꯁꯤꯒꯅꯦꯂꯁꯤꯡ ꯂꯦꯄꯈꯤꯗꯦ: ꯑꯅꯥꯕꯒꯤ ꯃꯔꯝ ꯑꯗꯨ ꯂꯧꯊꯣꯀꯈ꯭ꯔꯕꯥ ꯃꯇꯨꯡꯗꯁꯨ, ꯄꯦꯟ ꯔꯤꯁꯦꯞꯇꯔꯁꯤꯡꯅꯥ ꯍꯥꯏꯄꯔꯁꯦꯟꯁꯤꯇꯤꯚ ꯑꯣꯏꯔꯀꯏ ꯑꯃꯁꯨꯡ ꯕ꯭ꯔꯦꯅꯗꯥ ꯄꯦꯟ ꯁꯤꯒꯅꯦꯂꯁꯤꯡ ꯃꯈꯥ ꯇꯥꯅꯥ ꯊꯥꯏ꯫

ꯃꯁꯤ ꯃꯔꯨꯑꯣꯏꯕꯥ ꯃꯈꯜ ꯑꯅꯤꯗꯥ ꯈꯥꯌꯗꯣꯀꯄꯥ ꯌꯥꯏ:

1. ꯄ꯭ꯔꯥꯏꯃꯥꯔꯤ ꯍꯥꯏꯄꯔꯑꯦꯂꯖꯦꯁꯤꯌꯥ (primary hyperalgesia): ꯃꯁꯤ ꯑꯁꯣꯀꯄꯥ ꯃꯐꯝ ꯑꯗꯨꯈꯛꯇꯗꯥ ꯑꯁꯣꯛ-ꯑꯄꯟ ꯊꯣꯀꯄꯥ ꯃꯇꯃꯗꯥ ꯑꯣꯏ꯫ ꯈꯨꯗꯝ ꯑꯣꯏꯅꯥ, ꯅꯨꯃꯤꯠꯀꯤ ꯃꯉꯥꯂꯅꯥ ꯊꯜꯂꯕꯥ ꯈꯣꯡꯗꯥ ꯑꯁꯣꯀꯄꯥ ꯃꯐꯝ ꯑꯗꯨꯗꯥ ꯍꯦꯟꯅꯥ ꯁꯣꯀꯄꯥ ꯌꯥꯏ꯫

2. ꯁꯦꯀꯦꯟꯗꯔꯤ ꯍꯥꯏꯄꯔꯑꯦꯂꯖꯦꯁꯤꯌꯥ: ꯃꯁꯤ ꯑꯁꯣꯀꯄꯥ ꯃꯐꯝ ꯑꯗꯨꯒꯥ ꯃꯔꯤ ꯂꯩꯅꯗꯕꯥ, ꯑꯁꯣꯛ-ꯑꯄꯟ ꯑꯗꯨꯒꯤ ꯑꯀꯣꯌꯕꯗꯥ ꯂꯩꯕꯥ ꯃꯐꯃꯁꯤꯡꯗꯥ ꯑꯁꯣꯛ-ꯑꯄꯟ ꯊꯣꯀꯄꯥ ꯃꯇꯃꯗꯥ ꯑꯣꯏ꯫ ꯃꯁꯤ ꯑꯩꯈꯣꯌꯒꯤ ꯅꯔꯚ ꯁꯤꯁ꯭ꯇꯦꯃꯅꯥ ꯄꯦꯟ ꯁꯤꯒꯅꯦꯂꯁꯤꯡ ꯄ꯭ꯔꯣꯁꯦꯁ ꯇꯧꯕꯒꯤ ꯃꯑꯣꯡꯗꯥ ꯑꯍꯣꯡꯕꯥ ꯂꯥꯀꯄꯅꯥ ꯃꯔꯝ ꯑꯣꯏꯗꯨꯅꯥ ꯊꯣꯀꯏ꯫

ꯍꯥꯌꯄꯔꯑꯦꯂꯖꯦꯁꯤꯌꯥꯒꯤ ꯀꯃꯟ ꯑꯣꯏꯕꯥ ꯃꯔꯃꯁꯤꯡ ꯑꯗꯨ ꯀꯔꯤꯅꯣ?

ꯑꯩꯈꯣꯌꯅꯥ ꯍꯧꯖꯤꯛ ꯈꯉꯂꯦ ꯃꯗꯨꯗꯤ ꯀꯟꯗꯤꯁꯟ ꯑꯁꯤ ꯑꯩꯈꯣꯌꯒꯤ ꯍꯀꯆꯥꯡꯒꯤ ꯄꯦꯟ ꯔꯤꯁꯦꯄꯇꯔꯁꯤꯡꯅꯥ ꯍꯥꯏꯄꯔꯁꯦꯟꯁꯤꯇꯤꯕ ꯑꯣꯏꯔꯀꯄꯅꯥ ꯊꯣꯀꯍꯅꯕꯅꯤ꯫ ꯃꯁꯤꯒꯤ ꯑꯣꯏꯊꯣꯀꯄꯥ ꯌꯥꯕꯥ ꯃꯔꯝ ꯀꯌꯥ ꯂꯩꯔꯤ꯫

• ꯃꯩꯅꯥ ꯆꯥꯀꯄꯥ (ꯅꯨꯃꯤꯠꯀꯤ ꯃꯩꯁꯥ ꯌꯥꯎꯅꯥ)
• ꯏꯅꯁꯦꯛꯇꯁꯤꯡ, ꯔꯦꯄꯇꯤꯂꯁꯤꯡ ꯅꯠꯠꯔꯒꯥ ꯑꯇꯩ ꯁꯥ-ꯁꯅꯁꯤꯡꯗꯒꯤ ꯂꯥꯀꯄꯥ ꯁꯣꯀꯄꯥ ꯅꯠꯠꯔꯒꯥ ꯁꯣꯀꯍꯅꯕꯥ꯫
• ꯀꯦꯟꯁꯔꯒꯤ ꯐꯤꯚꯃꯁꯤꯡ꯫
• ꯑꯀꯛꯅꯕꯥ ꯍꯤꯗꯥꯛ-ꯂꯥꯡꯊꯀꯁꯤꯡ ꯃꯇꯝ ꯁꯥꯡꯅꯥ ꯁꯤꯖꯤꯟꯅꯕꯒꯤ ꯀꯃꯞꯂꯤꯀꯦꯁꯅꯁꯤꯡ (ꯃꯈꯥꯗꯥ ꯑꯩꯈꯣꯌꯅꯥ ꯃꯁꯤꯒꯤ ꯃꯇꯥꯡꯗꯥ ꯋꯥꯔꯤ ꯁꯥꯒꯅꯤ)
• ꯗꯥꯏꯑꯦꯕꯦꯇꯤꯖꯅꯥ ꯊꯣꯀꯍꯅꯕꯥ ꯅꯔꯚꯁꯤꯡꯗꯥ ꯑꯃꯥꯡ-ꯑꯇꯥ (Diabetic Neuropathy)
• ꯏꯝꯝꯌꯨꯟ ꯁꯤꯁ꯭ꯇꯦꯃꯒꯤ ꯂꯥꯌꯅꯥꯁꯤꯡ (ꯈꯨꯗꯝ ꯑꯣꯏꯅꯥ, ꯂꯨꯄꯁ, ꯃꯜꯇꯤꯄꯜ ꯁ꯭ꯛꯂꯦꯔꯣꯁꯤꯁ)
• ꯅꯔꯚꯁ ꯁꯤꯁ꯭ꯇꯦꯃꯗꯥ ꯁꯣꯀꯍꯜꯂꯤꯕꯥ ꯏꯅꯐꯦꯛꯁꯅꯁꯤꯡ (ꯈꯨꯗꯝ ꯑꯣꯏꯅꯥ, ꯁꯤꯉ꯭ꯒꯥꯄꯨꯔ, ꯍꯔꯄꯤꯁ ꯚꯥꯏꯔꯁ)
• ꯃꯥꯏꯒ꯭ꯔꯦꯅꯒꯨꯝꯕꯥ ꯀꯟꯗꯤꯁꯅꯁꯤꯡ꯫
• ꯀꯝꯞꯂꯦꯛꯁ ꯔꯤꯖꯅꯦꯜ ꯄꯦꯟ ꯁꯤꯟꯗ꯭ꯔꯣꯝꯒꯨꯝꯕꯥ ꯀ꯭ꯔꯣꯅꯤꯛ ꯄꯦꯟ ꯗꯤꯁꯑꯣꯔꯗꯔꯁꯤꯡ꯫
• ꯃꯄꯥꯅꯒꯤ ꯑꯁꯣꯛ-ꯑꯄꯟ ꯃꯈꯜ ꯑꯃꯍꯦꯛꯇ (ꯈꯨꯗꯝ ꯑꯣꯏꯅꯥ, ꯁꯔꯨ ꯇꯥꯡꯁꯤꯡ, ꯃꯁꯂꯁꯤꯡ ꯁꯣꯟꯊꯕꯥ, ꯅꯔꯚꯀꯤ ꯑꯁꯣꯛ-ꯑꯄꯅꯁꯤꯡ)

ꯄꯦꯅꯀꯤꯂꯔꯁꯤꯡꯅꯥ ꯃꯔꯝ ꯑꯣꯏꯗꯨꯅꯥ ꯑꯅꯥꯕꯥ ꯍꯦꯅꯒꯠꯂꯀꯄꯥ (Opioid-induced hyperalgesia - OIH)

ꯃꯁꯤ ꯌꯥꯝꯅꯥ ꯃꯔꯨꯑꯣꯏꯕꯥ ꯑꯃꯗꯤ ꯃꯔꯨ ꯑꯣꯏꯕꯥ ꯋꯥꯐꯝ ꯑꯃꯅꯤ ꯃꯁꯤꯗꯥ ꯄꯨꯛꯅꯤꯡ ꯆꯪꯒꯗꯕꯅꯤ꯫ ꯃꯇꯝ ꯁꯥꯡꯅꯥ ꯑꯣꯄꯤꯑꯣꯏꯗ ꯄꯦꯏꯅꯀꯤꯂꯔꯁꯤꯡ (ꯈꯔꯥ ꯃꯄꯥꯉ꯭ꯒꯜ ꯀꯅꯕꯥ) ꯁꯤꯖꯤꯟꯅꯔꯀꯄꯥ ꯃꯇꯃꯗꯥ, ꯀꯔꯤꯒꯨꯝꯕꯥ ꯃꯇꯃꯗꯥ ꯑꯣꯄꯤꯑꯣꯏꯗ-ꯏꯟꯗꯨꯁ ꯇꯧꯔꯕꯥ ꯍꯥꯏꯄꯔꯑꯦꯂꯖꯦꯁꯤꯌꯥ (OIH) ꯀꯧꯕꯥ ꯁꯥꯏꯗ ꯏꯐꯦꯛꯇ ꯑꯃꯥ ꯊꯣꯀꯄꯥ ꯌꯥꯏ꯫ ꯃꯁꯤꯅꯥ ꯇꯥꯀꯄꯗꯤ ꯑꯅꯥꯕꯥ ꯍꯟꯊꯍꯟꯅꯕꯥ ꯁꯤꯖꯤꯟꯅꯔꯤꯕꯥ ꯄꯦꯏꯅꯀꯤꯂꯔꯁꯤꯡ ꯑꯁꯤꯅꯥ ꯍꯀꯆꯥꯡꯒꯤ ꯑꯅꯥꯕꯒꯤ ꯁꯦꯟꯁꯤꯇꯤꯕꯤꯇꯤ ꯍꯦꯅꯒꯠꯂꯀꯏ, ꯃꯗꯨꯅꯥ ꯑꯅꯥꯕꯥ ꯑꯗꯨ ꯍꯦꯟꯅꯥ ꯁꯣꯀꯍꯜꯂꯤ꯫

ꯃꯁꯤ ꯇꯣꯂꯔꯦꯟꯁ ꯅꯠꯇꯦ, ꯃꯁꯤꯅꯥ ꯇꯥꯀꯄꯗꯤ ꯍꯀꯆꯥꯡꯅꯥ ꯗ꯭ꯔꯒ ꯑꯁꯤ ꯁꯤꯖꯤꯟꯅꯔꯦ ꯑꯃꯁꯨꯡ ꯃꯁꯤꯅꯥ ꯃꯈꯥ ꯇꯥꯅꯥ ꯊꯕꯛ ꯇꯧꯗ꯭ꯔꯦ꯫ ꯇꯣꯂꯔꯦꯟꯁ ꯑꯁꯤ ꯇꯣꯉꯥꯅꯕꯥ ꯋꯥꯐꯝ ꯑꯃꯅꯤ꯫ ꯑꯣ.ꯑꯥꯏ.ꯑꯩꯆ.ꯅꯥ ꯍꯀꯆꯥꯡꯅꯥ ꯑꯅꯥꯕꯥ ꯄ꯭ꯔꯣꯁꯦꯁ ꯇꯧꯕꯒꯤ ꯃꯑꯣꯡꯗꯥ ꯑꯍꯣꯡꯕꯥ ꯑꯃꯥ ꯄꯨꯔꯀꯄꯅꯤ꯫

ꯃꯁꯤꯅꯥ ꯃꯔꯝ ꯑꯣꯏꯗꯨꯅꯥ ꯗꯣꯛꯇꯔꯁꯤꯡꯅꯥ ꯃꯇꯝ ꯁꯥꯡꯅꯥ ꯑꯣꯄꯤꯑꯣꯏꯗ ꯄꯦꯅꯀꯤꯂꯔꯁꯤꯡ ꯄꯤꯕꯒꯤ ꯃꯇꯥꯡꯗꯥ ꯑꯅꯤꯔꯛ ꯈꯜꯂꯤ꯫ ꯀꯔꯤꯒꯨꯝꯕꯥ ꯀꯅꯥꯒꯨꯝꯕꯥ ꯃꯤꯑꯣꯏ ꯑꯃꯅꯥ ꯑꯣ.ꯑꯥꯏ.ꯑꯩꯆ. ꯃꯁꯤ ꯑꯃꯨꯛ ꯍꯟꯅꯥ ꯇꯧꯕꯥ ꯌꯥꯗꯦ, ꯃꯔꯃꯗꯤ ꯃꯁꯤꯅꯥ ꯈꯨꯗꯣꯡꯊꯤꯅꯤꯉꯥꯏ ꯑꯣꯏꯕꯥ ꯁꯥꯏꯗ ꯏꯐꯦꯛꯇꯁꯤꯡ ꯊꯣꯀꯍꯅꯕꯥ ꯌꯥꯏ꯫ ꯃꯔꯝ ꯑꯗꯨꯅꯥ ꯃꯁꯤ ꯗꯣꯛꯇꯔ ꯑꯃꯒꯤ ꯄꯥꯎꯇꯥꯛ ꯑꯃꯁꯨꯡ ꯌꯦꯡꯁꯤꯅꯕꯒꯤ ꯃꯈꯥꯗꯥ ꯈꯛꯇꯃꯛ ꯇꯧꯒꯗꯕꯅꯤ꯫

ꯍꯥꯌꯄꯔꯑꯦꯂꯖꯦꯁꯤꯌꯥꯒꯤ ꯂꯥꯏꯌꯦꯡꯁꯤꯡ ꯑꯗꯨ ꯀꯔꯤꯅꯣ?

ꯂꯥꯏꯌꯦꯡ ꯑꯁꯤ ꯍꯥꯏꯄꯔꯑꯦꯂꯖꯦꯁꯤꯌꯥꯒꯤ ꯃꯔꯝ ꯑꯃꯁꯨꯡ ꯃꯈꯂꯒꯤ ꯃꯈꯥ ꯄꯣꯜꯂꯤ꯫ ꯂꯥꯏꯌꯦꯡ ꯑꯃꯈꯛꯇꯃꯛ ꯅꯠꯠꯔꯒꯥ ꯂꯥꯏꯌꯦꯡꯒꯤ ꯀꯝꯕꯤꯅꯦꯁꯟ ꯑꯃꯥ ꯁꯤꯖꯤꯟꯅꯕꯥ ꯌꯥꯏ꯫ ꯅꯍꯥꯛꯀꯤ ꯀꯟꯗꯤꯁꯟ ꯑꯗꯨꯒꯤꯗꯃꯛꯇꯥ ꯈ꯭ꯕꯥꯏꯗꯒꯤ ꯐꯕꯥ ꯂꯥꯏꯌꯦꯡ ꯑꯗꯨ ꯅꯍꯥꯛꯀꯤ ꯗꯣꯛꯇꯔ ꯈꯛꯇꯅꯥ ꯈꯪꯒꯅꯤ꯫

ꯃꯌꯥꯝꯅꯥ ꯁꯤꯖꯤꯟꯅꯕꯥ ꯂꯥꯏꯌꯦꯡ ꯈꯔꯗꯤ ꯃꯈꯥꯗꯥ ꯄꯤꯔꯤ:

• ꯍꯤꯗꯥꯛ-ꯂꯥꯡꯊꯀꯁꯤꯡ: ꯃꯁꯤꯒꯤꯗꯃꯛꯇꯥ ꯇꯣꯉꯥꯟ-ꯇꯣꯉꯥꯅꯕꯥ ꯃꯈꯂꯒꯤ ꯍꯤꯗꯥꯛ-ꯂꯥꯡꯊꯀꯁꯤꯡ ꯁꯤꯖꯤꯟꯅꯩ꯫ ꯈꯨꯗꯝ ꯑꯣꯏꯅꯥ, ꯑꯦꯁꯤꯇꯥꯃꯤꯅꯣꯐꯦꯟ (ꯄꯦꯔꯥꯁꯤꯇꯥꯃꯣꯜ), ꯑꯦꯟ.ꯑꯦꯁ.ꯑꯦ.ꯑꯥꯏ.ꯗꯤ.ꯁꯤꯡ (ꯅꯟ-ꯁ꯭ꯇꯦꯔꯣꯏꯗ ꯑꯦꯟꯇꯤ-ꯏꯅꯐ꯭ꯂꯦꯃꯦꯇꯔꯤ ꯗ꯭ꯔꯒꯁꯤꯡ), ꯑꯦꯟꯇꯤꯗꯤꯞꯔꯦꯁꯦꯟꯇꯁꯤꯡ, ꯏꯄꯤꯂꯦꯄꯁꯤꯒꯤ ꯍꯤꯗꯥꯛ ꯈꯔꯗꯤ, ꯑꯃꯁꯨꯡ ꯂꯤꯗꯣꯀꯦꯟꯒꯨꯝꯕꯥ ꯂꯣꯀꯦꯜ ꯑꯦꯅꯥꯁ꯭ꯇꯦꯇꯤꯀꯁꯤꯡ꯫
• ꯅꯔꯚ ꯑꯦꯕꯂꯦꯁꯅꯁꯤꯡ (nerve ablations): ꯃꯁꯤꯗꯥ ꯑꯔꯥꯅꯕꯥ ꯄꯦꯟ ꯁꯤꯒꯅꯦꯂꯁꯤꯡ ꯊꯥꯔꯤꯕꯥ ꯅꯔꯚꯁꯤꯡ ꯑꯗꯨ ꯃꯇꯝ ꯈꯔꯒꯤ ꯑꯣꯏꯅꯥ ꯗꯤꯁꯑꯦꯕꯜ ꯇꯧꯕꯁꯤ ꯌꯥꯎꯏ꯫ ꯃꯁꯤ ꯔꯦꯗꯤꯑꯣꯐ꯭ꯔꯤꯛꯕꯦꯟꯁꯤ ꯑꯦꯕꯂꯦꯁꯟ ꯁꯤꯖꯤꯟꯅꯗꯨꯅꯥ ꯅꯠꯠꯔꯒꯥ ꯕꯣꯇꯣꯛꯁꯒꯨꯝꯕꯥ ꯀꯦꯃꯤꯀꯦꯜ ꯑꯃꯥ ꯏꯅꯖꯦꯀꯁꯟ ꯇꯧꯗꯨꯅꯥ ꯄꯥꯡꯊꯣꯀꯄꯥ ꯌꯥꯏ꯫
• ꯅꯔꯚ ꯕ꯭ꯂꯣꯀꯁꯤꯡ: ꯕ꯭ꯔꯦꯅꯗꯥ ꯑꯅꯥꯕꯥ ꯁꯤꯒꯅꯦꯂꯁꯤꯡ ꯌꯧꯕꯥ ꯊꯤꯡꯅꯕꯥ ꯅꯔꯚꯇꯥ ꯑꯦꯅꯥꯁ꯭ꯇꯦꯇꯤꯛ ꯗ꯭ꯔꯒ ꯑꯃꯥ ꯏꯅꯖꯦꯀꯁꯟ ꯇꯧꯕꯥ꯫
• TENS (Transcutaneous electrical nerve stimulation): ꯈꯣꯡꯒꯤ ꯃꯊꯛꯇꯥ ꯌꯥꯝꯅꯥ ꯄꯤꯀꯄꯥ ꯏꯂꯦꯛꯠꯔꯤꯀꯦꯜ ꯀꯔꯦꯟꯇ ꯑꯃꯥ ꯄꯤꯗꯨꯅꯥ ꯄꯦꯟ ꯁꯤꯒꯅꯦꯂꯁꯤꯡ ꯀꯟꯠꯔꯣꯜ ꯇꯧꯕꯒꯤ ꯃꯑꯣꯡ ꯑꯃꯅꯤ꯫

ꯗꯣꯛꯇꯔ ꯑꯃꯒꯥ ꯎꯅꯕꯒꯤ ꯈ꯭ꯕꯥꯏꯗꯒꯤ ꯐꯕꯥ ꯃꯇꯃꯁꯤꯡ ꯀꯔꯤꯅꯣ?

ꯏꯆꯝ ꯆꯝꯕꯥ ꯅꯨꯃꯤꯠꯀꯤ ꯃꯉꯥꯂꯒꯨꯝꯕꯥ ꯑꯄꯤꯀꯄꯥ ꯄꯣꯠꯁꯛ ꯑꯃꯗꯒꯤ ꯂꯥꯀꯄꯥ ꯑꯅꯥꯕꯥ ꯑꯁꯤ ꯃꯍꯧꯁꯥꯅꯥ ꯅꯨꯃꯤꯠ ꯈꯔꯅꯤꯒꯤ ꯃꯇꯨꯡꯗꯥ ꯂꯣꯏꯁꯤꯅꯒꯅꯤ꯫ ꯑꯗꯨꯝ ꯑꯣꯏꯅꯃꯛ, ꯀꯔꯤꯒꯨꯝꯕꯥ ꯑꯅꯥꯕꯥ ꯑꯗꯨ ꯌꯥꯝꯅꯥ ꯁꯥꯊꯤꯅꯥ ꯁꯣꯀꯍꯜꯂꯕꯗꯤ ꯑꯃꯁꯨꯡ ꯅꯍꯥꯛꯀꯤ ꯅꯨꯡꯇꯤꯒꯤ ꯊꯕꯛ ꯊꯧꯔꯃꯁꯤꯡ ꯄꯥꯡꯊꯣꯀꯄꯥ ꯉꯃꯗꯕꯥ ꯑꯣꯏꯔꯕꯗꯤ , ꯅꯠꯠꯔꯒꯥ ꯑꯅꯥꯕꯥ ꯑꯗꯨ ꯅꯨꯃꯤꯠ ꯀꯌꯥꯅꯤ ꯂꯩꯔꯕꯗꯤ , ꯃꯁꯤ ꯁꯣꯌꯗꯅꯥ ꯗꯣꯛꯇꯔ ꯑꯃꯒꯥ ꯇꯥꯟꯅꯒꯗꯕꯅꯤ ꯍꯥꯌꯕꯒꯤ ꯈꯨꯗꯝ ꯑꯃꯅꯤ꯫

ꯌꯥꯝꯅꯥ ꯁꯥꯊꯤꯕꯥ ꯃꯩꯅꯥ ꯆꯥꯀꯄꯥ (ꯁꯦꯀꯦꯟꯗ ꯗꯤꯒ꯭ꯔꯤ ꯅꯠꯠꯔꯒꯥ ꯃꯁꯤꯗꯒꯤ ꯍꯦꯅꯕꯥ), ꯅꯠꯠꯔꯒꯥ ꯃꯀꯣꯛ, ꯃꯥꯌ, ꯅꯠꯠꯔꯒꯥ ꯃꯤꯔꯣꯜꯂꯤꯉꯩ ꯃꯇꯃꯗꯥ ꯃꯩꯅꯥ ꯆꯥꯀꯄꯒꯤꯗꯃꯛ ꯃꯦꯗꯤꯀꯦꯂꯒꯤ ꯄꯥꯎꯇꯥꯛ ꯂꯧꯕꯥ ꯍꯥꯌꯕꯁꯤ ꯌꯥꯝꯅꯥ ꯃꯔꯨꯑꯣꯏ꯫ ꯀꯔꯤꯒꯨꯝꯕꯥ ꯅꯍꯥꯛꯀꯤ ꯑꯅꯥꯕꯥ ꯑꯗꯨ ꯏꯃꯔꯖꯦꯟꯁꯤ ꯗꯤꯄꯥꯔꯇꯃꯦꯟꯇ (ETU)ꯗꯥ ꯆꯠꯄꯥ ꯃꯊꯧ ꯇꯥꯔꯕꯗꯤ ꯅꯍꯥꯛꯀꯤ ꯗꯣꯛꯇꯔꯅꯥ ꯅꯍꯥꯀꯄꯨꯁꯨ ꯄꯥꯎꯇꯥꯛ ꯄꯤꯒꯅꯤ꯫

ꯀꯥꯑꯣꯔꯣꯏꯗꯕꯅꯤ, ꯁꯥꯊꯤꯕꯥ ꯑꯅꯥꯕꯥ ꯑꯁꯤ ꯑꯩꯈꯣꯌꯒꯤ ꯍꯀꯆꯥꯡꯗꯒꯤ ꯂꯥꯀꯄꯥ ꯆꯦꯀꯁꯤꯅꯋꯥ ꯑꯃꯅꯤ꯫ ꯃꯁꯤ ꯌꯥꯗꯕꯅꯥ ꯃꯈꯥꯒꯤ ꯀꯟꯗꯤꯁꯟ ꯑꯗꯨ ꯍꯦꯟꯅꯥ ꯐꯠꯆꯤꯜꯂꯛꯀꯅꯤ ꯅꯠꯠꯔꯒꯥ ꯑꯅꯥꯕꯥ ꯑꯗꯨ ꯀ꯭ꯔꯣꯅꯤꯛ ꯑꯣꯏꯍꯅꯒꯅꯤ꯫

ꯀꯟꯗꯤꯁꯟ ꯑꯁꯤ ꯂꯩꯕꯥ ꯃꯤꯑꯣꯏꯁꯤꯡꯅꯥ ꯄꯦꯏꯟ ꯐꯦꯛ ꯇꯧꯕꯥ ꯅꯠꯠꯔꯒꯥ ꯃꯈꯣꯌꯒꯤ ꯄꯦꯏꯟ ꯑꯗꯨ ꯑꯦꯛꯇꯤꯡ ꯇꯧꯕꯥ ꯅꯠꯇꯦ꯫ ꯃꯈꯣꯌꯒꯤ ꯍꯀꯆꯥꯡꯒꯤ ꯄꯦꯟ ꯄ꯭ꯔꯣꯁꯦꯁꯤꯡꯗꯥ ꯄ꯭ꯔꯣꯕ꯭ꯂꯦꯝ ꯑꯃꯥ ꯂꯩꯕꯅꯥ ꯃꯔꯝ ꯑꯣꯏꯗꯨꯅꯥ ꯑꯋꯥꯕꯥ ꯑꯁꯤ ꯌꯥꯝꯅꯥ ꯁꯥꯊꯤꯅꯥ ꯐꯥꯑꯣꯏ꯫ ꯑꯗꯨꯅꯥ ꯀꯔꯤꯒꯨꯝꯕꯥ ꯅꯍꯥꯛ ꯅꯠꯠꯔꯒꯥ ꯅꯍꯥꯛꯅꯥ ꯈꯪꯂꯤꯕꯥ ꯃꯤꯑꯣꯏ ꯑꯃꯅꯥ ꯑꯁꯤꯒꯨꯝꯕꯥ ꯃꯈꯂꯒꯤ ꯑꯆꯝꯕꯥ, ꯁꯥꯊꯤꯕꯥ ꯑꯅꯥꯕꯥ ꯑꯁꯤ ꯊꯦꯡꯅꯔꯕꯗꯤ, ꯈ꯭ꯕꯥꯏꯗꯒꯤ ꯐꯕꯥ ꯑꯃꯁꯨꯡ ꯁꯥꯐꯕꯥ ꯊꯕꯀꯗꯤ ꯃꯦꯗꯤꯀꯦꯂꯒꯤ ꯄꯥꯎꯇꯥꯛ ꯂꯧꯕꯅꯤ꯫