UDkt. Alex Jimenez, u-El Paso's Chiropractor
Ndiyathemba ukuba uye ujabulisa izithuba zethu zeblogi kwimpilo eyahlukeneyo, izihloko ezinxulumene nezondlo kunye nokulimala. Nceda unganqikazi ukusibiza okanye mna xa unemibuzo xa kufuneka ukuba ufune ukunakekelwa. Shayela iofisi okanye mna. I-915-850-0900 - I-915-540-8444 I-Great Regards. UDkt J

Amanqanaba okuNyango angabonakaliyo kwiMbuyiselo yokubuyisela e-El Paso, TX

Kubonelelwe ngumbono, njengesiqhelo se-chiropractors abanamava kwiindawo ezahlukahlukeneyo zokulimala kwamagundane kunye nemiqathango, intlungu emva koko yenye yezona nkalo zempilo eziqhelekileyo ezichazwe phakathi koluntu jikelele, oluchaphazela malunga ne-8 kubantu abathile be-10 ngexesha elithile ebomini babo. Nangona ezininzi iintlobo ezahlukeneyo zonyango zikhoyo ukuze zikuncede ukuphucula iimpawu zentlungu yangemuva, ukunakekelwa kwezempilo okusekelwe kubungqina bezonyango kunye nokuhlola kubangele impembelelo kwindlela yokwelapha abantu abaya kubafumana ngenxa yentlungu yabo. Izigulane ezininzi ezinonophelo lwempilo ziphendulela kwiindlela ezingenangxamnye zonyango zentlungu yazo emva kobubungqina obukhulayo obunxulumene nokukhuseleko nokusebenza kwayo.

 

Ngenye inqaku, Iindlela zokunyanga ezingenasiphakamiso zichazwa njengeenkqubo ezilondolozayo ezingafuneki ukunyanzeliswa emzimbeni, apho kungekho kuphuka kwesikhumba edalwe kwaye akukho dibana ne-mucosa okanye umzi womzimba wangaphakathi ngaphaya kwendalo yomzimba, okanye ukususwa iisishu. Izindlela zeklinikhi kunye nezovavanyo kunye neziphumo zeendlela ezahlukeneyo zonyango ezingenakunxamiseka kwiintlungu zenziwa emva koko zichazwe kwaye zixutyushwa ngokubanzi ngezantsi.

 

Abstract

 

Okwangoku, kukho ukunyuka kwamazwe ngamazwe ngokubhekiselele ekunakekeleni kwezempilo. Inzululwazi ye-intlupheko ye-back-back (LBP) ekunyamekelweni kweprayimari ngumzekelo obalaseleyo wokunakekelwa kwezempilo ngokusekelwe kubungqina kuba kunobungqina obuninzi bobuchule obuvela kwiilingo ezingenamsebenzi. Ezi zilingo zishwankathelwe kwinani elikhulu lokuhlaziywa okuchanekileyo. Eli phepha lishwankathela ubungqina obuninzi obufumanekayo ukusuka kuhlolisiso oluchanekileyo oluqhutywe kwisakhelo seCocaan Review Review Group kwizilonyango ezingenakunxamnye ne-LBP ezingezizo. Idatha yabuthelwa kwiNgcaciso yeKhabhinethi yeCchrane yeeNkqubo eziPhezulu ze-2005, Issue 2. Ukuhlaziywa kweCochrane kuhlaziywe ngezilingo ezongezelelweyo, ukuba zikhona. I-NSAID zendabuko, i-relaxation ye-muscle, kunye neengcebiso zokuhlala zisebenzayo zisebenza ngokukhawuleza kweentlungu zesikhashana kwi-LBP. Iseluleko sokuhlala sisisebenzayo siphumelele ekuphuculeni kwexesha elide lomsebenzi kwi-LBP enzima. Kwi-LBP engapheliyo, ukungenelela ngeendlela ezahlukeneyo kusebenza ngokukhawuleza kweentlungu zentlungu, oko kukuthi, ukuxhatshazwa, i-COX2 inhibitors, izikolo zokubuya, ukuphumula okuqhubekayo, unyango ophendulayo, ukunyanga, kunye nokunyanga okuninzi. Amanyango athile asebenzayo ekuphuculeni kwexesha elifutshane lomsebenzi kwi-LBP engapheliyo, okuyi-COX2 inhibitors, izikolo zokubuya, ukuphumula okuqhubekayo, unyango osebenzayo kunye nokunyangwa kwamanyathelo amaninzi. Akukho ubungqina bokuba nawaphi na amanyathelo angenelelo anika imiphumo yesikhathi eside kwiintlungu kunye nomsebenzi. Kwakhona, ezininzi izilingo zabonisa ubuthakathaka beendlela, imiphumo iyafaniswa ne-placebo, akukho nonyango okanye ulawulo lwemihla yokulinda, kwaye ubunzima bomsebenzi buncinane. Izilingo zexesha elizayo zifanele zihlangabezane nemigangatho yangoku esemgangathweni kwaye ibe nesayizi efanelekileyo yesampuli

 

Internet: Ubunzima beentlungu ezingezantsi, Ukunyanga okungekho-incinci, ukunakekelwa kweprayimari, Ukuphumelela, Ukuhlaziya ubungqina

 

intshayelelo

 

Iintlungu ezisezantsi zixhaphake ngokubanzi kwizicwangciso zonyango lwezempilo. Ukulawulwa kwezonyango kunye nobuhlungu obungapheliyo buhlungu (LBP) buhluka ngokubanzi phakathi kwababoneleli bezempilo. Kwakhona, ezininzi iinkonzo ezahlukeneyo zezempilo eziphambili zibandakanyeka ekulawuleni i-LBP, njengabagqirha abaqhelekileyo, oogqirha bezinto eziphathekayo, ii-chiropractors, i-osteopaths, i-therapists kunye nabanye. Kukho isidingo sokwandisa ukuhambelana nokulawulwa kwe-LBP kuwo wonke umsebenzi.

 

Okwangoku, kukho ukunyuka kwamazwe ngamazwe ngokubhekiselele ekunakekeleni kwezempilo. Kwisakhelo soononophelo lwempilo esekelwe kubungqina, iiklinikhi kufuneka zisebenzise ngononophelo, ngokucacileyo, kwaye zisetyenziswe ngokufanelekileyo ubungqina obuninzi bokwenza izigqibo malunga nokunyamekelwa kwezigulane ngamnye. Inzululwazi ye-LBP yophando kwinqanaba lokunyamekela ngokusisiseko ngumzekelo obalaseleyo wokunakekelwa kwezempilo ngokusekelwe kubungqina kuba kukho ubungqina obuninzi bobubungqina. Okwangoku, ngaphezu kwee-500 izilingo ezilawulwa ngandlela-thile (RCTs) zishicilelwe, zivavanya zonke iintlobo zonyango olulondolozayo nolunye uhlobo lwe-LBP oluqhelekileyo lusetyenziselwa ukunakekelwa kweprayimari. Ezi zilingo zishwankathelwe kwinani elikhulu lokuhlaziywa okuchanekileyo. I-Cochrane Back Review Group (i-CBRG) inikezela isakhelo sokuqhuba nokupapasha ukuhlaziywa okuchanekileyo kwimida yentlungu nentloko. Nangona kunjalo, izikhokelo zendlela ziye zaphuhliswa kwaye zanyatheliswa yi-CBRG ukuphucula umgangatho weengxelo kulolu hlobo kunye nokuququzelela ukuthelekiswa kokuhlaziywa nokukhuthaza ukuhambelana phakathi kwabahlalutyi. Eli phepha lishwankathela ubungqina obuninzi obufumanekayo ukusuka kuhlolisiso oluchanekileyo oluqhutyelwe kwisakhelo se-CBRG kwizonyango ezingenasiphene kwi-LBP engekho.

 

iinjongo

 

Ukuchonga ukuphumelela kokungenelelekanga (amachiza angenasiphakamiso (amayeza kunye nokungenawo amayeza) okuthelekiswa ne-placebo (okanye unyango lwe-sham, akukho nongenelelo kunye nokulawulwa kohlu lokulinda) okanye ezinye iindlela zokungenelela kwi-LBP engaqhelekanga. Iimvavanyo ezithelekisa iintlobo ezahlukeneyo zongenelelo olufanayo (umzekelo, iintlobo ezahlukeneyo ze-NSAID okanye iintlobo ezahlukeneyo zokuzivocavoca) zingabandakanywa. Ubungqina bokungenelela kwamachiza ancedisayo kunye namanye amayeza (ukulungiswa kwamanzi, amayeza ezityalo, i-massage, kunye neuroreflexotherapy) iye yapapashwa kwenye indawo. Ubu bungqina kunye nokunye ukungenelela okungenayo kwe-LBP kuya kufakwa kwelinye iphepha kwimiba efanayo ye-European Spine Journal.

 

tindlela

 

Iziphumo zokuphononongwa ngokuchanekileyo ezenziwe kwisikhokelo se-CBRG zisetyenzisiwe. Uninzi lwaloo mphononongo lushicilelwe, kodwa iziphumo zokuqala ezivela kwiCocrane enye yokuphononongwa kwimiba yesigulane (A. Engers et al., Engeniswe ukupapashwa) esithunyelweyo ukushicilelwa nayo isetyenziswa. Ngenxa yokuba akukho kuhlaziywa kweCochrane kufikeleleke, sasebenzise ukuhlaziywa kweendlela ezimbini ezipapashwe ngokutsha malunga nesishwankathelo senkcazo kwi-anti-depressants. Ukuhlaziywa kwe-Cochrane kwimeko yokusebenza, ukusebenza kanzima kunye nokubuyiselwa komsebenzi akuzange kuthathelwe ingqalelo kuba zonke izilingo ezibandakanyiweyo kule ngongoma zibandakanyiwe kwiingxelo zonyango kunye nokunyangwa kwamanyathelo ahlukeneyo. Iingxelo zeCochrane zihlaziywe ngezilingo ezongezelelweyo, ukuba zikhoyo, zisebenzisa i-Clinical Evidence njengomthombo (www.clinicalevidence.com). Le mibhalo ibhalwe ngamacandelo amabini: enye ngobungqina bongenelelo lwamachiza kunye nolunye ngobungqina bokuba kungenelelo lokungenawobisi kwi-LBP engeyiyo.

 

Isicwangciso soPhando kunye noKhetho lokuFunda

 

Isicwangciso esilandelayo sokukhangela sisetyenziswe kwiingcebiso zeCochrane:

 

  1. Uphando lwekhompyutha oluxhasayo lweMedline kunye neNgcaciso yolwazi ukususela ekuqaleni kwawo.
  2. Ukukhangela kwiRejista yaseCochrane Central yezilingo eziLawulayo (ePhakathi).
  3. Ukuboniswa kweenkcazo ezinikezelwe kwiimviwo ezichanekileyo kunye nezilingo ezichongiweyo.
  4. Unxibelelwano lomntu kunye neengcali zenkcubeko kwintsimi.

 

Ababuyekezi ababini bazibandakanya ngokuzimeleyo imigaqo-nkqubo yokufaka ukukhetha izilingo ezichaphazelekayo ezivela kwiibhloko, izibhengezo kunye neenkcukacha eziphambili zeenkcukacha ezifunyenwe ngophando lweencwadi. Amanqaku apho kungavumelani khona, kwaye amanqaku apho isihloko, esingabonakaliyo kunye namagama angundoqo anikezela ngolwazi olunganeleyo kwisigqibo malunga nokukhethwa lufunyenwe ukuvavanya ukuba badibanisa i-criteria yokungeniswa. Indlela yokubambisana isetyenziselwe ukuxazulula ukungavumelani phakathi kwababuyekezi ababini malunga nokufakwa kwezifundo. Umcebisi wesithathu waxoxwa ukuba ukungavumelani kungasombululwanga kwintlanganiso yesivumelwano.

 

Iingqinisiso zokufakwa

 

Uyilo lo kufunda. Ii-RCT zifakwe kuzo zonke izibuyekezo.

 

Abathathi-nxaxheba. Abathathi-nxaxheba bezilingo ezibandakanyiweyo kwiinkcazo ezichanekileyo babesenokuba nzima (iingaphantsi kweeveki ze-6), i-subacute (ii-6-12 iiveki), kunye / okanye ezingapheliyo (iiveki ze-12 okanye ngaphezulu) i-LBP. Zonke izibuyekezo zibandakanya izigulane ezine-LBP ezingezizo.

 

Ngoncedo. Zonke iimpendulo zibandakanya ukungenelelo oluthile. Ngokuqhelekileyo nayiphi na iqela lokufanisa lavunyelwa, kodwa ukuthelekiswa kungekho nonyango / indawo yokulinda / uludwe lwamagama okulinda kunye nezinye iindlela zokungenelela zenziwe ngokwahlukileyo.

 

Iziphumo. Amanyathelo okuphumeza afakwe kwiinkcazo ezihambelana neziphumo ziphumo zeziphumo (umz. Intlungu), ukuphuculwa ngokubanzi okanye ukwaneliseka ngonyango, umsebenzi (umz. Isimo esisebenza ngasemva), impilo (umz. Wobomi), ukukhubazeka (umz ukuhlala, umsebenzi wokungabikho emsebenzini) kunye nemiphumo emibi. Iziphumo zenziwe ngokwahlukileyo kwixesha elifutshane kunye nexesha elide lokulandela.

 

YoVavanyo lweMigangatho

 

Kwiinkoliso ezininzi, umgangatho wezobuchule ovavanyo olubandakanyiweyo kuhlolo luye lwahlolwa ngokusetyenziswa kweendlela eziphakanyiswe yiCBRG. Ezi zifundo zazingabonakali ngenxa yabalobi, amaziko, okanye iifayili apho uphando lwapapashwa khona. Imigaqo-nkqubo yayiyiyo: (1) ukufihla ukwabiwa okwaneleyo, (2) ngendlela efanelekileyo yokwenza i-randomization, (3) ukufana kweempawu ezisisiseko, (4) ukuphazamisa izigulane, (5) ukuphazamisa umniki-nkonzo, (6) (7) ukuthotyelwa ngokwaneleyo, (8) ixesha elifanayo lokuhlolwa kwesiphumo, (9) iphosakele ukuhlolwa kwesiphumo, (10) ukuhoxiswa nokuyeka ukuphuma, kunye (11) ukuhlaziywa kwenjongo yokuphatha. Zonke izinto zafunyanwa njengezinto ezintle, ezimbi, okanye ezingacacileyo. Umgangatho ophezulu wawuchazwa ngokuqhelekileyo njengokuzalisekisa i-6 okanye ngaphezulu kweempawu ze-11. Sithumela abafundi kubungqina bokuqala beCochrane ngeenkcukacha zomgangatho wezilingo.

 

Ukwaziswa kwedata

 

Idatha ekhishwe kwaye ifakwe kwiithebhile yayiquka iimpawu zabathathi-nxaxheba, ukungenelela, iziphumo, kunye neziphumo. Sithumela abafundi kubungqina bokuqala beCochrane malunga nesishwankathelo sedatha yesilingo.

 

Uhlalutyo lweenkcukacha

 

Ezinye iingxelo zenze i-meta-analysis ngokusebenzisa iindlela zokubala ukuhlalutya nokufingqa idatha. Ukuba idatha echanekileyo ekhoyo yayingabikhoyo (idatha yayingekho ncinane okanye imilinganiselo enganeleyo) okanye ukuba iinkcukacha zazingenangqamaniso (kwaye u-hterogeneity ayikwazanga ukuchazwa), ukukhutshwa kwamanani okuthintela kuye kwacinywa. Kule meko, abahlalutyi benza uhlalutyo olululo. Kuhlalutyo lwekhwalithi, amanqanaba ahlukeneyo obungqina asetyenziswayo athatha ingqalelo kubathathi-nxaxheba, ukungenelela, iziphumo, kunye nemigangatho yemigaqo yezifundo zangaphambili. Ukuba kuphela i-subset yezilingo ezifumanekayo zinikezela iinkcukacha ezaneleyo zokufakwa kwi-meta-analysis (umz. Ezinye izilingo ezichazwe ukuphambuka kwezinga eliqhelekileyo), zombini uhlalutyo olulinganisiweyo nolungqinisiso lwalusetyenziswa.

 

Insight of Dr. Alex Jimenez

Injongo yolu lulwazi kuphando olulandelayo luyilokuchonga ukuba zeziphi iindlela ezahlukeneyo zonyango ezisetyenziswayo zingakhuselekanga kwaye zisebenza ngokuthe ngqo ekukhuseleni, ukuxilongwa kunye nokunyangwa kweentlungu ezibuhlungu, ezingapheliyo kunye neengxaki ezingapheliyo, kunye noluntu jikelele umqolo obuhlungu. Zonke iimvavanyo ezichanekileyo zibandakanya abathathi-nxaxheba ngolunye uhlobo lweentlungu ezingezantsi, okanye i-LBP, apho elowo lafumana unyango lwezempilo ngoncedo olulodwa. Amanyathelo okuphumelela afakwe kwiinkcazo ezichanekileyo zisekelwe kwiimpawu, ukuphuculwa jikelele okanye ukwaneliseka ngonyango, umsebenzi, ukukhubazeka, ukukhubazeka kunye nemiphumo emibi. Idata yeziphumo zachithwa kwaye zinikezwa kwiiTables 1 kunye ne-2. Abaphandi bolu phando benze uhlalutyo olulungileyo lwabo bonke iinkcukacha zeenklinikhi kunye nolwazi ngaphambi kokubonisa kulo nqaku. Njengeengcali zonyango, okanye isigulane ngeentlungu zentlungu, ingcaciso kulolu cwaningo lunokukunceda ukuba i-modal yonyango engabonakaliyo inokuthi ithathelwe ingqalelo ukuba iphumelele imilinganiselo yempatho yokufunyanwa.

 

iziphumo

 

Amanyathelo okuNyango

 

Ukuxhatshazwa

 

Kukho izizathu ezintathu zokusebenzisa i-anti-depressants kunyango lwe-LBP. Isizathu sokuqala kukuba izigulana ezingapheliyo ze-LBP zihlala zijongana nokuxinezeleka, kwaye unyango oluneengxaki zokuxhatshazwa kwemvelo lunokuphakamisa imizwelo kunye nokwandisa ukunyamezela intlungu. Okwesibini, izidakamizwa ezininzi ezixhatshazwayo zihlala, kwaye kuye kwacetyiswa ukuba inxalenye yexabiso labo ekulawuleni izilonda zentsholongwane engapheliyo ingakwazi ukuphucula ubuthongo. Isizathu sesithathu sokusetyenziswa kwezidalwa ezidandathelwanayo kwizigulane ezingapheliyo ze-LBP ziyimpawu zabo zokuziphatha, ezenzeka kumanqanaba angaphantsi kunefuthe elixinzelelekayo.

 

Ukuphumelela kwezidandlululo kwiLBP Akukho zilingo zachongwa.

 

Ukusebenza kweengcinezelo ze-anti-depressants ezingama-LBP ezingapheliyo ngokumelene ne-placebo. Sifumene ukuhlaziywa kweendlela ezimbini ezibandakanya izibalo ezilisithoba. Olunye uphononongo lufumene ukuba i-anti-depressants kakhulu yandisa ukukhululeka kwentlungu xa kuthelekiswa ne placebo kodwa ayifumananga umehluko omkhulu ekusebenzeni [ubuhlungu: ukuhluka kwegama elithelekisiwe (SMD) 0.41, 95% CI 0.22-0.61; Umsebenzi: SMD 0.24, 95% CI -0.21 ukuya ku-0.69]. Olunye uphononongo aluzange ludibanise idatha kodwa lube nemiphumo efanayo.

 

Imiphumo emibi Imiphumo emibi ye-anti-depressants iquka umlomo owomileyo, ukulala, ukuzithemba, ukugcinwa kwemigodi, i-hypotension orthostatic, kunye ne-mania. Enye i-RCT yabona ukuba ukusabalalisa komlomo owomileyo, ukungazinzi, ukuguquka, kunye neempawu ze-orthostatic yi-60-80% ne-tricyclic antidepressants. Nangona kunjalo, amaxabiso ayengaphantsi kwinqanaba le-placebo kwaye akukho nto eyahlukileyo. Kwizilingo ezininzi, ukubikwa kwemiphumo emibi kwakungenako.

 

Ukuxhamla kwemizimba

 

Igama elithi 'imisipha yokuphumula, inkulu kakhulu kwaye iquka uluhlu olubanzi lweziyobisi kunye nezibonakaliso ezahlukeneyo nezindlela zokwenza. Ukuphucula izidumbu kungahlukana kwiindidi ezibalulekileyo: i-antispasmodic kunye neyeza zokungabikho.

 

I-Antispasmodics isetyenziselwa ukunciphisa ukuhluma kwemisipha ehambelana nezimo ezinzima ezifana ne-LBP. I-Antispasmodics ingafakwa phantsi kwe-benzodiazepines kunye ne-non-benzodiazepines. I-Benzodiazepines (umz. Diazepam, tetrazepam) isetyenziswe njenge-anxiolytics, sedatives, hypnotics, i-anticonvulsants, kunye / okanye i-skeletal muscle relaxants. I-non-benzodiazepines iquka iintlobo ezahlukeneyo zamachiza ezinokusebenza kwiqondo lobuchopho okanye kwintambo yomthambo. Iinkqubo zesenzo kunye nenkqubo ye-nervous central ayengacaciswanga ngokupheleleyo.

 

Ukusetyenziswa kwamachiza okuxhatshazwayo kusetshenziselwa ukunciphisa ukuphazamiseka okuphazamisa unyango okanye umsebenzi, njenge-cerebral palsy, i-multiple sclerosis, kunye nenxeba yomgudu. Indlela yokusebenza kwezidakamizwa ezingaphiliyo kunye nenkqubo yentsholongwane yomzila (umz. I-dantrolene sodium) kukukhutshwa kwesiteshi se-sarcoplasmic reticulum calcium. Oku kunciphisa uxinzelelo lwe-calcium kwaye kunciphisa ukusebenzisana kwe-actin-myosin.

 

Ukusebenza kwezihluthulelo ze-muscle ze-LBP ze-Benzodiazepines ngokuthe ngqo kwi-placebo. Olunye uphando lubonise ukuba kukho ubungqina obuncitshiweyo (linye ilingo; abantu be-50) ukuba i-injection ye-intramuscular ye diazepam ilandelwa yi-diazepam yomlomo yeentsuku ze-5 iphumelele ngakumbi kune-placebo yezigulane ezine-LBP ezinzulu kwiinkonzo zentlungu zangexesha elifutshane kunye nokuphuculwa komgangatho ophezulu, kodwa inxulumene nemiphumo engundoqo yenkqubo yeentambo zesistim.

 

I-non-benzodiazepines ngokumelene ne-placebo. Izifundo ezisibhozo zachongwa. Olunye uphando oluphezulu lwe-LBP lubonise ukuba kukho ubungqina obunokulinganisela (olunye ulingo; abantu be-80) ukuba enye ingeniso ye-60 mg ye-orphenadrine iphumelele ngakumbi kune-placebo ekuphumuleni kwentlungu kunye ne-spamm yezigulane ezine-LBP ezilukhuni.

 

Umgangatho ophezulu ophezulu kunye nesilingo esisodwa sempumelelo sibonise ukuba kukho ubungqina obuqinileyo (izilingo ezine; i-294 abantu) ukuba umlomo ongewona i-benzodiazepines uphumelele ngakumbi kune-placebo yezigulane ezine-LBP ngokukhawuleza kwintlungu yesikhashana, ukuphumelela kwehlabathi kunye nokuphuculwa kwenyama iziphumo. I-RR kunye ne-95% I-CI yentlungu ebuhlungu i-0.80 (0.71-0.89) emva kweentsuku ze-2-4 (izilingo ezine; 294 abantu) kunye ne-0.58 (0.45-0.76) emva kwe-5-7 iintsuku zokulandela (izilingo ezintathu; ). I-RR kunye ne-244% I-CI yokuphumelela kwehlabathi jikelele i-95 (0.49-0.25) emva kweentsuku ze-0.95-2 (izilingo ezine; 4 abantu) kunye ne-222 (0.68-0.41) emva kwe-1.13-5 iintsuku zokulandelelana (izilingo ezine; ).

 

Ukuxhatshazwa kweziyobisi ngokumelene ne-placebo. Izilingo ezimbini eziphezulu zibonakalise ukuba kukho ubungqina obuqinileyo (izilingo ezimbini; abantu be-220) ukuba i-antispasticity muscle relaxants iphumelele ngakumbi kune-placebo yezigulane ezine-LBP ngokukhawuleza kwintlungu kunye neyokunciphisa i-muscle spasm emva kweentsuku ze-4. Olunye uvavanyo lwekhwalithi ephakamileyo lubonise ubungqina obunokulinganiswa kwiinkonzo zentlungu efutshane, ukunciphisa imisipha yomzimba kunye nokuphuculwa ngokubanzi emva kweentsuku ze-10.

 

Ukusebenza kwezihlunu zokuphucula izifo ezingapheliyo ze-LBP Benzodiazepines ngokubhekiselele kwi-placebo. Izifundo ezintathu zachongwa. Izilingo ezimbini eziphezulu ze-LBP zibonisa ukuba kukho ubungqina obuqinileyo (izilingo ezimbini; abantu be-222) ukuba i-tetrazepam i-50 mg tid iphumelele kakhulu kune-placebo yezigulane ezine-LBP ezingapheliyo kwiinkonzo zentlungu efutshane kunye nophuculo olubanzi. I-RRs kunye ne-95% I-CI yentlungu ebuhlungu i-0.82 (0.72-0.94) emva kokulandelwa kweentsuku ze-5-7 kunye ne-0.71 (0.54-0.93) emva kweentsuku ze-10-14. I-RR kunye ne-95% CI yokuphuculwa ngokubanzi yi-0.63 (0.42-0.97) emva kokulandelwa kweentsuku ze-10-14. Olunye uvavanyo lwekhwalithi ephakamileyo lubonise ukuba kukho ubungqina obunokulinganisela (olunye ulingo; abantu be-50) ukuba i-tetrazepam isebenze ngakumbi kune-placebo kwi-short-term decrease of spasm muscle.

 

I-non-benzodiazepines ngokumelene ne-placebo. Izifundo ezintathu zachongwa. Olunye uvavanyo lwekhwalithi ephezulu lubonise ukuba kukho ubungqina obunokulinganisela (olunye ulingo; abantu be-107) abaphumelela ngakumbi kune-placebo kwizigulane ezine-LBP ezingapheliyo kunye nokuphuculwa kwexesha elifutshane kunye nokuphucula ngokubanzi emva kweentsuku ze-7, kodwa kungekhona ekunciphiseni i-spasm ye-muscle. Olunye uvavanyo lwekhwalithi ephezulu lubonise ukuba kukho ubungqina obunokulinganisela (olunye ulingo; abantu be-112) ukuba i-toperperone iphumelele ngakumbi kune-placebo yezigulane ezine-LBP ezingapheliyo kwixesha elifutshane eliphuculwayo emva kweentsuku ze-21, kodwa kungekhona kwintlungu yokunciphisa kunye nokunciphisa i-spasm.

 

Imiphumo emibi Ubungqina obuqilileyo ukusuka kwizilingo ezi-sibhozo kwi-LBP (724) abantu abathandekayo babonisa ukuba izihlunu zokuzihlaziya zihlangene nemiphumo emibi epheleleyo kunye neenkqubo ezisemgangathweni ezingathintekiyo kuneempembelelo ze-placebo, kodwa kungekhona nemiphumo emibi yesisu; I-RR kunye ne-95% I-CN yi-1.50 (1.14-1.98), i2.04 (1.23-3.37), kunye ne-0.95 (0.29-3.19), ngokulandelanayo. Iziganeko ezichaseleyo eziqhelekileyo eziqhelekileyo ezibandakanya inkqubo ye-nervous central bari bendoda kunye nezoxinzelelo. Ngenxa yesondlo sesisu sasisisongulu. Isiganeko sezinye iziganeko ezimbi ezinxulumene nezihlunu ze-muscle zazingekho phantsi.

 

NSAID

 

Isizathu sokonyango kwe-LBP kunye ne-NSAID isekelwe kokubili kwisakhono salo kunye nesenzo sabo sokuchasa.

 

Ukusebenza kwe-NSAID kwi-NSAID ezinzulu ze-LBP ngokubhekiselele kwi-placebo. Izifundo ezisi-9 zachongwa. Izifundo ezimbini ezibikwe nge-LBP ngaphandle kwemitha, i-sciatica, kunye nezinye ezihlanu kwiindawo ezixubekileyo. Kwakukho ubungqina obuphikisanayo bokuthi ii-NSAID zinikeza intlungu engcono kuneyona ndawo ye-LBP. Izifundo ezintandathu kwizifundo ezisi-9 ezithelekisa ii-NSAID kunye ne-placebo ze-LBP ezibi zichaze iinkcukacha ezichanekileyo ekuphuculweni kwehlabathi. I-RR edibeneyo yokuphucula umhlaba emva kweveki ye-1 isebenzisa imodeli echaphazelekayo yi-1.24 (95% CI 1.10-1.41), ebonisa impembelelo ephawulekayo kwi-NSAID xa kuthelekiswa ne-placebo. I-RR (ezintathu izilingo) zokusetyenziswa kwe-analgesic usebenzisa i-1.29 (95% CI 1.05-1.57), ebonisa ukusetyenziswa okungaphantsi kwe-analgesics kwiqela le-NSAID.

 

I-NSAID ngokumelene neparacetamol / acetaminophen. Kwakungekho nantlukwano phakathi kwe-NSAID kunye ne-paracetamol yabika kwizifundo ezimbini, kodwa olunye uphando lwabikwa iziphumo ezingcono kwizimbini ezine ze-NSAID. Kukho ubungqina obuphikisanayo bokuthi ii-NSAID ziphumelela ngakumbi kuneparacetamol kwi-LBP echaphazelekayo.

 

Ii-NSAID kunye nezinye iziyobisi. Izifundo ezithandathu zibikwe kwi-LBP enzima, apho ezintlanu azizange zifumane nantlukwano phakathi kwe-NSAID kunye ne-narcotic analgesics okanye i-relaxation muscle. Ubukhulu beqela kulezi zifundo zivela kwi-19 ukuya kwi-44 kwaye ngoko, ezi zifundo zenzeke nje zingenakho amandla okufumanisa umehluko ophawulekayo. Kukho ubungqina obunokulinganisela ukuba i-NSAID ayisebenzisekanga ngakumbi kunezinye iziyobisi kwiLBP enzima.

 

Ukusebenza kwe-NSAID kwii-NSAID ezingapheliyo ze-LBP ngokumelene ne-placebo. Enye into encinane yokufunda (n = 37) yafumanisa ukuba i-naproxen sodium i-275 mg capsules (ezimbini iifomsile bid) zanciphisa intlungu ngaphezu kwe-placebo kwiintsuku ze-14.

 

I-COX2 inhibitors kunye ne-placebo. Izilingo ezine ezongeziweyo zachongwa. Kukho ubungqina obuqinileyo bokuthi i-COX2 inhibitors (etoricoxib, rofecoxib kunye ne-valdecoxib) yanciphisa intlungu kunye nomsebenzi ophuculweyo xa kuthelekiswa ne-placebo kwi-4 neveki ze-12, kodwa imiphumo yayincinci.

 

Imiphumo emibi I-NSAID zingabangela iingxaki zesisu. Izifundo ezisixhenxe zeesithoba ezithe zafanisa ii-NSAID kunye ne-placebo kwi-LBP echaphazelekayo echazwe ngemiphumo emibi. I-RR edibeneyo kwimiphumo echaphazelekayo isebenzisa imodeli eneempembelelo ezixhasayo yi-0.83 (95% CI 0.64-1.08), ebonisa ukuba akukho mfahluko ophawulekayo. Ukuphononongwa ngokuchanekileyo kwezigulane ze-NSAID kufumene ukuba ibuprofen kunye ne-diclofenac banesisindo esiphantsi kakhulu sesisombululo sesisu, ikakhulu ngenxa yezilwanyana eziphantsi ezisetyenziselwa ukwenza umsebenzi (zifakwe OKANYE nemiphumo emibi kunye ne-placebo 1.30, 95% CI 0.91-1.80). I-COX2 inhibitors ziye zaboniswa ukuba zineziphumo ezincinci zesisu esiswini kwi-osteoarthritis kunye nezifundo ze-arthritis ze-rheumatoid. Nangona kunjalo, ukwanda komngcipheko we-cardiovascular (i-myocardial infarction ne-stroke) kuye kwabikwa ngokusetyenziswa kwexesha elide.

 

Amanyathelo angenelelo lweMishanguzo

 

Iseluleko sokuhlala siSebenzayo

 

Ukuphumelela kweengcebiso zokuhlala zikhuthele kwi-LBP eninzi Hlala usebenza ngokubhekiselele ekuphumleni kombhede. Uphengululo lweCochrane lufumene izifundo ezine ezithelekisa neengcebiso zokuhlala zisebenza njengonyango olunye kunye nokuphumla kwebhedi. Olunye uphononongo olukumgangatho ophezulu lubonise ukuba iingcebiso zokuhlala zikhuthele ngokubonakalayo ziphucule imeko yokusebenza kunye nokunciphisa ikhefu lokugula emva kweeveki ezi-3 xa kuthelekiswa neengcebiso zokuphumla ebhedini iintsuku ezi-2. Kwakhona kwafumanisa ukunciphisa ubunzima bentlungu ekuhlaleni iqela elisebenzayo ekulandeleni okuphakathi (ngaphezu kweeveki ezi-3). Izifundo ezikumgangatho ophantsi zibonise iziphumo eziphikisanayo. Uvavanyo olongezelelweyo (abantu abangama-278) alufumananga nantlukwano ebalulekileyo kwiintlungu kunye nokukhubazeka okusebenzayo phakathi kweengcebiso zokuhlala usebenza kunye nokuphumla kombhede emva kwenyanga ye-1. Nangona kunjalo, ifumanise ukuba ingcebiso yokuhlala usasebenza inciphise ikhefu lokugula ngokuthelekiswa nokuphumla kwebhedi ukuya kuthi ga kumhla we-5 (52% ngengcebiso yokuhlala usebenza nxamnye ne-86% ngokuphumla ebhedini; P <0.0001).

 

Hlala usebenza ngokubhekiselele ekuzilolweni. Olunye uvavanyo lwafumana ukuphuculwa kwexesha elifutshane kwiimeko zokusebenza kunye nokunciphisa ikhefu lokugula ngenxa yeengcebiso zokuhlala zisebenza. Ukunciphisa kakhulu ikhefu lokugula ngenxa yokuhlala iqela elisebenzayo kwabikwa kwakhona ekulandeleni ixesha elide.

 

Ukuphumelela kweengcebiso zokuhlala zikhuthele kwi-LBP engapheliyo Akukho zilingo ezichongiweyo.

 

Imiphumo emibi Akukho zilingo ezibikwe iziphumo ezibi.

 

Izikolo Emuva

 

Isiqalo 'sesikolo esikolweni saseSweden' saqaliswa nguZachrisson Forsell kwi-1969. Kwakujoliswe ekunciphiseni intlungu kunye nokukhusela ukuphindaphinda. Isikolo esikolweni saseSweden sineenkcukacha nge-anatomy ye-back, i-biomechanics, i-posture, i-ergonomics, kunye ne-back exercise. Iiseshoni ezine zeqela elincinane zacwangciswa ngexesha lexeshana ze-2, kunye neseshoni nganye ihlala i-45 min. Umxholo kunye nobude bezikolo zangasemva sele zitshintshile kwaye zibonakala zihluka ngokubanzi namhlanje.

 

Ukuphumelela kwezikolo zangasemva ze-LBP ezikolweni eziphambili ngokubhekiselele ekulawuleni uluhlu lwezinto zokulinda okanye ukungenelela kwe-placebo. Uvavanyo olulodwa kuphela oluqhathaniswa nesikolo kunye ne-placebo (i-shortwaves in the lowest intensity) kwaye ibonise ukuphucula okufutshane kwexesha elifutshane kwaye libuyele emsebenzini kumqolo wesikolo esikolweni. Akukho nantlukwano emfutshane okanye yexesha elide efunyenwe.

 

Izikolo ezibuya emva kwezinye iindlela. Izifundo ezine (izigulane ze-1,418) zibonise ubungqina obuphikisanayo malunga nokuphumelela kwezikolo zangasemva xa ziqhathaniswa nezinye iindlela zokwenza i-LBP kunye ne-LBP ngokungathandekiyo kwiintlungu, isimo sokusebenza, ukubuyisela, ukuphindaphinda, nokubuyela emsebenzini (elifutshane, eliphakathi, kunye nexesha elide elilandela -up).

 

Ukuphumelela kwezikolo zangasemva zezikolo ezingapheliyo ze-LBP Izikolo ezisezantsi emva kokulawulwa kwoluhlu lokulinda okanye ukungenelela kwe-placebo. Kukho ubungqina obuphikisanayo (izilingo ezisibhozo; izigulane ze-826) ekusebenzeni kwezikolo zangasemva eziqhathaniswa nokulawulwa kwoluhlu lwezinto zokulinda okanye i-placebo ukungenelela kwintlungu, isimo sokusebenza, nokubuyela emsebenzini (okufutshane-, okuphakathi, kunye nokulandela ixesha elide) kwizigulane ezine-LBP ezingapheliyo.

 

Izikolo ezibuya emva kwezinye izibonelelo. Izifundo ezithandathu zachongwa ziqhathaniswa nezikolo zangasemva kunye nokusetyenziswa, ukugulisa umlingo okanye ukudibanisa, unyango lwe-myofascial, kunye nolunye uhlobo lwemiyalelo okanye iingcebiso. Kukho ubungqina obunokulinganisela (izilingo ezintlanu; izigulane ze-1,095) ukuba isikolo esikolweni siphumelele ngakumbi kunamanye unyango kwizigulane ezine-LBP ezingapheliyo ngenxa yentlungu kunye nesimo sokusebenza (ukulandelelana kwexesha elifutshane neliphakathi). Kukho ubungqina obunokulinganisela (izilingo ezintathu; izigulane ze-822) ukuba akukho ntlukwano kwintlungu eninzi kunye neemeko zokusebenza.

 

Imiphumo emibi Akukho nanye kwezilingo ezichazwe nayiphi na imiphumo emibi.

 

Ukuphumla kweBhedi

 

Esinye isizathu sokuphumla kwesibhedlele kukuba izigulane ezininzi zifumana ukukhululeka kweempawu kwindawo ephilileyo.

 

Ukuphumelela kokuphumla kombhede weLBP Izilingo ezilishumi elinesibini zafakwa kwi-Cochrane. Ezinye izilingo zazingumxube wezilwanyana ezine-LBP ezinzima kunye ezingapheliyo okanye kwiindawo zezigulane ezine-sciatica.

 

Ibhedi iphumle kunye neengcebiso zokuhlala zisebenza. Izilingo ezintathu (izigulane ze-481) zifakwe kulo mzekeliso. Iziphumo zeemvavanyo ezimbini zezinga eliphezulu zibonisa ukungqinelana okuncinci kodwa okungafaniyo nokuhlala ngokusebenzayo, kwi-3- ukuya kwi-4-veki-up [intlungu: SMD 0.22 (95% CI 0.02-0.41); Umsebenzi: SMD 0.31 (95% CI 0.06-0.55)], kunye ne-12-veki-up [intlungu: SMD 0.25 (95% CI 0.05-0.45); Umsebenzi: SMD 0.25 (95% CI 0.02-0.48)]. Ezi zifundo zombini nazo zachaza ukungafani okukhulu kwekhefu lokugula ngenxa yokuhlala usebenza. Kukho ubungqina obuqinileyo bokuthi isiluleko sokuphumla embhedeni asikho ngaphantsi kweengcebiso zokuhlala zikhuthele ukunciphisa intlungu nokuphucula isimo somsebenzi kunye nokubuyela ngokukhawuleza emsebenzini.

 

Ikhefu liphumla ngokubhekiselele kwezinye iindlela zokungenelela. Izilingo ezintathu zafakwa. Izilingo ezimbini zifanisa iingcebiso zokulala kwindawo yokulala kunye nokufumana ubungqina obuqinileyo bokuthi akukho ntlukwano kwintlungu, isimo sokusebenza, okanye ikhefu lokugula ngexesha elifutshane kunye nokulandela ixesha elide. Olunye uphando alufumani nantlukwano ekuphuculeni intlungu edibeneyo, ukukhubazeka, kunye namanqaku okuhlola emzimbeni phakathi kokuphumla kwebhedlele kunye nokuphathwa, unyango lweziyobisi, i-physiotherapy, isikolo esikolweni okanye i-placebo.

 

Ukuphumla kwebhedlele emfutshane ngokumalunga nokuphumla kwexesha lokulala. Esinye isilingo kwizigulane ezine-sciatica zabika akukho mfahluko omkhulu kwiintlungu eziphakathi kwe-3 kunye ne-7 iintsuku zokuphumla kombhede, zilinganiswe iintsuku ze-2 emva kokuphela kokonyango.

 

Ukuphumelela kokuphumla kombhede weLBP engapheliyo Akukho zilingo ezichongiweyo.

 

Imiphumo emibi Akukho zilingo ezichaze iziphumo ezimbi.

 

Unyango lweZenzo

 

Ukunyangwa kwe-LBP engapheliyo kugxininise kuphela ekususeni i-organic pathology engundoqo, kodwa kwakhona kuzama ukunciphisa ukukhubazeka ngokuguqulwa kwamandla okusingqongileyo kunye neenkqubo zokuqonda. Ngokubanzi, iindlela zokuziphatha ezintathu zendlela yokuziphatha ziyakwazi ukwahlukana: osebenzayo, owaziyo, kunye nommangalelwa. Ngolunye lweendlela zijolise ekuguqulweni kwelinye leenkqubo ezintathu zokuphendula ezibonisa iimvakalelo zengqondo: ukuziphatha, ukuqonda, kunye nokusebenza komzimba.

 

Ukunyanga okusebenzayo kubandakanya ukuqiniswa okuqinisekileyo kweziphatho eziphilileyo kunye nokuhoxiswa ngokukhawuleza kwenkxalabo yokuziphatha kakubi, ixesha elixhomekeke ekulawuleni iintlungu, kunye nokubandakanya umtshato. Imigaqo yonyango yokusebenza ingasetyenziswa yizo zonke iinkathalo zempilo ezichaphazelekayo nesigulane.

 

Ingonyango yolwazi lujolise ekuboneni nasekuguquleni iingcamango zezigulana malunga neentlungu nokukhubazeka. Ukuqonda (intsingiselo yentlungu, ukulindela malunga nokulawulwa kwintlungu) kunokuguqulwa ngokuchanekileyo ngamacandelo okuhlengahlengiswa kwengqondo (njengemifanekiso kunye nokuphazamiseka kwengqalelo), okanye ngokungahambisani ngqo nokuguqulwa kweengcamango ezingathandekiyo, iimvakalelo kunye neenkolelo.

 

Uphulo lommangalelwa lujolise ekutshintsheni inkqubo yokuphendula umzimba, umzekelo ngokunciphisa uxinzelelo lwe-muscular. Unyango olummangalelwa luquka ukubonelela isigulane ngomzekelo wobudlelwane phakathi koxinzelelo kunye nentlungu, nokufundisa isigulane ukuthatha indawo yokuxhatshazwa kwemisipha ngokuphendula okungahambelaniyo, njengempendulo yokuphumula. I-Electromyographic (EMG) ye-biofeedback, ukuphumula okuqhubekayo kunye nokuphumula okusetyenziswa rhoqo kusetyenziswa.

 

Izindlela zokuziphatha zivame ukusetyenziswa kunye njengenxalenye yendlela yokwenza unyango olubanzi. Le nto ebizwa ngokuba yinkcazo-yokuziphatha yonyango isekelwe kwimodeli emininzi yeentlungu ezibandakanya izixhobo eziphathekayo, ezithintekayo, ezinokwenkcazo, kunye nezokuziphatha. Iindidi ezininzi zokuziphatha zendlela yokuziphatha zisebenziswa kwi-LBP engapheliyo ngenxa yokuba akukho mvumelwano jikelele malunga nencazelo yezindlela ezisebenzayo kunye nengqiqo. Ngaphezu koko, unyango lwendlela yokuziphatha luhlala lubandakanya ukudibanisa kwezi modal okanye lusetyenziswe ngokudibene nezinye iindlela zokwelapha (njengamachiza okanye ukuzivocavoca).

 

Ukusebenza kweyeza lokuziphatha kwi-LBP enzima Elinye i-RCT (abantu be-107) abachongiweyo ngokuphononongwa bafumene ukuba unyango oluthile lokuziphatha luyanciphisa intlungu kunye nokukhubazeka okubonakalayo emva kweenyanga ze-9-12 xa kuthelekiswa nokunyamekelwa kwendabuko (ama-analgesics kunye kunye nokuzivocavoca emva kokuba intlungu ibambelele).

 

Ukuphumelela kwonyango yokuziphatha kwi-LBP engapheliyo yokuziphatha ngokubhekiselele ekulawuleni uluhlu lokulinda. Kukho ubungqina obunokulinganisela obuvela kwiimvavanyo ezincinci ezimbini (inani le-39 yabantu) ukuba ukuphumula okuqhubekayo kunempembelelo enkulu kwiintlungu (1.16; 95% CI 0.47-1.85) kunye neziphumo zokuziphatha (1.31; 95% CI 0.61-2.01) kwifutshane -mitha. Kukho ubungqina obunqinqiweyo bokuthi ukuphumula okuqhubekayo kunempembelelo enokubakho kwixesha elifutshane elize libuye libuye lisebenza.

 

Kukho ubungqina obunokulinganisela ukusuka kwiimvavanyo ezincinci ezintathu (inani labantu abangama-88) ukuba akukho mvelaphi ephawulekayo phakathi kwe-EMG biofeedback kunye nokulawulwa kwoluhlu lokulinda kwiziphumo zokuziphatha ngexesha elifutshane. Kukho ubungqina obuphikisanayo (izilingo ezimbini; abantu be-60) ekusebenzeni kwe-EMG kunye nokulawulwa kohlu lokulinda kwiimeko eziqhelekileyo zokusebenza.

 

Kukho ubungqina obuphikisanayo ukusuka kwizilingo ezintathu ezincinci (i-153 yabantu) ngokumalunga nomphumo wonyango osebenzayo kwiintlungu zentsuku ezifutshane, kunye nobungqina obuncinane bokuthi akukho ntlukwano [0.35 (95% CI -0.25 ku-0.94)] phakathi kwonyango olusebenzayo kunye nokulinda uluhlu lwezinto zokuziphatha ezifutshane. Izifundo ezintlanu ziqhathanisa umphenduli ohlangeneyo kunye nonyango lokuqonda kunye nokulawula uluhlu lwezinto zokulinda. Kukho ubungqina obuqinileyo ukusuka kwizilingo ezine ezincinci (i-134 yabantu) abadibeneyo kunye ne-cognitive therapy ine-medium size, i-short-term effect in-intact effect. Kukho ubungqina obuqinileyo bokuthi akukho ntlukwano [0.44 (95% CI -0.13 kwi-1.01)] kwiziphumo zokuziphatha ezifutshane.

 

Inkqubo yokuziphatha ngokubhekisele kwezinye iindlela zokungenelela. Kukho ubungqina obunqinci (olunye ulingo; abantu be-39) ukuba akukho mvelaphi ephawulekayo phakathi kokuphathwa kwendlela yokuziphatha kunye nokuzivocavoca kwintlungu, ubunzima bomsebenzi osebenzayo kunye neziphumo zokuziphatha, okanye emva kokunyanga, okanye kwi-6- okanye i-12-inyanga yokulandelelana.

 

Imiphumo emibi Akukho zichazwe kwizilingo.

 

Ukunyanga kwamayeza

 

Ukusebenzisa unyango luqhinga lokulawula olusetyenziswa kakhulu kwi-LBP; iquka iqela eliyingcipheko lokungenelela okuvela kwimpilo yomzimba jikelele okanye ukusetyenziswa kwe-aerobic, ukuqiniswa kwemisipha, kwiintlobo ezahlukeneyo zokuguquguquka nokuzilolonga.

 

Ukuphumelela kokusetyenziswa kweyeza kwi-LBP yokuzivocavoca ngokungekho nonyango. Uhlalutyo oluhlanganisiwe aluphumelelanga ukubonisa ulwahlulo lwentlungu yesikhashana phakathi kokusetyenziswa kweyeza kwaye akukho nonyango, enefuthe le -0.59 points / 100 (95% CI -12.69 ku-11.51).

 

Ukuzivocavoca ngokubhekiselele kwezinye iindlela zokungenelela. Kwizilingo ze-11 ezibandakanya abantu abadala be-1,192 nge-LBP enzima, i-10 yayingafanisi nokuziqhelanisa. Ezi zilingo zinika ubungqina obuphikisanayo. Uhlalutyo oluhlanganisiweyo lubonise ukuba akukho mmahluko ekulandeleni kokuqala ekuphumuleni kwentlungu xa kuthelekiswa nezinye izigulane ezilondolozayo: Iiposenti ze-0.31 (95% CI -0.10 kwi-0.72). Ngokufanayo, akukho miphumo ebalulekileyo yokuzivocavoca kwiziphumo zokusebenza. Iziphumo zibonisa iintlobo ezifanayo kwixesha elifutshane-, eliphakathi, kunye nexesha elide lokulandelelana.

 

Ukuphumelela kokusetyenziswa kweyeza ukunyanzelisa i-LBP Ukuzivocavoca ngokubhekisele kwezinye iindlela zokungenelela. Izifundo ezithandathu ezibandakanya izifundo ze-881 zazingabonakali. Izilingo ezimbini zifumene ubungqina obulinganisiweyo bokunciphisa umsebenzi wokungabikho komsebenzi kunye nomsebenzi oqhelanisiweyo onxamnye nokunyamekela. Ubungqina obuphikisanayo malunga nokusebenza kwamanye amayeza athile ngokubhekiselele kwi-LBP xa kuthelekiswa namanye amachiza.

 

Ukusebenza kokunyanga kwamayeza okungaxhamli kwe-LBP Ukuzivocavoca ngokubhekisele kwezinye iindlela zokungenelela. Amaqela angamashumi amathathu anesithathu ekusebenzisweni kwezilingo ze-25 kwi-LBP engapheli ayenomsebenzi wokuthelekiswa. Ezi zilingo zinika ubungqina obuqinileyo bokusebenzisa utyando ubuncinane njengezinye iindlela zokungenelela ezikhuselekileyo ze-LBP ezingapheliyo. Amacandelo amabini asebenzisayo kwizifundo eziphakamileyo eziphezulu kunye namaqela asithoba kwizifundo eziphantsi kweenkonzo ezifumeneyo zifumene ukusebenza ngokugqithiseleyo kunokugqithisa unyango. Ezi zifundo, ngokubanzi ziqhutyelwe kwizicwangciso zezononophelo zempilo, iinkqubo eziqhelekileyo ezisetyenziswayo ezenziwe ngabanye kwaye zithunyelwa (ngokuchasene nokuzimela kwekhaya ezizimeleyo). Iiprogram zokusetyenziswa ziquka ukuqinisa okanye ukuzithobela umzimba. Ukunyamekela kokunyamekela ngokunyusa ukusetyenziswa kwonyango bekuye kubandakanywa kule ndlela yokungenelela ngempumelelo, kubandakanywa unyango lokuziphatha kunye nolwazi olusesikweni, iingcebiso zokuhlala zikhuthele kunye nemfundo. Uvavanyo oluthile lomgangatho oluluncedo olufunyenwe iqela-olunikezwa i-aerobics kunye nokuqinisa inkqubo yokuzilolonga lwaphumela ekuphuculeni ubuncinane kwiintlungu kunye neziphumo zokusebenza kunonyango lokuziphatha. Kwimizamo eseleyo, i-14 (2 esemgangathweni kunye ne-12 quality quality) ayifumananga nantlukwano ebonakalayo okanye ekliniki phakathi kokunyanga kwezilwanyana kunye nezinye izibonelelo zonyango; I-4 yalezi zilingo zazingenakukwazi ukufumana ukungafani kliniki okungenani kwisiphumo esisodwa. Iimvavanyo zabalinganiswe kumgangatho ophantsi ngokuqhelekileyo ngenxa yokuba umhloli ongenakulinganiswa.

 

Uhlalutyo lweemeta zeziphumo zentlungu ekulandeleleni kokuqala zibandakanya amaqela e-23 ekusebenziseni ngokuthelekiswa okuzimeleyo kunye nolwazi olufanelekileyo. Isisiphumo siphumelele kwisilinganisi esilinganisiweyo sithetha ukuphuculwa kweengongoma ze-10.2 (95% CI 1.31-19.09) yokusebenzisa unyango xa kuthelekiswa nalukho unyango, kunye neengcambu ze-5.93 (95% CI 2.21-9.65) xa kuthelekiswa nezinye iindlela zokongela [vs. konke kuqhathaniswa neengxelo ze-7.29 (95% CI 3.67-0.91)]. Ukuphuculwa okuncinci kuboniswe kwiziphumo ezisebenzayo kunye nefuthe elibonakalayo elibonakalayo leempembelelo ze-3.15 (95% CI -0.29 ku-6.60) xa kuthelekiswa nalukho unyango, kunye neenombolo ze-2.37 (95% CI 0.74-4.0) ngokubhekiselele kwonyango olulondolozo olulandelayo kwi- phezulu [vs. konke kuqhathaniswa neengxelo ze-2.53 (95% CI 1.08-3.97)].

 

Imiphumo emibi Uninzi lwezilingo aluzange zibize naziphi na iziphumo zecala. Iingxelo ezimbini zivakalisa iziganeko zengqondo ezithathwa njengezingabangelwa yonyango.

 

Lumbar Supports

 

I-Lumbar inkxaso ihlinzekwa njengonyango kubantu abajongene ne-LBP ngenjongo yokwenza ukukhubazeka nokukhubazeka kuphephe okanye kuyancipha. Imisebenzi efunwayo eyahlukeneyo iye yaphakanyiswa ukuba i-lumbar ifake inkxaso: (1) ukulungisa ukubola, (2) ukukhawulela ukunyuka kwemfudu, (3) ukuzinzisa inxalenye yomgudu, (4) ukunciphisa ukulayishwa komatshini, kunye (5) nemiphumo eyahlukeneyo: ukusila, ukushisa, indawo ye-placebo. Nangona kunjalo, ngeli xesha iindlela zokwenza izinto zenkxaso ye-lumbar zihlala ziyimpikiswano.

 

Ukusebenza kwe-lumbar isekela i-LBP enzima Akukho zilingo zachongwa.

 

Ukusebenza kwe-lumbar isekela i-LBP engapheliyo Akukho RCT efanisa i-lumbar isekela ne-placebo, akukho unyango okanye ezinye iindlela zokwelapha ze-LBP ezingapheliyo.

 

Ukusebenza kwe-lumbar isekela abantu abaxubekileyo be-LBP Izifundo ezine ziquka udibaniso lwezigulane ezine-acute, subacute, ne-LBP ezingapheliyo. Isifundo esinye asizange sinike naluphi na ulwazi malunga nobude bezikhalazo ze-LBP zezigulane. Kukho ubungqina obunokulinganisela ukuba inkxaso ye-lumbar ayinakusebenza ngakumbi ekunciphiseni intlungu kunezinye iintlobo zonyango. Ubu bungqina malunga nokuphuculwa ngokubanzi kunye nokubuyela emsebenzini kwakuphikisana.

 

Imiphumo emibi Ukusetyenziswa kweziphumo ezinobungozi ezinxulumene nokusetyenziswa kwexesha elide lenkxaso kubandakanya ukunciphisa amandla esiqubuthe, isicatshulwa sobuqhetseba, ukuthukuthela, ukukhathazeka kwesikhumba, izilonda zesikhumba, ukuphazamiseka kwesisu kunye nokuchithwa kwemisipha, uxinzelelo lwegazi oluphezulu kunye nemilinganiselo ephezulu yeentliziyo kunye nokuphazamiseka ngokubanzi.

 

IiNkqubo zoLonyango lweMatridisciplinary

 

Unyango oluthile lwezonyango ngenxa yeentlungu zangemva zivela kwiiklinikhi zentlungu. Ekuqaleni, unyango oluninzi lwazo lujoliswe kumzekelo wemveli wendalo kunye nokunciphisa intlungu. Iindlela ezikhoyo zamanqanaba ahlukeneyo ezibuhlungu obungapheliyo zisekelwe kwimodeli ye-biopsychosical imodeli yokubambisana nomzimba, ngokwengqondo, nakwentlalo / kwimiba yokusebenza. Umxholo weenkqubo ezininzi ezihlukeneyo zihluka ngokubanzi kwaye, okwangoku, akucaci ukuba yintoni umxholo ophezulu kwaye ngubani na onokubandakanyeka.

 

Ukuphumelela kweyonyango ehlukeneyo yokuhlukumeza i-LBP Akukho zilingo ezichongiweyo.

 

Ukuphumelela kweyonyango ehlukeneyo yokunyanzelisa i-LBP unyango oluninzi ngokubhekiselele kunyango oluqhelekileyo. Ii-RCT ezimbini ezibhekiselele kwi-LBP zifakiwe. Ubuninzi bokufunda kwizifundo zombini zenziwa ngabasebenzi kwikhefu lokugula. Kwisifundo esinye izigulane kwiqela lokungenelela libuyela emsebenzini ngokukhawuleza (iiveki ze-10) zifaniswe neqela lolawulo (iiveki ze-15) (P = 0.03). Iqela lokungenelela nalo likhefu lokugula elincinci ngexesha lokulandelwa kunokuba iqela lokulawula (ulwahlulo lentsingiselo = -IXXXX days, 7.5% CI -95 kwi15.06). Kwakungekho nomehluko olwahlukileyo kwiintlungu phakathi kokungenelela kunye neqela lokulawula, kodwa ukukhubazeka ngokuzimeleyo kwaye kwahla kakhulu kuncinci kwiqela lokungenelela kuneqela elilawulayo (uguquko lentsingiselo = -0.06, 1.2% CI -95 kwi-1.984). Kwesinye isifundo, ubude bemihla yokungabikho emsebenzini oqhelekileyo yimihla ye-0.416 yeqela kunye nentsebenziswano yokungenelela emsebenzini kunye nekliniki, iintsuku ze-60 kunye neqela lokungenelela emsebenzini, iintsuku ze-67 kunye neqela le-intervention intervention, kunye neentsuku ze-131 eziqhelekileyo iqela lokunyamekela (P = 120.5). Ukubuyela emsebenzini kwakukho amaxesha e-0.04 ngokukhawuleza kwiqela kunye kunye nokungenelela kwimizimba kunye nekliniki (2.4% CI 95-1.19) kuneqela elikhathaleleyo lexhala, kunye namaxesha e-4.89 ngokukhawuleza kumaqela amabini anempembelelo yokusebenza kunamacandelo amabini angenazo ukungenelela emsebenzini ( 1.91% CI 95-1.18). Kukho ubungqina obunokulinganisela ukuba unyango oluninzi lwezohambo kunye nohambo lwendawo yokusebenza kunye nokunyanzeliswa kwezempilo ngoncedo olubanzi lusebenza ngokumalunga nokubuyela emsebenzini, ikhefu lokugula kunye nokukhubazeka ngokuzimela kwezigulane ezingenakuxhaswa kwe-LBP.

 

Ukuphumelela kwonyango lwamanyathelo ahlukeneyo lwe-LBP ezingapheliyo unyango oluninzi ngokubhekisele kwezinye iindlela zokungenelela. I-RCT ezilishumi kunye nezifundo ze-1,964 zifakiwe kwi-Cochrane. Amaphepha amathathu athile anikwe ingxelo malunga neziphumo zexesha elide ezimbini kwezi zilingo. Zonke izilingo ezilishumi azibandakanyi izigulane ezine-radiculopathy enkulu okanye enye inkalo yokuhlinzwa. Kukho ubungqina obuqinileyo bokuthi unyango olunzulu lweenkqubo ezahlukeneyo kunye nendlela yokubuyisela ukusebenza kuphucula umsebenzi xa kuthelekiswa nesifo sengqondo okanye isifo sengqondo esingekho ematyaleni amaninzi. Kukho ubungqina obunokulinganisela ukuba unyango olunzulu lweenkqubo ezahlukeneyo kunye nendlela yokubuyisela ukusebenza kuyanciphisa intlungu xa kuthelekiswa nomntu ongeyena-multi-disciplinary rehabilitation okanye ukunakekelwa okuqhelekileyo. Kukho ubungqina obuphikisanayo malunga neziphumo zomsebenzi. Izilingo ezintlanu zokuvavanya iinkqubo ezinonophelo zonyango ezininzi ezingenakukwazi ukubonisa iziphumo ezincedisayo kwiintlungu, umsebenzi, okanye iziphumo zengqesho xa kuthelekiswa nokunyanga okungekho emininzi yezigulane okanye unyango oluqhelekileyo. Enye i-RCT eyongezelelweyo yaboniswa ukuba ayibonisi umahluko phakathi kwonyango oluninzi kunye nolondolozo oluqhelekileyo kumgangatho kunye nempilo enxulumene nempilo emva kweenyanga ze-2 kunye ne-6.

 

Izifundo ezihlaziyiweyo zibonelela ubungqina bokuba (> 100 h yonyango) i-MBPSR enendlela yokubuyisela esebenzayo ivelisa ukuphucuka okukhulu kwintlungu kunye nokusebenza kwezigulana ezikhubaza i-LBP engapheliyo kunokubuyiselwa kwimeko yesiqhelo okanye ukunakekelwa okuqhelekileyo. Unyango oluncinci alukhange lubonakale lusebenza.

 

Imiphumo emibi Akukho miphumo emibi echazwe.

 

Ukunyanyiswa koMgcini

 

Ukuguqulwa komgudu kuchazwa njengendlela yokwenza unyango olusisigxina olubandakanya ukuhamba kwexesha elidlulileyo lokuhamba kwexesha eliqhelekileyo lokuhamba, kodwa akudluli uluhlu lwayo lwe-anatomic. Ukunyanzeliswa komgudu kubhekwa kuthathwa njengento yexesha elide, ukunyuka okuphantsi, uhlobo oluthile lwezonyango ngokuchasene ne-short lever, high speed, ulungiso oluthile. Iingcamango ezinokwenzeka malunga nendlela yokusebenza yokusetyenziswa kwemigudu yilezi zilandelayo: (1) ukukhululwa kweengxowa ze-synovial ezibanjwe, (2) ukuphumla kwe-hypertonic muscle, (3) ukuphazamiseka kokubambelela kwe-articular okanye ngezikhathi ezithile, (4) ukuxubusha kwamagqabantshintshi athambileyo (5) yokunciphisa i-disc bulge, (6) ukulungiswa kwakhona kwezakhiwo ezisemgangathweni kwi-articular surface, (7) ukuvuselela ukucwangciswa kwee-fibers joint, (8) kwinguqu ye-neurophysiological, kunye ne-9 yokunciphisa i-muscle spasm.

 

Ukuphumelela kokunyanzeliswa kwemisipha yomnxeba we-LBP ngokugqithisileyo ngokugqithisileyo. Izilingo ezimbini zachongwa. Izigulane ezithola unyango olubandakanya ukunyanzeliswa kwempompo zazibaluleka kwaye zibaluleka ezibalulekileyo kwixesha elifutshane kwintlungu (ukuhluka kwe-10-mm; i-95% CI 2-17 mm) ngokuthelekiswa nonyango lwe-sham. Nangona kunjalo, ukuphuculwa komsebenzi kwakucatshulwa njengekliniki efanelekileyo kodwa kungabalulekanga (ukuhluka kwe-2.8-mm kumlinganiselo we-Roland Morris; 95% CI -0.1 ku-5.6).

 

Ukuguqulwa kwamagqabi kunye nezinye iindlela zokwelapha. Izilingo ezilishumi elinesibini zachongwa. Ukugqithiswa kwemisipha kwabangela ukukhululeka kweentlungu zentlungu efutshane-ncinane xa kuthelekiswa nezinye iindlela zokwelapha ezigwetywayo ukuba zingasebenzi okanye mhlawumbi ziyingozi (ukuhluka kwe4-mm; 95% CI 1-8 mm). Nangona kunjalo, ukubaluleka kweklinikhi kwesi sifundo kuyambuza. Uqikelelo lwamanqaku okuphuculwa komsebenzi wexesha elifutshane lokwenyango ngokunyanzeliswa kwemisipha xa kuthelekiswa neendlela ezingasebenziyo kubonwa njengeklinikhi ebalulekileyo kodwa kwakungenanto ebalulekileyo (u-2.1-point difference on the scale of Roland Morris; 95% CI -0.2 ku-4.4). Kwakungekho nantlukwano ekusebenzeni phakathi kwezigulane eziphathwe ngokunyanzeliswa kwemigudu kunye nalabo baphathwe naluphi na uhlobo lwezonyango ezithandwayo.

 

Ukuphumelela kokunyanzeliswa kwemisipha yokugula okungapheliyo kwe-LBP yokuguqulwa kwamanzi ngokugqithiseleyo. Izilingo ezintathu zachongwa. Ukunyanzeliswa kwamagqabi kwakubaluleke kakhulu xa kuqhathaniswa nokuchithwa kwe-sham inxephezelo yexesha elifutshane (10 mm; 95% CI 3-17 mm) kunye noxinzelelo lwexesha elide (19 mm; 95% CI 3-35 mm). Ukunyanzeliswa kwamagqabi kwakubaluleke kakhulu ekusebenziseni ukuphuculwa kwexesha elifutshane lomsebenzi (amanqaku e-3.3 kwi-Questionnaire ye-Roland no-Morris yokukhubazeka (RMDQ); 95% CI 0.6-6.0).

 

Ukuguqulwa kwamagqabi kunye nezinye iindlela zokwelapha. Izilingo ezisibhozo zachongwa. Ukunyanga kwamagqabi kwakubaluleke kakhulu xa kuqhathaniswa neqela lezonyango ezithathwa njengezingasebenzi okanye mhlawumbi ezinobungozi ekuncediseni intlungu yesikhashana (4 mm; 95% CI 0-8), kunye nokuphuculwa kwexesha elifutshane kumsebenzi (ama2.6 amanqaku RMDQ; 95% CI 0.5-4.8). Kwakungekho nantlukwano kwixesha elifutshane kunye nexesha elide xa kuthelekiswa namanye amachiza athatyathwa ngokuqhelekileyo njengokwenziwa kwenkathalo yokuqhelekileyo, ukunyanga okanye ukunyanga, nokubuya esikolweni.

 

Imiphumo emibi Kwii-RCT ezichazwe ngokuphononongwa okusetyenziswe umgqirha oqeqeshiwe ukukhetha abantu kunye nokwenza ukunyanzeliswa kwempompo, umngcipheko weengxaki ezinzulu ziphantsi. Uqikelelo lomngcipheko wokugulisa umlenze obangela ukuba idiski okanye i-cauda syndrome ekhatywayo ekliniki emzimbeni kwisigulana esinikezela nge-lumbar disk herniation ibalwa ukusuka kwidatha epapashwe ukuba ibe ngaphantsi kwe-1 kwi-3.7 yezigidi.

 

Utyando

 

I-Lumbar traction isebenzisa i-harness (kunye ne-velcro strapping) ebeka ngapha kwinqanaba lembambo elisezantsi kwaye lijikeleze i-aliacal crest. Ixesha kunye nezinga lequmrhu eliqhutywe ngayo le harni linokuhluka kwimodi eqhubekayo okanye ephakathi. Kuphela kwindlela yokuphumla ngeenjini kunye nokulala kwebhedlele inamandla angalinganiswa. Ngamanye amaqhinga okubala umzimba wonke kwaye amandla omgulane okanye ugqirha ugqithise umkhosi. Ekusebenziseni amandla okubamba, kufuneka kuqwalaselwe ukunyanzelisa ukuxhatshazwa kwemisipha yomzimba, isalathisi sesikhumba esiswini kunye nokunyanzeliswa kwesisu, okuxhomekeke kwisiseko somzimba. Ukuba isigulane silele etafileni yokulandelelana, ukuxubana komzimba etafileni kunika amandla okubambisa ngexesha lokuhamba. Indlela echanekileyo apho ukulandelelana kunokusebenza kakuhle akucaci. Kuye kucetyiswa ukuba i-spinal elongation, ngokusebenzisa i-lordosis yokunciphisa nokunyuka kwe-interverterbral space, inqanda ukuphazamiseka kwe-nociceptive, kuphucula ukuhamba, kunciphisa uxinzelelo lomxinaniso, kuncitshiswe i-muscle spasm okanye i-spinal nerve compress compression (ngenxa ye-osteophytes), ikhupha i-disc okanye i-capsule udibaniso lwe-zygo-apophysial, kwaye ukhupha umxhasi we-zygo-apophysial kunye ne-annulus fibrosus. Kuze kube ngoku, iindlela ezicetywayo azixhaswanga ngolwazi olwaneleyo lwezobugcisa.

 

Ilishumi elinesithathu kwizifundo ezichazwe kwi-Cochrane ukuhlaziywa zazibandakanya inani labantu abafana nezilwanyana ze-LBP ezineempawu eziphazamisayo. Izifundo ezisele ziquka umxube wezigulane ezingenazo zikarhulumente. Kwakungekho zifundo ezibandakanya kuphela izigulane ezingenazo iimpawu zokukhanya.

 

Izifundo ezintlanu zibandakanya kuphela okanye ngokukodwa izigulane ezine-LBP ezingapheliyo kweeveki ze-12; kwisigulane esisodwa sogqirha sasisonke kwisigaba sokuxhatshazwa (iiveki ze-4-12). Kwizifundo ze-11 ubude be-LBP yinto engumxube we-acute, subacute, kwaye engapheliyo. Kwimizuzu emine yezifundo azizange zichazwe.

 

Ukusebenza kwetraction kwi-LBP enzima Akukho zi-RCT eziquka ngokubanzi abantu abane-LBP enzima. Kufunyenwe olunye uphando olubandakanya izigulane ezithintela i-LBP, kodwa eli nani lenziwe ngumxube wezigulane ezingenawo umbane.

 

Ukusebenza kwe-traction ye-LBP engapheliyo Olunye uvavanyo lwafumanisa ukuba ukulandelelana okuqhubekayo akusebenzi kakuhle kwiintlungu, umsebenzi, ukuphuculwa ngokubanzi, okanye ukungabikho emsebenzini ngaphandle kwe-placebo. Enye i-RCT (abantu be-42) ayifumananga nantlukwano ekusebenzeni phakathi kwonyango lomzimba oluqhelekileyo kuquka ukulandelelana okuqhubekayo kunye nenkqubo efanayo ngaphandle kokuhamba. Enye i-RCT (i-152 yabantu) ayifumananga umehluko omkhulu phakathi kwe-lumbar traction kunye ne-massage kunye nokuphazamiseka kwindlela yokuphucula ubuhlungu, okanye ukuphucula ukukhubazeka kweeveki ze-3 kunye neenyanga ze-4 emva kokuphela kokonyango. Le RCT ayibandakanyi abantu abane-sciatica, kodwa akukho nkcukacha ezongezelelweyo malunga nenani labantu abane-sciatica zabikwa. Elinye i-RCT (abantu be-44) bafumene ukuba ukuzenzekela ngeyona ndlela kusebenza ngakumbi kunokuba kuqhutywe umatshini wokuphucula umhlaba, kodwa kungekhona kwintlungu kunye nomsebenzi, kwizigulane ezingapheliyo ze-LBP okanye ngaphandle kokuphazamisa iimpawu. Nangona kunjalo, eli lingo luneengxaki ezininzi zeendlela ezidibaniswa neziphumo ezikhethiweyo.

 

Imiphumo emibi Akukho nto eyaziwayo malunga nemiphumo emibi yokuthwala. Kukho iingxelo ezimbalwa zeemeko ezikhoyo, ezibonisa ukuba kukho ingozi yokunyanzelwa kweentambo kwi-traction enzima, oko kukuthi i-lumbar-traction forces enqabile i-50% yobungakanani bomzimba. Ezinye izingozi ezichazwe kwi-lumbar traction ziyimithintelo yokuphefumula ngenxa yokuhamba kwintsimbi okanye ukunyuka kwengcinezelo yegazi ngexesha lokutshatyalaliswa kwemiqathango. Eminye imiphumo emibi yokuthintela ibandakanya ukuxhatshazwa, ukulahlekelwa kwetoni ye-muscle, i-demineralization yeethambo kunye ne-thrombophlebitis.

 

I-Transcutaneous Electrical Nerve Stimulation

 

Ukukhushulwa kwamagciwane okuhamba nge-Transcutaneous (TENS) yindlela yokwelapha engeyona intshabayo eyenziwa ngokukhululeka kwintlungu ngenxa yombane ovuselela iimbilini ze-electrodes. Iintlobo ezininzi zezicelo ze-TENS, ezahlukileyo kwiimpawu zogesi, zisetyenziselwa ukwenziwa kweeklinikhi: (1) ukuvama kwexesha elide, (2) i-frequency frequency, (3) i-frequency frequency, kunye ne-4).

 

Ukusebenza kwe-TENS ye-LBP enzima: Akukho zilingo zachongwa.

 

Ukusebenza kwe-TENS ye-LBP engapheliyo Ukuhlaziywa kweCochrane kufaka ii-RCT ezimbini ze-TENS ze-LBP ezingapheliyo. Iziphumo zesilingo esincinci esisodwa (N = 30) sibonisa ukwehla okukhulu kwiintlungu eziphantsi kokunyanga kunye ne-TENS unyango oluqhathaniswa ne-placebo phezu kwekhosi ye-60 yonyango. Ukunciphisa intlungu ebonwe ekupheleni kokuvuselela kwagcinwa kuyo yonke i-60-min yangethuba lexesha lokuvavanywa lixesha (i-data engaboniswa). Ukulandelelana kwexesha elide akuzange kwenziwe kulesi sifundo. Isilingo sesibini (N = 145) asibonisi umehluko omkhulu phakathi kwe-TENS esebenzayo kunye ne-placebo yiphina yeziphumo ezilinganisweyo, kuquka intlungu, isimo sokusebenza, uluhlu lokunyakaza, kunye nokusetyenziswa kweenkonzo zonyango.

 

Imiphumo emibi Kwisithathu sabathathi-nxaxheba kuvavanyo olunye, isikhumba esincinci senzekile kwindawo yokubekwa kwe-electrode. Ezi ziphumo zibi zajongwa ngokulinganayo kwii-TENS ezisebenzayo kunye namaqela e-placebo. Umthathi-nxaxheba omnye ohleliweyo kwi-placebo TENS uphuhlise kakhulu i-dermatitis kwiintsuku ezi-4 emva kokuqala unyango kwaye kwafuneka ukuba arhoxe (Iitafile 1,? 2).

 

Itheyibhile ye-1 Impumelelo yoNgeniso loLungelelaniso lweNgcaciso eNgqalileyo eyiyo
Ithebula 1: Ukusebenza kwamanyathelo angenelo olusisigxina kwiintlungu ezingezantsi ezingekho ngqo.

 

Uluhlu lwe-2 Impumelelo yoNgeniso loLungelelaniso lweNtsholongwane engapheliyo
Ithebula 2: Ukuphumelela kwamanyathelo angenelo olusisigxina kwiintlungu ezingapheliyo zentlungu.

 

ingxoxo

 

Ubungqina obuninzi bokufumana unyango olungapheliyo kwi-LBP engeyiyo ichanekileyo kule nkcazo lubonisa ukuba ukungenelela kwamanye okusebenzayo kuyasebenza. I-NSAID zendabuko, i-relaxation ye-muscle, kunye neengcebiso zokuhlala zisebenzayo zisebenza ngokukhawuleza kweentlungu zesikhashana kwi-LBP. Iseluleko sokuhlala sisisebenzayo siphumelele ekuphuculeni kwexesha elide lomsebenzi kwi-LBP enzima. Kwi-LBP engapheliyo, ukungenelela ngeendlela ezahlukeneyo kusebenza ngokukhawuleza kweentlungu zentlungu, oko kukuthi, ukuxhatshazwa, i-COX2 inhibitors, izikolo zokubuya, ukuphumula okuqhubekayo, unyango ophendulayo, ukunyanga, kunye nokunyanga okuninzi. Amanyango athile asebenzayo ekuphuculeni kwexesha elifutshane lomsebenzi kwi-LBP engapheliyo, okuyi-COX2 inhibitors, izikolo zokubuya, ukuphumula okuqhubekayo, unyango lovavanyo, kunye nokunyangwa kwamanyathelo amaninzi. Akukho ubungqina bokuba nawaphi na amanyathelo angenelelo anika imiphumo yesikhathi eside kwiintlungu kunye nomsebenzi. Kwakhona, ezininzi izilingo zabonisa ubuthakathaka beendlela, imiphumo iyafaniswa ne-placebo, akukho nonyango okanye ulawulo lwemihla yokulinda, kwaye ubunzima bomsebenzi buncinane. Izilingo zexesha elizayo zifanele zihlangabezane nemigangatho yangoku esemgangathweni kwaye ibe nesayizi efanelekileyo yesampuli Nangona kunjalo, ngesishwankathelo, kukho ubungqina bokuba ezinye iindlela zokungenelela ziyasebenza xa ubungqina bokuba amanye amancedo angenelo okanye kukho ubungqina bokuba abaphumelelanga.

 

Kwiminyaka elishumi edlulileyo, izikhokelo ezahlukeneyo zekliniki ekulawuleni i-LBP enzima kwiinkathalo eziphambili ziye zashicilelwa eziye zasebenzisa lo bungqina. Okwangoku, izikhokelo zikhoyo kwii-12 kumazwe ahlukeneyo: i-Australia, iDenmark, i-Finland, iJamani, i-Israel, iNetherlands, iNew Zealand, iNorway, iSweden, iSwitzerland, i-United Kingdom kunye ne-United States. Ekubeni ubungqina obukhoyo buvela kumazwe ngamazwe, umntu unokulindela ukuba izikhokelo zelizwe ngalinye ziza kunika iingcebiso ezifanayo okanye ezincinci malunga nokuxilongwa nokunyangwa. Ukuthelekiswa kwezikhokelo zeklinikhi zokulawulwa kwe-LBP kwinkathalo eyintloko kwii-11 kumazwe ahlukeneyo kubonise ukuba umxholo wezikhokelo malunga nokungenelela kwindlela yokwelapha kuyafana. Nangona kunjalo, kwakukho ukungahambisani kweziphakamiso kwizikhokelo. Ukwahlukahlukana kweziphakamiso phakathi kwezikhokelo kungenziwa ngenxa yokungaphelelanga kobungqina, amanqanaba ahlukeneyo obungqina, ubuninzi beempembelelo, iziphumo ezibi kunye neendleko, ulwahlulo kwiinkqubo zononophelo lwempilo (intlangano / mali), okanye ukungafani kobulungu lwezikhokelo zeekomiti. Izikhokelo zakutshanje zingabandakanywa izilingo ezishicilelwe kutshanje kwaye, ngoko ke, zingagqiba ngeengcebiso ezichaseneyo. Kwakhona, izikhokelo zingaba zisekelwe kwiingxelo ezichanekileyo ezibandakanya iimvavanyo kwiilwimi ezahlukeneyo; Uninzi lweengxelo ezikhoyo ziqwalasele kuphela izifundo ezipapashwe ngeelwimi ezimbalwa, kwaye ezininzi, kuphela ezo zipapashwa ngesiNgesi. Iingcebiso kwizikhokelo azisekelwe kuphela kubungqina bobunzululwazi, kodwa nakwi-consensus. Iikhomishana ezikhokelo ziyakucinga ngeengxabano ezahlukileyo, ezifana nobukhulu bemiphumo, iimiphumo ezichaphazelekayo, ukusetyenziswa kweendleko, kunye nokusetyenziswa kwezixhobo ezikhoyo kwilizwe labo. Ngokukodwa njengoko siyazi ukuba iimpembelelo kwintsimi ye-LBP, ukuba zikhona, zihlala ziyingcipheko kunye nexesha elifutshane kuphela, ukuchazwa kweziphumo kuyahluka phakathi kweekomiti ezikhokelo. Kwakhona, iikomiti ezikhokelo ziyakucinganisa ngezinye iinkalo ezinjengeempembelelo kunye neendleko. Umgaqo-siseko weekomiti zekhokelo kunye namaziko oqeqesho abawamelayo angabonakalisa i-bias-mhlawumbi okanye malunga nonyango oluthile. Oku akusithethi ukuba esinye isikhokelo sihle kunomnye okanye ukuba enye ilungile kwaye enye ingalunganga. Ibonisa nje ukuba xa ukuguqulwa kobubungqina kwiinkcazo ezichaphazelekayo kwiikliniki ezininzi zidlala indima, kwaye ukuba le micimbi iyahlukahluka kwindawo okanye kwilizwe.

 

Izikhokelo zaseYurophu eziphambili zokulawulwa kwe-LBP zaphuhliswa ukwenzela ukwandisa ukuhambelana nokulawulwa kwe-LBP engekho kwiiYurophu. IKhomishini yaseYurophu iye yamkela kwaye ixhaswa ngemali kule projekthi ebizwa ngokuthi 'I-COST B13'. Iinjongo eziphambili zale nkqubo yeCOST zakha izikhokelo zaseYurophu zokukhusela, ukuxilongwa kunye nokunyangwa kwe-LBP engekho-mali, ukuqinisekisa ubungqina obusekelwe kububungqina ngokusebenzisa iindlela zokuphononongwa ngokuchanekileyo kunye nezikhokelo zenkxaso-kliniki ezikhoyo, ukwenzela indlela yokwenza izinto ezahlukeneyo kunye nokukhuthaza intsebenziswano phakathi ababoneleli ngononophelo lwempilo kunye nokukhuthaza ukuhambelana kwabo bonke ababoneleli kunye namazwe aseYurophu. Abameli abavela kumazwe e-13 bathathe inxaxheba kule projekthi eqhutywe phakathi kwe-1999 ne-2004. Iingcali zimelele zonke izakhono zempilo ezichaphazelekayo kwintsimi ye-LBP: i-anatomy, i-anaesthesiology, i-chiropractic, i-epidemiology, i-ergonomy, i-practice jikelele, ukunakekelwa kwezemisebenzi, ukunyangwa kwamathambo, ukugula, i-physiology, i-physiotherapy, i-psychology, ukunakekelwa kwezempilo karhulumente, ukulungiswa kwempilo kunye ne-rheumatology. Kule projekthi ye-COST B13 izikhokelo ezine ze-Yurophu zaphuhliswa kwi: (1) i-LBP, (2) engapheliyo ye-LBP, (3) yokukhusela i-LBP, kunye ne-4) intlungu yebhande ye-pelvic. Izikhokelo ziza kushicilelwa ngokukhawuleza njengezongezelelo kwi-European Spine Journal.

 

I ngcaciso

 

UMaurits W. van Tulder, uBart Koes, uAntti Malmivaara: Ncbi.nlm.nih.gov

 

Ukuququmbela, Ubungqina beklinikhi kunye novavanyo olungentla lweendlela ezingezizo zokunyanga kwiintlungu zangasemva zibonise ukuba uninzi lonyango lukhuselekile kwaye lusebenza kakuhle. Ngelixa iziphumo zeendlela ezahlukeneyo ezisetyenziselwa ukuphucula iimpawu zeentlungu zangqineka zisebenza kakuhle, ezinye iindlela zonyango ezininzi zifuna ubungqina obongezelelekileyo kwaye ezinye zaxelwa ukuba azisebenzi ekuphuculeni iimpawu zentlungu. Eyona njongo iphambili yesifundo sophando yayikukufumanisa isikhokelo esikhuselekileyo nesisebenzayo sokuthintela, ukufumanisa isifo kunye nokunyanga iintlungu ezingakhange zibekho. Ulwazi olukhankanyiweyo kwiZiko leSizwe loLwazi lweBiotechnology (NCBI). Ubungakanani bolwazi lwethu bukhawulelwe kwi-chiropractic kunye nokulimala komqolo kunye neemeko. Ukuxoxa ngesihloko, nceda ukhululeke ukubuza uGqirha Jimenez okanye unxibelelane nathi apha 915-850-0900 .

 

Ikhutshwe nguDkt. Alex Jimenez

 

Green-Call-Now-Button-24H-150x150-2-3.png

 

Imixholo eyongezelelweyo: iSciatica

 

I-Sciatica ibhekiselwa kuyo njengeqoqo leempawu kunokuba luhlobo oluthile lokulima okanye imeko. Iimpawu zibonakaliswa njenge-radiating intlungu, ukuxubha kunye nokuvakala kwintsholongwane kwi-nerve ye-sciatic kumqolo ongaphantsi, phantsi kweentsimbi kunye namathanga kunye nemilenze enye okanye zombini kunye neenyawo. I-Sciatica idla ngokubangela ukucaphukisa, ukuvuvukala okanye ukunyanzeliswa kwesibindi esikhulu kunazo zonke emzimbeni womntu, ngokubanzi ngenxa disc disc okanye i bone.

 

umfanekiso webhlogi weendaba eziphambili zephepha lephepha

 

INGXELO EBALULEKILEYO: UKUPHATHA KWE-EXTRA: Ukunyanga i-Sciatica Pain

 

1. Alaranta H, Rytokoski U, Rissanen A, Talo S, Ronnemaa T, Puukka P, Karppi SL, Videman T, Kallio V, Slatis P. Inkqubo yokuqeqeshwa ngokwenyama kunye nengqondo yengqondo yezigulane ezinentlungu engapheliyo. Uvavanyo olulawulwayo. Isihlwele. 1994;19: 1340-1349. [PubMed]
2. U-Alcoff J, uJones E, uRust P, uNewman R. Uvavanyo olulawulwayo lwe-imipramine ngenxa yeentlungu ezingapheliyo. J Fam Pract. 1982;14: 841-846. [PubMed]
3. Alexandre NM, Moraes MA, Correa Filho HR, Jorge SA. Ukuphononongwa kweprogram yokunciphisa intlungu yangemva kwabahlengikazi. USal Salud Publica. 2001;35: 356-361. [PubMed]
4. UAmlie E, Weber H, Holme I. Ukwelashwa kweentlungu ezisezantsi eziphambene ne-piroxicam: iziphumo zolu vavanyo olulawulwa yi-placebo oluyimpumputhe. Isihlwele. 1987;12:473–476. doi: 10.1097/00007632-198706000-00010. [PubMed][Umnqamlezo]
5. Arbus L, Fajadet B, Aubert D, Morre M, Goldfinger E. Umsebenzi we-tetrazepam kwiintlungu ezisezantsi. Izilingo zikaJ 1990;27: 258-267.
6. Assendelft WJ, Morton SC, Yu EI, Suttorp MJ, uSkelle P. Spinal unyango olusisigxina kwiintlungu ezisezantsi. Uhlalutyo lwe-meta lokusebenza ngokumalunga namanye amachiza. Ann Intern Med. 2003;138: 871-881.[PubMed]
7. Atkinson JH, uSlater MA, Williams RA. Uvavanyo lwe-placebo olulawulwa ngolu hlobo lwezonyango lwe-nortriptyline lweentlungu ezingapheliyo. Ubuhlungu. 1998;76:287–296. doi: 10.1016/S0304-3959(98)00064-5. [PubMed][Umnqamlezo]
8. Atkinson JH, uSlater MA, Wahlgren DR. Iimpembelelo ze-noradrenergic kunye ne-serotonergic anti-depressants kwi-static back back pain. Ubuhlungu. 1999;83:137–145. doi: 10.1016/S0304-3959(99)00082-2. [PubMed][Umnqamlezo]
9. I-Babej-Dolle R, i-Freytag S, i-Eckmeyer J, i-Zerle G, i-Schinzel S, i-Schmeider G, i-Stankov G. i-Parenteral i-dipyrone kunye ne-diclofenac kunye ne-placebo kwizigulane ezinezilonda ezinzima okanye i-sciatic intlungu: i-observer-blind blind-study. Int J Clin Pharmacol Ther. 1994;32: 204-209. [PubMed]
10. UBabtista R, uBrizzi J, Dutra F, uJosef H, uKeisermann M, de Lucca R (1988) I-Terapeutica da lombalgia com a tizanidina (i-DS 103-282), i-novo agente mioespasmolitico. I-love love multicentrico, i-duplo-cego edibeneyo. Folha Medica
11. Barrata R. Ukufunda ngokuphindaphindiweyo kwe-cyclobenzaprine kunye ne-placebo ekhatyweni kweemeko ezinzima ze-muskuloskeletal zangaphantsi. I-Curr Ther Res. 1982;32: 646-652.
12. UBasler H, uJakle C, uKroner-Herwig B. Ukubandakanywa kwonyango lokuziphatha kwengqondo kwiinkonzo zezigulana ezingapheliyo emva kweengxaki eziqhelekileyo: uphando olulawulwe ngokulandelelana kwiziko laseJamani. Iingcebiso zoLuntu. 1997;31:113–124. doi: 10.1016/S0738-3991(97)00996-8. [PubMed] [Umnqamlezo]
13. I-Basmajian J. Cyclobenzaprine i-hydrochloride yempembelelo kwi-skeletal muscle spasm kwingingqi kunye nentamo. IArch Phys Med Rehabil. 1978;59: 58-63.[PubMed]
14. I-Basmajian JV. Intlungu ebuhlungu kunye ne-spasm: isilingo esilawulwayo semimandla ehlanganisiweyo ye-analgesic kunye ne-antispasm agents. Isihlwele. 1989;14:438–439. doi: 10.1097/00007632-198904000-00019. [PubMed][Umnqamlezo]
15. Bendix AF, iBendix T, Ostenfeld S, Bush E, Andersen A. Iinkqubo zonyango ezisebenzayo kwizigulane ezinentlungu engapheliyo: i-randomised-observer-blind-study study. J. Eur Spine 1995;4: 148-152. i-doi: 10.1007 / BF00298239. [PubMed] [Umnqamlezo]
16. I-Bendix AF, iBendix T, Vaegter KV, uLund C, uFrolund L, Holm L. unyango olunzulu lwezixhobo ezininzi zeentlungu ezingapheliyo: i-randomized, study prospective. Cleve kliniki J Med. 1996;63: 62-69. [PubMed]
17. I-Bendix AE, iBendix T, uLund C, Kirkbak S, Ostenfeld S. Ukuthelekiswa kwezinkqubo ezintathu ezinzulu zezigulana ezingapheliyo zezigulana ezisezantsi: umfundi ozayo, ongenamaphupha, ofundiswe ngumbono onyakeni owodwa. I-Scand J Rehabil Med. 1997;29: 81-89. [PubMed]
18. I-Bendix AE, iBendix T, i-Haestrup C, i-Busch E. Umfundi oza kulandelwa ngokulandelelana kwe-5-nyaka wokubuyiswa okusebenzayo kwizigulana ezingapheliyo ezibuhlungu. J. Eur Spine 1998a;7: 111-119. i-doi: 10.1007 / s005860050040. [PubMed] [Umnqamlezo]
19. I-Bendix AE, iBendix T, uLabriola M, iBoekgaard P. Ukubuyiselwa kwemisebenzi yeentlungu ezingapheliyo emva. Ukulandelelwa kweminyaka emibili yeemvavanyo ezimbini zonyango. Isihlwele. 1998b;23:717–725. doi: 10.1097/00007632-199803150-00013. [PubMed] [Umnqamlezo]
20. Bendix T, iBendix A, uLabriola M, Haestrup C, Ebbehoj N. Ukubuyiselwa kokusebenza ngokubhekiselele ekuqeqesheni okusemzimbeni ongaphantsi kwintlungu engapheliyo yokubuya: isifundo esilinganiselweyo. Isihlwele. 2000;25:2494–2500. doi: 10.1097/00007632-200010010-00012. [PubMed] [Umnqamlezo]
21. U-Bergquist-Ullman M, uLarsson U. Intlungu ebuhlungu emva kwintsimi. Acta Orthop Scand. 1977;170(I-Suppl.): 1-117. [PubMed]
22. U-Berry H, u-Hutchinson D. Uphononongo olulawulwa yi-placebo olulawulwa ngokubanzi oluqhelekileyo ukuhlola usebenze nokukhuseleko kwe-tizanidine kwiintlungu ezibuhlungu. J Int Med Res. 1988;16: 75-82. [PubMed]
23. U-Berry H, uBloom B, u-Hamilton EBD, i-Swinson DR. I-Naproxen i-sodium, i-diflunisal, ne-placebo xa unyango lwentlungu engapheliyo. Ann Rheum Dis. 1982;41: 129-132. i-doi: 10.1136 / ard.41.2.129.[Inkcazelo yamahhala ye-PMC] [PubMed] [Umnqamlezo]
24. Beurskens AJ, Vet HC, Köke AJ, Lindeman E, Regtop W, Heijden GJ, Knipschild PG. Ukusebenza kwendlela yokubandezeleka kweentlungu ezingezantsi ezizodwa: inzulul Lancet. 1995;346:1596–1600. doi: 10.1016/S0140-6736(95)91930-9. [PubMed] [Umnqamlezo]
25. Beurskens AJ, Vet HC, Köke AJ, Regtop W, Heijden GJ, Lindeman E, Knipschild PG. Ukusebenza koxinzelelo lweentlungu ezingaphantsi. I-12-iveki kunye neziphumo zeenyanga ze-6 zesilingo sekliniki esingenamsebenzi. Isihlwele. 1997;22:2756–2762. doi: 10.1097/00007632-199712010-00011. [PubMed] [Umnqamlezo]
26. Bianchi M. Ukuvavanywa kwe-cyclobenzaprine ye-muscle spusm yemvelaphi yangaphandle. Uvavanyo lwezonyango lwe-flexeril (i-cyclobenzaprine i-HCL / MSD) I-Minneapolis: I-Postgraduate Medicine Communications; 1978. iphe. 25-29.
27. I-Bigos S, i-Bowyer O, i-Braen G (i-1994) Iingxaki eziphantsi ezisezantsi kubantu abadala. Isikhokelo seKliniki yokuSebenza no14. AHCPR Ukupapashwa kweNombolo 95-0642. I-Arhente yoMgaqo-nkqubo woNonophelo lwezeMpilo kunye noPhando, iNkonzo yezeMpilo kaRhulumente, iSebe lezeMpilo lase-US kunye neeNkonzo zoLuntu, i-Rockville
28. Bihaug O. Autotraksjon ye-ischialgpasienter. Ukuqhafaza ngokukodwa kokusetyenziswa kwe-Auto-traksjon-B kunye ne-isomethrikhi yokuvelisa i-intanethi ye-Hume endall ne-Jenkins. Fysioterapeuten. 1978;45: 377-379.
29. UBerbara CA, uPuopolo AD, iMunoz DR. Unyango lweentlungu ezingapheliyo emva kwe-etoricoxib, i-cyclo-oxygenase entsha-i-2 i-inhibitor ekhethiweyo: ukuphuculwa kwentlungu nokukhubazeka: i-random, i-placebo elawulwa yi-3-ngenyanga. J Pain. 2003;4:307–315. doi: 10.1016/S1526-5900(03)00633-3. [PubMed][Umnqamlezo]
30. Blomberg S, Hallin G, Grann K, Berg E, Sennerby U. unyango lwe-Manual nge-injection ye-steroid-indlela entsha yokunyanga iintlungu eziphantsi. Uvavanyo olulandelwayo oluninzi olulinganisiweyo kunye nokuvavanywa ngabagqirha bamazinyo. Isihlwele. 1994;19:569–577. doi: 10.1097/00007632-199403000-00013. [PubMed] [Umnqamlezo]
31. Bombardier C, uLaine L, Reicin A, Shapiro D, Burger-Vargas R, Davis B, Usuku R, uFerraz MB, i-Hawkey CJ, i-Hochberg MC, iKvien TK, i-Schnitzer TJ, iQela lokuFunda i-VIGOR. Ukuthelekiswa kwesifo somzimba esiswini esiphambili se-rofecoxib kunye ne-naproxen kwizigulane ezine-arthritis ye-rheumatoid. VIGOR Group Study. N Engl J Med. 2000;343: 1520-1528. I-doi: 10.1056 / NEJM200011233432103. [PubMed] [Umnqamlezo]
32. Borman P, Keskin D, Bodur H. Ukusebenza kwe-lumbar traction ekulawuleni izigulane ezinentlungu ephantsi. Rheumatol Int. 2003;23: 82-86. [PubMed]
33. UBurter LM, uPennick V, iBombardier C, iBhodi yokuHlaziya yeCandelo eliPhindayo leCorgan Review Review Group. Isihlwele. 2003;28:1215–1218. doi: 10.1097/00007632-200306150-00002. [PubMed][Umnqamlezo]
34. UBraun H, uHuberty R. unyango lwe-lumbar sciatica. Ucwaningo olulinganisiweyo lwekliniki ye-monosubstance ye-corticoid-free and corticoid equkethe isilwanyana. Med Welt. 1982;33: 490-491. [PubMed]
35. Bronfort G, Goldsmith CH, uNelson CF, uBoline PD, Anderson AV. Umzimba weTrunk kunye ne-spinal manipulative okanye i-NSAID yonyango yeengxaki ezingapheliyo zentlungu: i-clinical trial-blinded-blinded-trial. J Uluhlu lwePhysiol Ther. 1996;19: 570-582. [PubMed]
36. Brown FL, Bodison S, Dixon J, Davis W, Nowoslawski J. Ukuthelekiswa kwe-diflunisal kunye ne-acetaminophen kunye nekhodi ye-codeine ekwenzeni unyango oluqala okanye oluphindaphindiweyo lwentlungu. Clin Ther. 1986;9(I-Suppl c): 52-58.[PubMed]
37. Bru E, Mykletun R, Berge W, Svebak S. Iimpembelelo zokungenelela ngeengqondo ezahlukeneyo entanyeni, emagxeni nasezintlukweni eziphantsi kwezilwanyana zabasebenzi basebhedlele. ZeMpilo yeNgqondo. 1994;9: 371-382. i-doi: 10.1080 / 08870449408407495. [Umnqamlezo]
38. I-Calmels P, i-Fayolle-Minon I. Ukuhlaziywa kwezixhobo ze-orthotic kwi-lumbar spine ngokusekelwe kokuhlaziywa kweencwadi. Rev Rhum. 1996;63: 285-291. [PubMed]
39. I-Casale R. Iintlungu zentlungu ephantsi: unyango olumqondiso olusisisigxina seziyobisi. Iiklinikhi J Pain. 1988;4: 81-88.
40. UCherkin DC, uDeyo RA, Battie M, iSitalato J, uBarlow W. Ukuthelekiswa kwonyango lomzimba, ukuphathwa kwamathambo, kunye nokubonelelwa kwencwadana yemfundo ekwenzeni izigulane ezinentlungu ephantsi. N Engl J Med. 1998;339: 1021-1029. I-doi: 10.1056 / NEJM199810083391502. [PubMed] [Umnqamlezo]
41. Chok B, Lee R, uLatimer J, Seang BT. Uqeqesho lokunyamezela izidumbu ze-trunk ezidlulayo kubantu abanobuhlungu obunzima beentlungu. Phys Ther. 1999;79: 1032-1042. [PubMed]
42. U-Clarke J, van Tulder M, Blomberg S, uBronfort G, van der Heijden G, de Vet HCW (2005) Ukubethelwa kweentlungu eziphantsi: ukuphononongwa okuhlelekile kwisakhelo soBambiswano beCchrane. Ku: I-Library yeCchrane, i-3. Update Software, i-Oxford
43. Iingubo zeTL, iBorenstein DG, Nangia NK, Brown MT. Iimpembelelo ze-valdecoxib kunyango lweentlungu ezingapheliyo zentlungu: iziphumo zolu vavanyo olulawulwe ngokungahleliwe, olulawulwa yi-placebo. Clin Ther. 2004;26:1249–1260. doi: 10.1016/S0149-2918(04)80081-X. [PubMed] [Umnqamlezo]
44. Coomes NE. Ukuthelekiswa phakathi kwe-epestural anesthesia kunye nokuphumla kombhede kwi-sciatica. Br Med J. 1961;Jan: 20-24. [Inkcazelo yamahhala ye-PMC] [PubMed]
45. Coxhead CE, i-Inskip H, i-Meade TW, i-North WRS, i-Troup JDG. Ulingo oluninzi lwe-physiotherapy ekulawuleni iimpawu zesifo. Lancet. 1981;1:1065–1068. doi: 10.1016/S0140-6736(81)92238-8.[PubMed] [Umnqamlezo]
46. I-Cramer GD, i-Humphreys CR, i-Hondras MA, uMcgregor M, i-Triano JJ. Umlinganiselo weHmax / Mmax njengesilinganiselo somphumo weentlungu eziphantsi eziphantsi. J Uluhlu lwePhysiol Ther. 1993;16: 7-13. [PubMed]
47. I-Dalichau S, i-Scheele K. Iimiphumo zeebhanti ze-lumbar ezithintekayo kwimpembelelo yenkqubo yokuqeqesha imisipha yezigulane ezinentlungu engapheliyo [isiJamani] Zt Orthop Grenzgeb. 2000;138:8–16. doi: 10.1055/s-2000-10106. [PubMed] [Umnqamlezo]
48. I-Dalichau S, Scheele K, Perrey RM, uElliehausen HJ, uHuebner J. Ultraschallgestützte Haltungs- und Bewegungsanalyse der Lendenwirbelsäule zum Nachweis der Wirksamkeit einer Rückenschule. Zbl Arbeitsmedizin. 1999;49: 148-156.
49. UDapas F. Baclofen unyango lwe-back-back syndrome. Isihlwele. 1985;10:345–349. doi: 10.1097/00007632-198505000-00010. [PubMed] [Umnqamlezo]
50. UDavies JE, iGibson T, uVavanyo L. Ixabiso lentsebenzo ekwenzeni unyango oluphantsi. Rheumatol Rehabil. 1979;18: 243-247. [PubMed]
51. UDeyo RA, Diehl AK, Rosenthal M. Zingaphi iintsuku zokuphumla kokulala ngenxa yentlungu ephantsi? Uvavanyo lwekliniki olungenamsebenzi. N Engl J Med. 1986;315: 1064-1070. [PubMed]
52. UDeyo RA, uWalsh NE, uMartin DC, uSchoenfeld LS, uRamamurthy S. Uvavanyo olulawulwayo lwe-stimulated nerve stimulation (TENS) kunye nokuzivocavoca iintlungu ezingapheliyo. N Engl J Med. 1990;322: 1627-1634. [PubMed]
53. UDickens C, uJayson M, uSutton C. Ubudlelwane phakathi kobuhlungu kunye nokudakumba kwilingo usebenzisa i-paroxetine kubantu abanezifo ezibuhlungu ezingapheliyo. Psychosomatics. 2000;41: 490-499. I-doi: 10.1176 / appi.psy.41.6.490. [PubMed] [Umnqamlezo]
54. UDonchin M, Woolf O, Kaplan L, Floman Y. Ukuthintela kwinqanaba leentlungu eziphantsi. Uvavanyo lweklinikhi. Isihlwele. 1990;15: 1317-1320. [PubMed]
55. UDoran DML, uNewell DJ. Ukunyanzeliswa kwonyango lwentlungu ephantsi: isifundo se-multiticentre. Br Med J. 1975;2: 161-164. [Inkcazelo yamahhala ye-PMC] [PubMed]
56. U-Evans DP, uBurke MS, uLloyd KN, uRoberts EE, uRoberts GM. I-Lumbar yokugulisa umlingo kwilingo. Icandelo 1: uvavanyo lweklinikhi. Rheumatol Rehabil. 1978;17: 46-53. [PubMed]
57. Evans DP, Burke MS, iNewcombe RG. Amachiza okhethekileyo kwiintlungu ezisezantsi. Curr Med Res Opin. 1980;6: 540-547. [PubMed]
58. I-Faas A, i-Chavannes AW, i-Eijk JTM, i-Gubbels JW. Iilingo elilawulwa ngeso lengqondo lokusetyenziswa kweyeza kugulane ezineentlungu ezisezantsi. Isihlwele. 1993;18: 1388-1395. [PubMed]
59. I-Faas A, i-Eijk JTM, i-Chavannes AW, i-Gubbels JW. Iilingo elingenangqondo lokusebenzisa unyango kwiigulane ezineentlungu eziphantsi. Isihlwele. 1995;20:941–947. doi: 10.1097/00007632-199504150-00012. [PubMed][Umnqamlezo]
60. Farrell JP, Twomey LT. Iintlungu zentlungu ephantsi: ukuthelekiswa kweendlela ezimbini zokwenza unyango. Med J Aust. 1982;1: 160-164. [PubMed]
61. U-Fordyce WE, uBrockway JA, uBergman JA, u-Spengler D. Intlungu ebuhlungu emva: iqela elilawulayo leendlela zokuziphatha ngokubhekiselele kwindlela yolawulo lwendabuko. J Behav Med. 1986;9: 127-140. i-doi: 10.1007 / BF00848473. [PubMed] [Umnqamlezo]
62. UFrost H, uKlaber Moffett JA, uMoser JS, i-Fairbank JCT. Icandelo elilawulwa ngokungalindelekanga lokuvavanya inkqubo yokukhubazeka kwezigulane ezineentlungu ezingapheliyo. Br Med J. 1995;310: 151-154.[Inkcazelo yamahhala ye-PMC] [PubMed]
63. UFrost H, iMvana SE, uKlaber Moffett JA, i-Fairbank JCT, i-Moser JS. Inkqubo yokunyamekela izigulane ezinentlungu engapheliyo emva kwe-2-year-up of trial. Ubuhlungu. 1998;75:273–279. doi: 10.1016/S0304-3959(98)00005-0. [PubMed] [Umnqamlezo]
64. I-Frost H, i-Lamb SE, i-Doll HA, i-Taffe Carver P, i-Stewart-Brown. Br Med J. 2004;329: 708-711. I-doi: 10.1136 / bmj.38216.868808.7C. [Inkcazelo yamahhala ye-PMC] [PubMed] [Umnqamlezo]
65. I-Galantino ML, i-Bzdewka TM, i-Eissler-Russo JL, i-Holbrook ML, i-Mogck EP, i-Geigle P. Impembelelo ye-hatha yoga eguquguqukayo kwiintlungu ezibuhlungu ezingaphantsi: isifundo somqhubi. Inye yeTher Health Med. 2004;10: 56-59.[PubMed]
66. UGemignani G, u-Olivieri I, u-Ruju G, u-Pasero G. Ukunyusa kwamandla omnyuzi wesibindi kwi-spondylitis engabonakaliyo: ukufundisisa kabini. Arthritis Rheum. 1991;34: 788-789. I-doi: 10.1002 / ubugcisa.1780340624.[PubMed] [Umnqamlezo]
67. Gibson T, Grahame R, Harkness J, Woo P, Blagrave P, Hills R (1985) Ukuqhathaniswa okulawulwa kwindlela yokwenza i-short-wave diathermy yonyango ngokunyanga kwe-osteopathic kwiintlungu ezingezantsi. I-Lancet 1258-1261[PubMed]
68. Gilbert JR, Taylor DW, Hildebrand A, Evans C. Iilingo lezonyango zonyango oluqhelekileyo ngenxa yentlungu ephantsi kwentsapho. Br Med J Clin Res Ed. 1985;291: 791-794. [Inkcazelo yamahhala ye-PMC] [PubMed]
69. I-Glomsrød B, uLønn JH, i-Soukup MG, uBø K, uLarsen S. Isikolo esilandelayo esikolweni, ukuphathwa kweprophylactic ngenxa yentlungu ephantsi: ukulandelelwa kweminyaka emithathu yolu vavanyo olulawulwa ngononophelo. J Rehabil Med. 2001;33: 26-30. i-doi: 10.1080 / 165019701300006506. [PubMed] [Umnqamlezo]
70. Glover JR, Morris JG, Khosla T. Intlungu ebuhlungu: isilingo esilungelelaniso lweklinikhi yokuqhutyelwa kwe-trunk. Br J Ind Med. 1974;31: 59-64. [Inkcazelo yamahhala ye-PMC] [PubMed]
71. U-Godfrey CM, uMorgan PP, uSchatzker J. Uvavanyo olungenangqondo lokunyanzeliswa kwentlungu ephantsi kwimeko yezokwelapha. Isihlwele. 1984;9:301–304. doi: 10.1097/00007632-198404000-00015. [PubMed] [Umnqamlezo]
72. I-Gold R. i-Orphenadrine citrate: i-sedative okanye i-muscle ephumayo? Clin Ther. 1978;1: 451-453.
73. I-Goldie I. Uvavanyo lwekliniki kunye ne-indomethacin (indomee) kwiintlungu ezisezantsi kunye ne-sciatica. Acta Orthop Scand. 1968;39: 117-128. [PubMed]
74. I-Goodkin K, i-Gullion CM, i-Agras WS. Iilingo ezilawulwa ngokungaqhelekanga ezimbini, i-placebo elawulwa yi-placebo ye-trazodone hydrochloride kwisifo esingapheliyo sesifo se-back back syndrome. J Clin Psychopharmacol. 1990;10:269–278. doi: 10.1097/00004714-199008000-00006. [PubMed] [Umnqamlezo]
75. Gur A, Karakoc M, Cevik R, Nas K, Sarac AJ, Karakoc M. Ukusebenza kwamathambo e-low power laser kunye nokuzivocavoca kwiintlungu nemisebenzi kwiintlungu ezingapheliyo. Lasers Surg Med. 2003;32: 233-238. I-doi: 10.1002 / lsm.10134. [PubMed] [Umnqamlezo]
76. UGuyman J, u-Esmail R, uKarjalainen K. Ukulungiswa kwamanqanaba amaninzi eentlungu ezingapheliyo emva: ukuhlaziywa okucwangcisiweyo. Br Med J. 2001;322: 1511-1516. I-doi: 10.1136 / bmj.322.7301.1511. [Inkcazelo yamahhala ye-PMC][PubMed] [Umnqamlezo]
77. I-Hadler NM, Curtis P, i-Gillings DB, iStinnett S. Inzuzo yokuguqulwa kwamagulane njengonyango olusisigxina kwiintlungu ezibuhlungu eziphantsi: isilingo esilawulwayo. Isihlwele. 1987;12:703–705. doi: 10.1097/00007632-198709000-00012. [PubMed] [Umnqamlezo]
78. Hagen KB, Hilde G, Jamtvedt G (2003) Ibhedi yokuphumla ngenxa yeentlungu ezisezantsi ze-back and sciatica (Ukuhlaziywa kweCchrane). Ku: I-Library yeCchrane, i-1. Update Software, i-Oxford
79. Hameroff SR, Weiss JL, uLerman JC. Imiphumo ye-Doxepin kwiintlungu ezingapheliyo kunye nokudandatheka: uphando olulawulwayo. J Clin Psychiatry. 1984;45: 47-52. [PubMed]
80. Hansen FR, iBendix T, Skov P, iCV Jensen, uKristensen JH, uKrohn L. Ukunyamezela, ukuguqulwa kwe-muscle, i-physiotherapy, okanye ulawulo lwe-placebo lweentlungu ezisezantsi. Isihlwele. 1993;18:98–107. doi: 10.1097/00007632-199301000-00015. [PubMed][Umnqamlezo]
81. Härkäpää K, Järvikoski A, Mellin G, Hurri H. Uphononongo olulawulwayo malunga nesiphumo sokugula kunye nesifo sengqondo sokuphulukana nentlungu. Icandelo I. I-Scand J Rehabil Med. 1989;21: 81-89. [PubMed]
82. Härkäpää K, Mellin G, Järvikoski A, Hurri H. Uhlolisiso olulawulwayo malunga nesiphumo sokugula kunye nesifo sengqondo sokuphulukana nentlungu. Icandelo III. I-Scand J Rehabil Med. 1990;22: 181-188. [PubMed]
83. Hayden JA, Tulder MW, Malmivaara AV, Koes BW. Uhlalutyo lwama-meta: sebenzisa unyango ngenxa yeentlungu ezingaphantsi. Ann Intern Med. 2005;142: 765-775. [PubMed]
84. Hemmila HM, Keinanen-Kiukaanniemi SM, Levoska S. Ngaba umsebenzi weeyeza zamadoda? Uvavanyo olulungelelweyo lwezonyango kwizigulane ezinokubuhlungu kwexesha elide. IArch Phys Med Rehabil. 1997;78:571–577. doi: 10.1016/S0003-9993(97)90420-2. [PubMed] [Umnqamlezo]
85. Hemmila H, Keinanen-Kiukaanniemi SM, Levoska S, Puska P. Ukusebenza kwexesha elide lokubeka amathambo, unyango olululayo, kunye ne-physiotherapy ngenxa yentlungu eqhubekayo: iilingo ezilawulwa ngokungenamthetho. J Uluhlu lwePhysiol Ther. 2002;25: 99-104. I-doi: 10.1067 / mmt.2002.122329. [PubMed] [Umnqamlezo]
86. Henry D, Lim LLY, Rodriguez LAG. Ukuchasana kwengozi yokuxhamla esiswini kunye nezidakamizwa ezingafaniyo ezichasayo: iziphumo zohlalutyo lweemeta-mveliso. Br Med J. 1996;312: 1563-1566. [Inkcazelo yamahhala ye-PMC] [PubMed]
87. Herzog W, Conway PJW, Willcox BJ. Iimpembelelo zendlela ezahlukeneyo zonyango kwi-symmetry ye-gait kunye namanyathelo ekliniki kwizigulane ezihlangeneyo ze-sacroiliac. J Uluhlu lwePhysiol Ther. 1991;14: 104-109. [PubMed]
88. Heymans MW, Tulder MW, Esmail R, iBombardier C, Koes BW. Izikolo ezibuyiselwa kwiintlungu ezingaphantsi kweentlungu: ukuphononongwa ngokuchanekileyo kwisakhelo seCocrane Co-collaborative Review Group. Isihlwele. 2005;30:2153–2163. doi: 10.1097/01.brs.0000182227.33627.15. [PubMed] [Umnqamlezo]
89. Ufihla i-JA, uJull GA, uRichardson CA. Imiphumo emide yexesha elide lokuzivocavoca oluthile lwe-episode episode. Isihlwele. 2001;26:E243–E248. doi: 10.1097/00007632-200106010-00004. [PubMed][Umnqamlezo]
90. UHilde G, Hagen KB, uJamtvedt G (2003) Iseluleko sokuhlala sisebenza njengonyango olulodwa lweentlungu eziphantsi kunye ne-sciatica (Ukuhlaziywa kweCchrane). Ku: I-Library yeCchrane, i-1. Update Software, i-Oxford [PubMed]
91. I-Hildebrandt VH, i-Proper KI, i-van den BR, i-Douwes M, i-Heuvel i-SG, i-Buuren S. Ulwaphulo lwe-Cesar lusetyenziswa kancinci kwizigulane ezineentlungu ezingapheliyo zonyango kunokuba unyango oluqhelekileyo lugqirha lwenzululwazi: ukulandelelana [isiDatshi] INed Tijdschr Geneesk. 2000;144: 2258-2264. [PubMed]
92. I-Hindle T. Ukuqhathaniswa kwe-carisoprodol, i-butabarbital, kunye ne-placebo kwonyango lwe-back back syndrome. Calif Med. 1972;117: 7-11. [Inkcazelo yamahhala ye-PMC] [PubMed]
93. Hofstee DJ, Gutenbeek JMM, Hoogland PH, Houwelingen HC, Kloet A, Lötters F, Tans JTJ. Icandelo likaWesteinde sciatica: Ukufunda ngokuzenzekelayo ngokulala ngokulala kunye ne-physiotherapy kwi-sciatica enzima. J Neurosurg. 2002;96: 45-49. [PubMed]
94. Hsieh CJ, Phillips RB, Adams AH, uPapa MH. Iziphumo ezisebenzayo zeentlungu ezisezantsi: ukuthelekiswa kwamacandelo amane kunyango kwiilingo ezilawulwa ngokungenamthetho. J Uluhlu lwePhysiol Ther. 1992;15: 4-9.[PubMed]
95. U-Hurri H. Isikolo saseSweden esikolweni esiphantsi kwintlungu engapheliyo. Icandelo I. Iinzuzo. I-Scand J Rehabil Med. 1989;21: 33-40. [PubMed]
96. I-Indahl A, iVelund L, iReikeraas O. Ukulungelelanisa okulungileyo kwintlungu ephantsi emva kokushiywa ngaphandle. Uvavanyo lwekliniki olungenamsebenzi. Isihlwele. 1995;20: 473-477. [PubMed]
97. Indahl A, Haldorsen EH, Holm S, Reikeras O, Ursin H. Uvavanyo olulandelayo lokulandelelwa kwetyala lokulawulwa kweeklinikhi ngokusebenzisa ukukhanya okulula kunye nendlela yokwazisa intlungu ephantsi. Isihlwele. 1998;23:2625–2630. doi: 10.1097/00007632-199812010-00018. [PubMed] [Umnqamlezo]
98. UJamess JH, iGreyon MF. Uvavanyo lwe-e-anti-inflammatory agent (i-indomethacin) kwiintlungu ezisezantsi emva kokungabandakanyeki. Br Med J. 1968;3: 158-160. [Inkcazelo yamahhala ye-PMC] [PubMed]
99. I-Jenkins DG, i-Ebbutt AF, i-CD ye-Evans. I-Tofranil kwonyango lwentlungu ephantsi. J Int Med Res. 1976;4: 28-40. [PubMed]
100. UJückel WH, uCziske R, Gerdes N, Jacobi E. Überprüfung der Wirksamkeit stationerrer Ukubuyiselwa kwamanani kwi-Patienten mit chronishen I-Kreuzschmerzen: i-prospective randomisierte, i-kontrollierte Studie. Ku hlaziywa. 1990;29: 129-133. [PubMed]
101. I-Kankaanpaa M, iTaimela S, Airaksinen O, Hanninen O. Ukuphumelela kokuvuselelwa okusebenzayo kwiintlungu ezingapheliyo zentlungu. Impembelelo ekubandezelekeni kwintlungu, ukukhubazeka okuzimeleyo, kunye nokuphelelwa amandla. Isihlwele. 1999;24:1034–1042. doi: 10.1097/00007632-199905150-00019. [PubMed] [Umnqamlezo]
102. I-Katz N, i-Ju WD, i-Krupa DA. Ukusebenza kunye nokukhuselwa kwe-rofecoxib kwizigulane ezineentlungu ezingapheliyo zentlungu: iziphumo ezivela kwi-4-veki ezimbini, i-randomized, i-placebo-elawulwa yiqela. Izilingo ezimbini. Isihlwele. 2003;28:851–859. doi: 10.1097/00007632-200305010-00002. [PubMed] [Umnqamlezo]
103. Keijsers JFEM, Groenman NH, Gerards FM, Oudheusden E, Steenbakkers M. Isikolo esikolweni eNetherlands: ukuvavanya iziphumo. Iingcebiso zoLuntu. 1989;14:31–44. doi: 10.1016/0738-3991(89)90005-0. [PubMed] [Umnqamlezo]
104. Keijsers JFME, Steenbakkers WHL, Meertens RM, Bouter LM, Kok GJ. Ukusebenza kwe-back school: ityala elingahleliyo. I-Arthritis Care Res. 1990;3: 204-209.
105. UKlaber Moffett JA, Chase SM, Portek I, Ennis JR. Ukuhlolwa okuza kulawulwa ukuhlola ukuphumelela kwesikolo esikolweni emva kokunciphisa ubuhlungu obungapheliyo. Isihlwele. 1986;11:120–122. doi: 10.1097/00007632-198603000-00003. [PubMed] [Umnqamlezo]
106. U-Klaber Moffett J, uTorgerson D, uBell-Syer S, uJackson D, uLlewlyn-Phillips H, Farrin A. Uvavanyo olunokulawulwa ngolu hlobo olwenziwa ngokunyanzeliswa kweentlungu eziphantsi: iziphumo zonyango, iindleko kunye nokukhetha. Br Med J. 1999;319: 279-283. [Inkcazelo yamahhala ye-PMC] [PubMed]
107. Klinger N, Wilson R, Kanniainen C., Wagenknecht K, Re O, i-Gold R. Intravenous orphenadrin yokunyanga kwe-lumbar paravertebral muscle strain. I-Curr Ther Res. 1988;43: 247-254.
108. Koes BW, Bouter LM, Mameren H, Essers AHM, Verstegen CMJR, Hofhuizen DM, Houben JP, Knipschild PG. Uvavanyo olulinganisiweyo lwezonyango zonyango kunye ne-physiotherapy yezikhalazo eziqhubekayo nangentamo: iziphumo zonyaka wokulandela. Br Med J. 1992;304: 601-605. [Inkcazelo yamahhala ye-PMC] [PubMed]
109. I-Koes BW, iTulder MW, i-Ostelo R, uKim Burton A, i-Waddell G. Izikhokelo zezonyango zokulawulwa kweentlungu eziphantsi kwiinkathalo eziphambili: ukuthelekiswa kwamazwe ngamazwe. Isihlwele. 2001;26:2504–2513. doi: 10.1097/00007632-200111150-00022. [PubMed] [Umnqamlezo]
110. Konrad K, Tatrai T, Hunka A, Vereckei E, Korondi L. Uvavanyo olulawulwayo lwe-balneotherapy ekwenzeni unyango oluphantsi. Ann Rheum Dis. 1992;51: 820-822. i-doi: 10.1136 / ard.51.6.820. [Inkcazelo yamahhala ye-PMC][PubMed] [Umnqamlezo]
111. Kuukkanen TM, Malkia EA. Uvavanyo olulawulwayo olwenziwa ngokulandelwayo kwindlela yokuhamba emva kokuhamba kunye nokusetyenziswa kwezilwanyana kwizifundo ezineentlungu eziphantsi. KwiKlinikhi yokubuyisela. 2000;14: 192-202. i-doi: 10.1191 / 026921500667300454. [PubMed] [Umnqamlezo]
112. I-Lacey PH, iDodd GD, iDannon DJ. I-placebo eyimpumputhe ilawulwa i-piroxicam ekulawuleni iziphazamiso ezinzima ze-musculoskeletal. Eur J Rheumatol Inflamm. 1984;7: 95-104. [PubMed]
113. I-Lankhorst GJ, i-Stadt RJ, i-Vogelaar TW, iKorst JK, i-Prevo AJH. Impembelelo yesikolo saseSweden esikolweni kwisifo esibuhlungu esingapheliyo. I-Scand J Rehabil Med. 1983;15: 141-145. [PubMed]
114. ULarsson U, uCööler U, Lindström A. Ukuzenzekela ngokuzenzekelayo unyango lwe-lumbago-sciatica. Uphando olulawulwa ngokubanzi. Acta Orthop Scand. 1980;51: 791-798. i-doi: 10.3109 / 17453678008990875.[PubMed] [Umnqamlezo]
115. ULeclaire R, u-Esdaile JM, uSuissa S, uRosssignol M, uProulx R, uDupuis M. Isikolo esilandelayo kwisiqephu sokuqala sokuhlawulelwa kweentlungu ezisezantsi ezibuhlungu: ukuvavanywa kweklinikhi ukuvavanya ukuphumelela nokukhusela ukubuyela. IArch Phys Med Rehabil. 1996;77:673–679. doi: 10.1016/S0003-9993(96)90007-6. [PubMed] [Umnqamlezo]
116. I-Lepisto P. Uvavanyo lwe-dS 103-282 kunye ne-placebo ekhatyweni kwamathambo omzimba osisigxina ngenxa yokuphazamiseka kwemva. Res Res. 1979;26: 454-459.
117. Letchuman R, Deusinger RH. Ukuqhathaniswa kwe-sacrospinalis nomsebenzi wamanqanaba kunye neentlungu ezigulane ezithatha izibilini ezisezantsi kunye neziphakathi. Isihlwele. 1993;18:1361–1365. doi: 10.1097/00007632-199308000-00017. [PubMed] [Umnqamlezo]
118. I-Lidstrom A, i-Zachrisson M. Ulwaphulo olusisigxina kwiintlungu eziphantsi kwe-back and sciatica. I-Scand J Rehabil Med. 1970;2: 37-42. [PubMed]
119. I-Lindequist SL, uLundberg B, i-Wikmark R, i-Bergstad B, i-Loof G, i-Ottermark AC. Ulwazi kunye nolawulo kwiintlungu ezisezantsi. I-Scand J Rehabil Med. 1984;16: 113-116. [PubMed]
120. Lindstrom I, Ohlund C, Eek C, Wallin L, Peterson LE, Fordyce WE. Impembelelo yomsebenzi odibeneyo kwizigulana ezithintela ubuhlungu beentlungu eziphantsi: i-randomized study clinic kunye nendlela yokuziphatha yokuziphatha. Phys Ther. 1992;72: 279-293. [PubMed]
121. ULinton SJ, uBradley LA, uJensen I, uSpangfort E, uSundell L. Ukuthintela okwesibini kweentlungu ezisezantsi: uvavanyo olulawulwayo ngokulandelelana. Ubuhlungu. 1989;36:197–207. doi: 10.1016/0304-3959(89)90024-9. [PubMed][Umnqamlezo]
122. I-Ljunggren E, Weber H, uLarssen S. Ukuzenzekela ngokuhambelanayo nokulandelelana komsebenzi kwizigulane ezineengxowankulu ze-intervertebral discs. I-Scand J Rehabil Med. 1984;16: 117-124. [PubMed]
123. Loisel P, Abenhaim L, Durand P, Esdaile J, Suissa S, Gosselin L, Simard R, Turcotte J, uLemaire J. Isiseko esiphezulu sabantu, esilungelelaniso lweklinikhi ngokulandelelaniswa kolawulo lwentlungu. Isihlwele. 1997;22:2911–2918. doi: 10.1097/00007632-199712150-00014. [PubMed] [Umnqamlezo]
124. ULønn JH, u-Glomsrød B, u-Soukup MG, uBø K, uLarsen S. Isikolo esiphindayo esikolweni: ukuphathwa kweprophylactic ngenxa yentlungu ephantsi. Uphononongo olulandelayo lokulawulwa kwe-1-year. Isihlwele. 1999;24:865–871. doi: 10.1097/00007632-199905010-00006. [PubMed] [Umnqamlezo]
125. Lukinmaa Kansanelakelaitoksen julkaisuja. 1989;ML: 90.
126. McGill SM. Amabhande amabhinqa kwishishini: iphepha lokuma kwiimpahla zabo, amatyala kunye nokusetyenziswa. Ngaba i-Ind Hyg Assoc. 1993;54: 752-754. [PubMed]
127. Malmivaara A, Hãkkinen U, Aro T, Heinrichs ML, Koskenniemi L, Kuosma E, Lappi S, Paloheimo R, Servo C, Vaaranen V, Hernberg S. Ukunyangwa kokuphumla kwamathambo aphantsi kwamanzi, ukusetyenziswa, okanye umsebenzi oqhelekileyo. N Eng J Med. 1995;332: 351-355. I-doi: 10.1056 / NEJM199502093320602. [PubMed][Umnqamlezo]
128. Marchand S, Charest J, Li J, Chenard JR, uLavignolle B, uLaurencelle L. Ngaba i-TENS iyinto kuphela yempembelelo ye-placebo? Ukufundiswa okulawulwayo kwintlungu engapheliyo emva. Ubuhlungu. 1993;54:99–106. doi: 10.1016/0304-3959(93)90104-W. [PubMed] [Umnqamlezo]
129. I-Mathews JA, i-Hickling J. Lumbar traction: i-sciatica eyayilawulwa kabini imfama. Rheumatol Rehabil. 1975;14: 222-225. I-doi: 10.1093 / rheumatology / 14.4.222. [PubMed] [Umnqamlezo]
130. I-Mathews JA, i-Mills SB, i-Jenkins VM. Intlungu ebuhlungu kunye ne-sciatica: izilingo ezilawulwayo zokuphathwa, ukulandelelana, i-sclerosant kunye ne-epidural injections. Br J Rheumatol. 1987;26: 416-423. I-doi: 10.1093 / rheumatology / 26.6.416. [PubMed] [Umnqamlezo]
131. U-Mathews W, uMorkel M, uMathews J. Ukunyanzeliswa kunye nokulandelelana kwe-lumbago kunye ne-sciatica: iindlela zobugcisa ezisebenzisayo kwizilingo ezimbini ezilawulwayo. I-Physiother Pract. 1988;4: 201-206.
132. Mellin G, Hurri H, Härkäpää K, Järvikoski A. Uphononongo olulawulwayo malunga nesiphumo sokugula kunye nesifo sengqondo sokuphulukana nentlungu. Icandelo II. I-Scand J Rehabil Med. 1989;21: 91-95. [PubMed]
133. Mellin G, Härkäpää K, Hurri H, Järvikoski A. Uphononongo olulawulwayo malunga nesiphumo sokugula kunye nesifo sengqondo sokuphulukana nentlungu. Icandelo IV. I-Scand J Rehabil Med. 1990;22: 189-194. [PubMed]
134. IMilgrom C, i-Finestone A, i-Lev B, i-Wiener M, i-Floman Y. I-lumbar ne-thoracic intlungu ebuhlungu phakathi kwabantu abaqeshweyo: abaza kuhlolisisa izinto ezinobungozi kunye neenkqubo zonyango. Iintlobo zeengxaki ze-Spinal Disord. 1993;6:187–193. doi: 10.1097/00002517-199306030-00001. [PubMed] [Umnqamlezo]
135. UMilne S, i-welch V, i-Brosseau L (2004) I-Transcutaneous electrical nerve stimulation (TENS) yeentlungu ezingapheliyo zentlungu. Ku: I-Library yeCchrane, i-4. Update Software, i-Oxford
136. UMitchell RI, uCarmen GM. Indlela yokubuyisela ukusebenza kwonyango lobuhlungu obungapheliyo kwizigulane ezinesisindo esithambileyo kunye nokulimala kwangemva. Isihlwele. 1994;19:633–642. doi: 10.1097/00007632-199403001-00001. [PubMed] [Umnqamlezo]
137. I-Moll W. Zur yonyango ye-akuter lumbovertebraler syndrome idlulele kwi-optimal medicamentos muskelrelaxation mittels diazepam. Med Welt. 1973;24: 1747-1751. [PubMed]
138. UMosesley L. I-physiotherapy kunye nezemfundo ezihlangeneyo ziyimpumelelo yeentlungu ezingapheliyo. Aust J Physiother. 2002;48: 297-302. [PubMed]
139. I-Newton-John TR, i-Spence SH, iSchotte D. I-Cognitive-behavioral therapy ngokubhekiselele kwi-EMG biofeedback ekwenzeni unyango olungapheliyo lwentlungu. Behav Res Ther. 1995;33:691–697. doi: 10.1016/0005-7967(95)00008-L. [PubMed] [Umnqamlezo]
140. U-Niemistö L, uLahtinen-Suopanki T, uRissanen P, Lindgren KA, uSarna S, Hurri H. Uvavanyo olungenangqiqo lokuxhatshazwa ngokuhlangeneyo, ukubonisana nokuzinzisa kunye nodokotela xa kuqhathaniswa nodokotela obonisana naye kuphela ngenxa yeentlungu ezingapheliyo. Isihlwele. 2003;28:2185–2191. doi: 10.1097/01.BRS.0000085096.62603.61. [PubMed] [Umnqamlezo]
141. UNicholas MK, Wilson PH, Goyen J. Ukusebenza-ukuziphatha nokuziphatha-ukuziphatha kwintlungu engaphantsi. Behav Res Ther. 1991;29:225–238. doi: 10.1016/0005-7967(91)90112-G.[PubMed] [Umnqamlezo]
142. UNicholas MK, Wilson PH, Goyen J. Ukuthelekiswa kolwaphulo lwenkcazo yokuziphatha kunye nolunye uhlobo olungenalo kwengqondo olunyango lweentlungu ezingapheliyo. Ubuhlungu. 1992;48:339–347. doi: 10.1016/0304-3959(92)90082-M. [PubMed] [Umnqamlezo]
143. U-Nouwen A. EMG i-biofeedback esetyenziselwa ukunciphisa amanqanaba okuma emzimbeni we-muscular disorders in painless back back pain. Ubuhlungu. 1983;17:353–360. doi: 10.1016/0304-3959(83)90166-5. [PubMed] [Umnqamlezo]
144. U-Oliphant D. Ukhuselo lokuguqulwa kwamagqabi ekunyanga kwe-disk-disk herniations: uhlolo lokuhlalutya kunye nokuhlolwa komngcipheko. J Uluhlu lwePhysiol Ther. 2004;27: 197-210. I-doi: 10.1016 / j.jmpt.2003.12.023. [PubMed] [Umnqamlezo]
145. U-Ongley MJ, uKlein RG, uDorman TA, uEek BC, uHubert LJ. Indlela entsha yokunyanga intlungu engapheliyo emva. Lancet. 1987;2:143–146. doi: 10.1016/S0140-6736(87)92340-3. [PubMed] [Umnqamlezo]
146. Ostelo RW, van Tulder MW, Vlaeyen JW, uLinton SJ, Morley SJ, Assendelft WJ (2005) Ukunyangwa kobuhlungu beentlungu ezingapheliyo. Ku: I-Library yeCchrane, i-1. Update Software, i-Oxford[PubMed]
147. Pal P, Mangion P, Hossian MA, Diffey L. Ulingo olulawulwayo oluqhubekayo lokutshatyalaliswa kwintlungu kunye ne-sciatica. Br J Rheumatol. 1986;25: 181-183. I-doi: 10.1093 / rheumatology / 25.2.181. [PubMed] [Umnqamlezo]
148. Pallay RM, Seger W, Adler JL, Ettlinger RE, Quaidoo EA, Lipetz R, O'Brien K, Mucciola L, Skalky CS, Petruschke RA, Bohidar NR, Geba GP. I-Etoricoxib yanciphisa intlungu kunye nokukhubazeka kunye nokuphucula umgangatho wobomi kwizigulana ezineentlungu ezingapheliyo: i-3 inyanga, iilingo ezilawulwa ngokungenangqondo. Scand J Rheumatol. 2004;33: 257-266. i-doi: 10.1080 / 03009740410005728. [PubMed] [Umnqamlezo]
149. I-Penrose KW, i-Chook K, iStump JL. Imiphumo emihle kwaye engapheliyo yenkxaso ye-lumbar inkxaso ye-lumbar kwi-muscular power, ukuguquguquka kwemvelo, kunye nekhompyutheni yokukhubazeka. Umdlalo weTeams Med uhlaziywa. 1991;2: 121-129.
150. I-Penttinen J, i-Nevala-Puranen N, i-Airaksinen O, i-Jaaskelainen M, i-Sintonen H, i-Takala J. Isilingo esilawulwayo esilawulwayo esikolweni esikolweni kunye nangaphandle kwenkxaso yabontanga. J Occup Rehabil. 2002;12: 21-29. I-doi: 10.1023 / A: 1013594103133. [PubMed] [Umnqamlezo]
151. I-Pheasant H, i-Bursk A, i-Goldfarb J, i-Azen SP, i-Weiss JN, i-Borelli L. i-Amitriptyline kunye neentlungu ezingapheliyo zentlungu. Isihlwele. 1983;8:552–557. doi: 10.1097/00007632-198307000-00012. [PubMed] [Umnqamlezo]
152. I-Postacchini F, i-Facchini M, i-Palieri P. Ukusebenza kweendlela ezahlukeneyo zonyango olulondolozayo kwiintlungu ezisezantsi. Ucwaningo lokuthelekisa . Neuro-Orthopedics. 1988;6: 28-35.
153. I-Pratzel HG, i-Alken RG, i-Ramm S. Ukusebenza kunye nokunyamezela ngokuphindaphindiweyo kwemilinganiselo yomlomo ye-tolperisone hydrochloride ekwenzeni unyango oluxakekileyo lwe-reflex muscle spasm: iziphumo zolu vavanyo lwe-placebo olulawulwa yi-double blind-trial. Ubuhlungu. 1996;67:417–425. doi: 10.1016/0304-3959(96)03187-9. [PubMed] [Umnqamlezo]
154. Preyde M. Ukuphumelela kwonyango lokuxilonga ukuxilonga intlungu ephantsi-intlawulo: ityala elilawulwa ngokungenamthetho. J. Med Medso 2000;162: 1815-1820. [Inkcazelo yamahhala ye-PMC] [PubMed]
155. IRasmussen GG. Ukunyanzeliswa kwonyango lweentlungu eziphantsi: isilingo seklinikhi esingenamsebenzi. Man Med. 1979;1: 8-10.
156. URasmussen-Barr E, uNilsson-Wikmar L, uArvidsson I. Uqeqesho oluzinzileyo oluqhathaniswa nophatho lwezonyango kwiintlungu ezingaphantsi kunye ezingapheliyo. Ther Man. 2003;8:233–241. doi: 10.1016/S1356-689X(03)00053-5. [PubMed] [Umnqamlezo]
157. Gcina iP, iChantraine A, i-Vischer TL. Ukuphathwa ngeetekisi ze-lombosciatalgies avec ou sans déficit neurologique. Schweiz Med Wochenschr. 1988;118: 271-274. [PubMed]
158. Sengozi SV, Norvell NK, Pollock Ml, Risch ED, uLanger H, uFulton M. Lumbar ukuqinisa kwizigulana ezingapheliyo zentlungu: i-physiological and psychological benefits. Isihlwele. 1993;18:232–238. doi: 10.1097/00007632-199302000-00010. [PubMed] [Umnqamlezo]
159. I-Rozenberg S, i-Delval C, i-Rezvani Y. Ukuphumla kwebhedi okanye umsebenzi oqhelekileyo kwizigulana ezineentlungu ezibuhlungu ezisezantsi: iilingo elilawulwa ngononophelo. Isihlwele. 2002;27:1487–1493. doi: 10.1097/00007632-200207150-00002.[PubMed] [Umnqamlezo]
160. I-Sackett D (1997) Iingcebiso ezisekelwe kwiingcali. Churchill Livingstone
161. Salerno SM, Browning R, Jackson JL. Impembelelo yonyango oluxinzelelekayo kwiintlungu ezingapheliyo: i-meta-analysis. Arch Intern Med. 2002;162: 19-24. i-doi: 10.1001 / archinte.162.1.19. [PubMed] [Umnqamlezo]
162. Salzmann E, uPforringer W, Paal G, Gierend M. Ukunyanga kwesifo esingapheliyo sesifo se-back-back nesifo se-tetrazepam kwindawo yokulawula i-placebo elawulwa yi-double-blind eye. J Drug Dev. 1992;4: 219-228.
163. Schonstein E, uKenny D, uKeating J, uKoes B, uHerbert RD. Iiprogram zokumisa imimiselo yabasebenzi abanentlungu emva nangentamo: uhlolo lweCochrane oluhlelekile. Isihlwele. 2003;28:E391–E395. doi: 10.1097/01.BRS.0000092482.76386.97. [PubMed] [Umnqamlezo]
164. U-Serferlis T, uLindholm L, Nemeth G. Uhlalutyo lokunciphisa indleko kweenkqubo ezintathu zonyango ezixhasayo kwizigulane ze-180 ezibhalwe zizifo ezidwelisiweyo. I-Scand J Prim Health Care. 2000;18: 53-57. i-doi: 10.1080 / 02813430050202578. [PubMed] [Umnqamlezo]
165. Silverstein FE, Faich G, Goldstein JL, Simon LS, Pincus T, Whelton A, Makuch R, Eisen G, Agrawal NM, Stenson WF, Burr AM, Zhao WW, Kent JD, Lefkowith JB, Verburg KM, Geis GS. Ubunyoyi bezinyosi kunye ne-celecoxib vs izidakamizwa ezingabhubhisiyo nge-nonsteroidal ye-osteoarthritis kunye ne-rheumatoid arthritis: isifundo seCASS. Ulingo olulawulwa ngokungenamthetho. Ucwaningo lwe-arthritis lwexesha lokugqibela lwe-arthritis. JAMA. 2000;284: 1247-1255. i-doi: 10.1001 / jama.284.10.1247. [PubMed] [Umnqamlezo]
166. Skargren EI, Oberg BE, uCarlsson PG, uGade M. Iindleko kunye nohlalutyo lophuculo lwe-chiropractic kunye ne-physiotherapy unyango ngenxa yentlungu ephantsi nasemqaleni. Ukulandelwa kweenyanga ezintandathu. Isihlwele. 1997;22: 2167-2177.[PubMed]
167. Ukukhupha iMG, Glomsrod B, uLonn JH, Bo K, uLarsen S, Fordyce WE. Isiphumo seprogram yoqeqesho lwe-Mensendieck njengeprophylaxis yesibili yeentlungu eziphindaphindiweyo eziphantsi: inzululwazi olulawulwa ngokungaphendulwanga kunye ne-12-inyanga yokulandelelana. Isihlwele. 1999;24:1585–1592. doi: 10.1097/00007632-199908010-00013. [PubMed][Umnqamlezo]
168. Ukukhuphela M, uLonn J, Glomsrod B, Bo K, uLarsen S. Ukuzivocavoca kunye nemfundo njengokhuseleko lwesibini kwiintlungu ezisezantsi eziphindaphindiweyo. Reshyother Res Int. 2001;6: 27-39. I-doi: 10.1002 / pri.211. [PubMed] [Umnqamlezo]
169. Staal JB, Hlobil H, Twisk JWR, Smid T, Köke AJA. Umsebenzi oqokelelweyo weentlungu ezisezantsi ezikhuselekileyo kwiinkonzo zempilo: umsebenzi olawulwa ngokungahleliwe. Ann Intern Med. 2004;140: 77-84. [PubMed]
170. I-Staiger O, uBharak G, uSullivan MD, uDeyo RA. Ukuphononongwa ngokuchanekileyo kwezidandathelwana ekunyangeni iintlungu ezingapheliyo. Isihlwele. 2003;28:2540–2545. doi: 10.1097/01.BRS.0000092372.73527.BA.[PubMed] [Umnqamlezo]
171. U-Stankovic R, uJohnell O. unyango lwe-Conservative lweentlungu ezisezantsi. Uvavanyo olulindelekileyo oluthile: I-McKenzie indlela yokonyango ngokubhekiselele kwimfundo yesigulane kwi "Mini Back School" Isihlwele. 1990;15:120–123. doi: 10.1097/00007632-199002000-00014. [PubMed] [Umnqamlezo]
172. U-Stankovic R, uJohnell O. unyango olulondolozo lwentlungu ye-back-back pain: i-5-uphando lwama-nyaka lweendlela ezimbini zonyango. Isihlwele. 1995;20:469–472. doi: 10.1097/00007632-199502001-00010. [PubMed][Umnqamlezo]
173. Storheim K, Brox JI, Holm I, Koller AK, Bo K. Uqeqesho olunzulu lweqela ngokumelene nokungenelela kwengqondo kwintlungu engaphantsi kwe-back-acute: iziphumo ezifutshane zexesha elifutshane elilawulwa ngolu hlobo olulawulwa ngononophelo. J Rehabil Med. 2003;35: 132-140. i-doi: 10.1080 / 16501970310010484. [PubMed] [Umnqamlezo]
174. I-Stuckey SJ, uJacobs A, i-Goldfarb J. EMG uqeqesho lwe-biofeedback, uqeqesho lokuphumula, kunye ne-placebo yokukhulula intlungu engapheliyo. I-Percept Sk Skills. 1986;63: 1023-1036. [PubMed]
175. I-Sweetman BJ, i-Baig A, i-Parsons DL. I-Mefenamic acid, i-chlormezanone-paracetamol, ethoheptazine-i-aaspirin-meprobamate: isifundo sokuthelekiswa kwintlungu ephantsi. Br J Clin Pract. 1987;41: 619-624.[PubMed]
176. I-Sweetman BJ, uHeinrich I, Anderson JAD. Iilingo elilawulwa ngokungaqhelekanga lokuzivocavoca, i-short circulation diathermy, kunye ne-traction yeentlungu ezisezantsi, ngobungqina bendlela yokuxilongwa ngokuphathelele ukuxilongwa. J Ortho Rheumatol. 1993;6: 159-166.
177. Szpalski M, Hayez JP. Zingaphi iintsuku zokuphumla kokulala ngenxa yeentlungu ezisezantsi? Ukuhlolwa kwenjongo yomsebenzi we-trunk. J. Eur Spine 1992;1: 29-31. i-doi: 10.1007 / BF00302139. [PubMed] [Umnqamlezo]
178. Szpalski M, Hayez JP. Uvavanyo olusebenzayo lwenjongo yokusebenza kwe-tenoxicam kwonyango lwentlungu ephantsi: i-double-blind blind-study study. Br J Rheumatol. 1994;33: 74-78. I-doi: 10.1093 / rheumatology / 33.1.74. [PubMed] [Umnqamlezo]
179. I-Tesio L, i-Merlo A. Ukuzenzekela ngokubambisana ne-traction trasive: i-study control evulekile kwi-disc ye-disc. IArch Phys Med Rehabil. 1993;74:871–876. doi: 10.1016/0003-9993(93)90015-3. [PubMed][Umnqamlezo]
180. I-Topol EJ. Ukungaphumeleli kwimpilo yoluntu-rofecoxib, Merck, kunye ne-FDA. N Engl J Med. 2004;351: 1707-1709. i-doi: 10.1056 / NEJMp048286. [PubMed] [Umnqamlezo]
181. Torstensen TA, Ljunggren AE, Meen HD, Odland E, Mowinckel P, Geijerstam SA. Ukusebenza kakuhle kunye neendleko zonyango lwezobuchopho, i-physiotherapy yesiganeko kunye nokuzivocavoca kwezigulane ezineentlungu ezingapheliyo zentlungu: i-pragmatic, i-blind-blinded, i-trial-controlled control, kunye ne-1-year-up. Isihlwele. 1998;23:2616–2624. doi: 10.1097/00007632-199812010-00017. [PubMed] [Umnqamlezo]
182. Triano JJ, McGregor M, Hondras MA, Brennan PC. Ulwaphulo oluxilisayo ngokumalunga nemfundo kwiintlungu ezingapheliyo. Isihlwele. 1995;20:948–955. doi: 10.1097/00007632-199504150-00013. [PubMed] [Umnqamlezo]
183. Turner JA. Uthelekiso lweqela lokuqeqesha nokuphucula uqeqesho lwenkcazo yokuziphatha yeengxaki ezingaphantsi. J Consult Consulting Psychol. 1982;50:757–765. doi: 10.1037/0022-006X.50.5.757. [PubMed] [Umnqamlezo]
184. I-Turner JA, uClancy S. Ukuqhathaniswa kwendlela yokusebenza yendlela yokuziphatha-yokuziphatha kunye neyokuziphatha kwengxaki yokugula engapheliyo. J Consult Consulting Psychol. 1988;56:261–266. doi: 10.1037/0022-006X.56.2.261.[PubMed] [Umnqamlezo]
185. I-Turner JA, i-MP yeJensen. Ukusebenza kwonyango yolwazi lweengxaki zentlungu engapheliyo. Ubuhlungu. 1993;52:169–177. doi: 10.1016/0304-3959(93)90128-C. [PubMed] [Umnqamlezo]
186. I-Turner JA, uClancy S, uMcQuade KJ, uCardenas DD. Ukusebenza kwonyango yokuziphatha ngenxa yeentlungu ezingapheliyo zentlungu: ukuhlaziywa kwamacandelo. J Consult Consulting Psychol. 1990;58:573–579. doi: 10.1037/0022-006X.58.5.573. [PubMed] [Umnqamlezo]
187. Underwood MR, uMorgan J. Ukusetyenziswa kwemigangatho yokufundisa eklasini yokubuyisela ekunyangekeni kweentlungu ezisezantsi zonyango. Fam Pract. 1998;15: 9-15. I-doi: 10.1093 / fampra / 15.1.9. [PubMed][Umnqamlezo]
188. U-Valle-Jones JC, u-Walsh H, u-O'Hara J, uOHara H, uDavey NB, u-Hopkin-Richards H. Uvavanyo olulawulwayo lwe-back support kwiigulane ezineentlungu ezingezantsi. Curr Med Res Opin. 1992;12: 604-613.[PubMed]
189. Heijden GJMG, Beurskens AJHM, Dirx MJM, uBurter LM, uLindeman E. Ukusebenza kwe-lumbar traction: ilingo lezonyango elingenamsebenzi. Omzimba. 1995;81:29–35. doi: 10.1016/S0031-9406(05)67032-0.[Umnqamlezo]
190. I-MW, i-Scholten RJPM, i-Koes BW, i-Deyo RA. Izidakamizwa ezingekho-steroidal ezichasayo zintlungu ezibuhlungu ezisezantsi: ukuphononongwa okucwangcisiweyo kwisakhelo se-Cochrane Co-collaboration. Isihlwele. 2000;25:2501–2513. doi: 10.1097/00007632-200010010-00013. [PubMed] [Umnqamlezo]
191. I-Tulder M, i-Furlan A, i-Bombardier C, i-Bouter L. Izikhokelo zendlela ezihlaziyiweyo zokuphononongwa ngokuchanekileyo kwi-Cochrane Colaboration I-Review Review Group. Isihlwele. 2003a;28:1290–1299. doi: 10.1097/00007632-200306150-00014. [PubMed] [Umnqamlezo]
192. I-MW, i-Touray T, i-Furlan AD, i-Solway S, i-Bouter LM. Ukuphucula izidumbu zeentlungu ezingaphantsi kwamanzi: ukuphononongwa okuhlelekile kwisakhelo seCocrane Cooperation. Isihlwele. 2003b;28:1978–1992. doi: 10.1097/01.BRS.0000090503.38830.AD. [PubMed] [Umnqamlezo]
193. I-Tulder M, i-Furlan A, i-Gagnier J. I-Complementary kunye nezinye iindlela zokwelapha iintlungu eziphantsi. Ballieres Best Pract Rheumatol. 2005;19: 639-654. I-doi: 10.1016 / j.berh.2005.03.006. [PubMed] [Umnqamlezo]
194. UVideman T, uHeikkila J, Partanen T. Ucwaningo oluphindaphindileyo oluphambeneyo lwe-meptazinol kunye ne-diflunisal kunyango lwe-lumbago. Curr Med Res Opin. 1984;9: 246-252. [PubMed]
195. I-Vollenbroek-I-Hutten i-MMR, iHermens HJ, i-Wever D, i-Gorter M, iRinket J, i-IJzerman MJ. Ulwahlula kwisiphumo se-multidisciplinary treatment phakathi kwamagqabantshintshi asisigxina esiphathekayo esiphathekayo esichazwa usebenzisa izixhobo ezimbini zokuhlola i-multiaxial: i-inventory multidimensional inventory kunye ne-lumbar dynamometry. KwiKlinikhi yokubuyisela. 2004;18:566–579. doi: 10.1191/0269215504cr772oa. [PubMed] [Umnqamlezo]
196. UVroomen PJAJ, uMarc CTFM, uWilmink JT, u-Kester ADM, uKnottnerus JA. Ukungabi nokusebenza kokuphumla kombhede we-sciatica. N Engl J Med. 1999;340: 418-423. I-doi: 10.1056 / NEJM199902113400602. [PubMed][Umnqamlezo]
197. Waagen GN, Haldeman S, Cook G, Lopez D, DeBoer KF. Iilingo elifutshane elijongene nokulungiswa kwe-chiropractic ukwenzela ukukhululeka kweentlungu ezingapheliyo. Manual Med. 1986;2: 63-67.
198. UWaddell G. Imodeli entsha yeklinikhi yokunyangwa kwentlungu ephantsi. Isihlwele. 1987;12:632–644. doi: 10.1097/00007632-198709000-00002. [PubMed] [Umnqamlezo]
199. Walker L, uSvenkerud T, Weber H. Traksjonsbehandling ved lumbago-ischias. Qhagamshelana ne-Spina-trac. Fysioterapeuten. 1982;49: 161-163.
200. Iwadi N, iBokan JA, i-Phillips M, i-Benedetti C, i-Butler S, i-Spengler D. Iingxaki zokuxhatshazwa kwiintlungu ezibuhlungu kunye nokudandatheka: i-doxepin kunye ne-desipramine xa kuthelekiswa. J Clin Psychiatry. 1984;45: 54-57.[PubMed]
201. I-Waterworth RF, i-Hunter A. Ukufundwa ngokuvulekileyo kwindlela yokwelapha i-diflunisal, eyalondolozayo neyonyango ekulawuleni ubuhlungu obunzima bokubuyisela emuva. NZ Med J. 1985;95: 372-375. [PubMed]
202. I-H. H. Traction unyango kwi-sciatica ngenxa ye-disc incela. J Oslo City Hospital. 1973;23: 167-176.[PubMed]
203. UHeber H, uAasand G. Impembelelo ye phenylbutazone kwizigulane ezine-acala lumbago-sciatica: ityala eliyimfama elimbini. J Oslo City Hospital. 1980;30: 69-72. [PubMed]
204. Weber H, uLjunggren E, Walker L. Utyando lwezonyango kwizigulane ezineeskrini ze-lumbar intervertebral. J Oslo City Hospital. 1984;34: 61-70. [PubMed]
205. UHeber H, Holme I, Amlie E. Inkambo yemvelo ye-sciatica enomdla ngeempawu zeengcambu zesibindi esilawulwa yi-placebo ezivandlakisayo ukuvavanya umphumo we-piroxicam. Isihlwele. 1993;18:1433–1438. doi: 10.1097/00007632-199312000-00021. [PubMed] [Umnqamlezo]
206. I-Werners R, iPynsent PB, i-Bulstrode CJK. Iilingo ezingalindelekanga ukuthelekisa unyango oluphazamisayo kunye ne-lumbar traction and massage ekulawuleni iintlungu ezisezantsi kwiindawo zokunyamekela. Isihlwele. 1999;24:1579–1584. doi: 10.1097/00007632-199908010-00012. [PubMed] [Umnqamlezo]
207. UWiesel SW, iJuck Cuckler, uDeluca F, uJohn F, uZeide MS, uRothman RH. Iintlungu zentlungu ephantsi: ukuhlalutya kwinjongo yonyango olulondolozayo. Isihlwele. 1980;5:324–330. doi: 10.1097/00007632-198007000-00006. [PubMed] [Umnqamlezo]
208. UWilkinson MJ. Ngaba ikhefu le-48 yekhefu lokuphumla liba nefuthe kwisiphumo seentlungu ezisezantsi? Br J Gen Pract. 1995;45: 481-484. [Inkcazelo yamahhala ye-PMC] [PubMed]
209. UWörz R, uBolten W, iHerber J, uKrainick U, i-Pergande G. I-Flupirtin im vergleich i-chlormezanon kunye ne-placebo i-chronische i-muskuloskelettalen i-ruckenschmerzen. I-Fortschritte der Therapie. 1996;114(35-36): 500-504. [PubMed]
210. UWreje U, Nordgren B, Aberg H. Ukonyango kwe-pelvic ukungasebenzi kwezinto eziphambili-uphando olulawulwayo. I-Scand J Prim Health Care. 1992;10: 310-315. i-doi: 10.3109 / 02813439209014080. [PubMed][Umnqamlezo]
211. Yelland MJ, Glasziou PP, Bogduk N, Schluter PJ, McKernon M. Iiprojekti ze-prolotherapy, injection saline, kunye nokuzivocavoca iintlungu ezingapheliyo: iilingo ezingenangqondo. Isihlwele. 2004;29:9–16. doi: 10.1097/01.BRS.0000105529.07222.5B. [PubMed] [Umnqamlezo]
212. UZachrisson Forsell M. Isikolo esikolweni. Isihlwele. 1981;6:104–106. doi: 10.1097/00007632-198101000-00022. [PubMed] [Umnqamlezo]
213. Zylbergold RS, iPiper MC. Isifo se-Lumbar sisifo: uhlalutyo olulinganiswa nolunye unyango lwezonyango. IArch Phys Med Rehabil. 1981;62: 176-179. [PubMed]
Thumela i-Disclaimer

Umgangatho wobuchule wokuSebenza *

Ulwazi olulapha ku "Amanqanaba okuNyango angabonakaliyo kwiMbuyiselo yokubuyisela e-El Paso, TX"Ayenzelwanga ukuthatha indawo yobudlelwane obubodwa kunye nomntu oqeqeshiweyo wezempilo, okanye ugqirha onelayisenisi, kwaye akusiyo ingcebiso yezonyango. Siyakukhuthaza ukuba wenze izigqibo zakho zokhathalelo lwempilo ngokusekelwe kuphando lwakho kunye nentsebenziswano kunye nengcali yezempilo eqeqeshiweyo. .

Ulwazi lweBlog kunye neengxoxo zoMda

Umda wethu wolwazi ilinganiselwe kwiChiropractic, i-musculoskeletal, amayeza omzimba, impilo, igalelo le-etiological ukuphazamiseka kwe-viscerosomatic ngaphakathi kweentetho zeklinikhi, ezinxulumene ne-somatovisceral reflex clinical dynamics, i-subluxation complexes, imiba yezempilo ebuthathaka, kunye / okanye amanqaku amayeza asebenzayo, izihloko kunye neengxoxo.

Sibonelela kwaye sibonise intsebenziswano yeklinikhi neengcaphephe kuluhlu olubanzi lwamacandelo. Ingcali nganye ilawulwa ngumsebenzi wabo wobugcisa kunye negunya labo lokufumana iphepha-mvume. Sisebenzisa iiprothokholi ezisebenzayo zempilo kunye nempilo entle ukunyanga nokuxhasa ukhathalelo kumonzakalo okanye ukuphazamiseka kwenkqubo ye-musculoskeletal.

Iividiyo zethu, iiposti, izihloko, izifundo, kunye nokuqonda kugubungela imicimbi yeklinikhi, imiba kunye nezihloko ezinxulumene nokuxhasa, ngokuthe ngqo okanye ngokungathanga ngqo, umda weklinikhi yethu yokusebenza.

Iofisi yethu yenze iinzame ezifanelekileyo zokubonelela ngeziqendu ezixhasayo kwaye ichonge uphando olufanelekileyo okanye izifundo ezixhasa izithuba zethu. Sinikezela ngeekopi zophando ezixhasayo ezifumanekayo kwiibhodi ezilawulayo nakuluntu ngesicelo.

Siyaqonda ukuba sigubungela imicimbi efuna inkcazo eyongezelelweyo yokuba inganceda njani kwisicwangciso esithile sokhathalelo okanye inkqubo yonyango; ke, ukuqhubeka nokuxoxa ngombandela ongentla, nceda ukhululeke ukubuza UDkt Alex Jimenez DC okanye qha ga mshelana nathi 915-850-0900.

Silapha ukunceda wena kunye nosapho lwakho.

Iintsikelelo

UDkt Alex Jimenez DC, I-MSACP, I-CCST, IFMCP*, I-CIFM*, I-ATN*

email: qeqeshi@elpasofunctionalmedicine.com

Ilayisenisi kwi: Texas & New Mexico*

UGqr. Alex Jimenez DC, MSACP, CIFM*, IFMCP*, ATN*, CCST
Ikhadi lam loShishino lweDijithali

Kwakhona Siyakwamkela¸

Injongo yethu kunye nokuThatheka: NdinguGqirha weChiropractic egxile ekuqhubekeni, kunyango olunqamlezileyo kunye neenkqubo zokusebenza kwimo yesiqhelo egxile kunyango lweklinikhi, impilo iyonke, uqeqesho lwamandla, kunye nemeko epheleleyo. Sijolise ekubuyiseleni imisebenzi yesiqhelo yomzimba emva kwentamo, umva, umqolo kunye nokwenzakala kwezicubu ezithambileyo.

Sisebenzisa iiProtocol ezikhethekileyo zeChiropractic, iiNkqubo zeMpilo, ukuSebenza kunye nokuHlanganisa kwesondlo, ubuGcisa kunye noQeqesho loQeqesho loQeqesho, kunye neNkqubo yokuHlaziya kuyo yonke iminyaka.

Njengolwandiso ekuvuseleleni ngokufanelekileyo, nathi sinika abaguli bethu, amagqala akhubazekileyo, iimbaleki, abancinci nabadala iphothifoliyo eyahlukeneyo yezixhobo zamandla, imithambo ephezulu yokusebenza, kunye nokhetho lonyango oluphambili. Siye sasebenza kunye nezixeko eziziintloko zoogqirha, iingcali zonyango, kunye nabaqeqeshi ukubonelela iimbaleki ezikhuphisanayo ezikumgangatho ophakamileyo amathuba okuzinyanzela kwezona zakhono zawo aphezulu kwizibonelelo zethu.

Siyintsikelelo ukusebenzisa iindlela zethu kunye namawaka e-El Pasoans kwiminyaka emashumi amathathu edlulileyo esivumela ukuba sibuyise impilo yethu yezigulane kunye nokuqina xa sisenza uphando lweendlela ezingezizo uphando kunye neenkqubo zokuphila kakuhle.

Iinkqubo zethu zendalo kwaye zisebenzisa amandla omzimba ukufezekisa iinjongo ezithile ezilinganisiweyo, endaweni yokuzisa iikhemikhali eziyingozi, ukutshintshwa kwehomoni enempikiswano, utyando olungafunekiyo, okanye iziyobisi. Sifuna ukuba uphile ubomi obusebenzayo obuzalisekayo ngamandla ngakumbi, isimo sengqondo esifanelekileyo, ukulala okungcono, kunye nentlungu encinci. Injongo yethu kukuxhobisa abaguli bethu ekugcineni eyona ndlela isempilweni yokuphila.

Ngomsebenzi omncinci, sinokufikelela kwimpilo efanelekileyo kunye, kungakhathaliseki ukuba ubudala okanye ukukhubazeka.

Joyina nathi ekuphuculeni impilo yakho kunye nentsapho yakho.

Imalunga noku: UKUPHILA, UKUTHANDA NOKUTHANDA!

Wamkelekile kwaye uThixo akusikelele

EL PASO

Icala laseMpuma: Iklinikhi engundoqo*
11860 Vista Del Sol, Ste 128
ifowuni: 915-412-6677

Ephakathi: IZiko lokuHlaziya
6440 Gateway East, Ste B
ifowuni: 915-850-0900

North East IZiko lokuHlaziya
7100 Airport Blvd, Ste. C
ifowuni: 915-412-6677

UDkt Alex Jimenez DC, MSACP, CIFM, IFMCP, ATN, CCST
Ikhadi lam loShishino lweDijithali

Iikliniki Indawo 1

idilesi: I-11860 Vista Del Sol I-Dr Suite 128
El Paso, TX 79936
mfono
: (915) 850-0900
ImeyliThumela Email
webUGqrAlexJimenez.com

Iikliniki Indawo 2

idilesi: I-6440 Gateway East, isakhiwo B
El Paso, TX 79905
ifowuni: (915) 850-0900
ImeyliThumela Email
webElPasoBackClinic.com

Iikliniki Indawo 3

idilesi: 1700 N Zaragoza Rd # 117
El Paso, TX 79936
ifowuni: (915) 850-0900
ImeyliThumela Email
webChiropracticScientist.com

Dlala nje ukomelela kunye nokuRehab*

idilesi: 7100 Airport Blvd, Suite C
El Paso, TX 79906
ifowuni: (915) 850-0900
ImeyliThumela Email
webChiropracticScientist.com

Push njengeRx kunye neRehab

idilesi: I-6440 Gateway East, isakhiwo B
El Paso, TX 79905
mfono
: (915) 412-6677
ImeyliThumela Email
webPushAsRx.com

Push 24 / 7

idilesi: 1700 E Cliff uDkt
El Paso, TX 79902
mfono
: (915) 412-6677
ImeyliThumela Email
webPushAsRx.com

UBHALISO LWEMICIMBI: Iziganeko ezibukhoma kunye neeWebinars*

(Yiza ujoyine nathi kwaye ubhalise namhlanje)

Akukho Minyhadala ifunyenweyo

Ifowuni (915) 850-0900 Namhlanje!

Ilinganiswe nguGqirha oPhezulu we-El Paso kunye neNgcali ngeRateMD * | Iminyaka 2014, 2015, 2016, 2017, 2018, 2019, 2020 & 2021

Eyona chiropractor i-El Paso

Skena iKhowudi yeQR Apha-Qhagamshelana Apha noGqr Jimenez Ngokwakho

Qrcode Chiropractor
UGqr Jimenez QR Code

Amakhonkco ongezelelweyo kwi-Intanethi kunye nezixhobo (ziyafumaneka 24/7)

  1. Ukuqeshwa kwi-Intanethi okanye Ukudibana:  bit.ly/Book-Online-Appointment
  2. Ukonzakala kwe-Intanethi ngokwasemzimbeni / Ifom yokuThathwa kwengozi:  bit.ly/Fill-Out-Your-Online-History
  3. Uvavanyo lweMayeza oluSebenzayo kwi-Intanethi:  bit.ly/functionmed

I-Disclaimer*

Ulwazi olulapha alujoliswanga ukuba luthathe indawo yobudlelwane buqu kunye nomqeqeshi oqeqeshiweyo wezempilo, ugqirha onelayisensi, kwaye ayililo ingcebiso kwezonyango. Siyakukhuthaza ukuba wenze izigqibo zokhathalelo lwempilo ngokubhekisele kuphando lwakho kunye nentsebenziswano kunye noqeqesho kukhathalelo lwempilo. Umda wethu wolwazi ukhawulelwe kwi-chiropractic, musculoskeletal, amayeza omzimba, impilo, imiba yezempilo ebuthathaka, amanqaku amayeza asebenzayo, izihloko kunye neengxoxo. Sinikezela kwaye sibonise intsebenziswano yeklinikhi kunye neengcali ezivela kuluhlu olubanzi lwezifundo. Ingcali nganye ilawulwa ngumsebenzi wabo wobugcisa kunye negunya labo lokufumana iphepha-mvume. Sisebenzisa iiprothokholi ezisebenzayo zempilo kunye nempilo entle ukunyanga nokuxhasa ukhathalelo kumonzakalo okanye ukuphazamiseka kwenkqubo ye-musculoskeletal. Iividiyo zethu, izithuba, izihloko, imixholo, kunye nokuqonda kugubungela imiba yezonyango, imiba, kunye nezihloko ezinxulumene nenkxaso, ngokuthe ngqo okanye ngokungathanga ngqo, umda wokuziqhelanisa wekliniki.* I-ofisi yethu yenze umzamo ofanelekileyo wokunika ucaphulo oluxhasayo kwaye ichonge. isifundo sophando esifanelekileyo okanye izifundo ezixhasa izithuba zethu. Sinikezela ngeekopi zophando ezixhasayo ezifumanekayo kwiibhodi ezilawulayo nakuluntu ngesicelo.

Siyaqonda ukuba sigubungela imicimbi efuna inkcazo eyongezelelweyo yokuba inganceda njani kwisicwangciso esithile sokhathalelo okanye inkqubo yonyango; ke, ukuqhubeka nokuxoxa ngombandela ongentla, nceda ukhululeke ukubuza UDkt Alex Jimenez okanye qha ga mshelana nathi 915-850-0900.

UDkt Alex Jimenez DC, I-MSACP, I-CCST, IFMCP*, I-CIFM*, I-ATN*

email: qeqeshi@elpasofunctionalmedicine.com

Ifowuni: 915-850-0900

Ilayisenisi kwi I-Texas kunye neNew Mexico *

UDkt Alex Jimenez DC, MSACP, CIFM, IFMCP, ATN, CCST
Ikhadi lam loShishino lweDijithali

Thumela i-Disclaimer

Umgangatho wobuchule wokuSebenza *

Ulwazi olulapha ku "Amanqanaba okuNyango angabonakaliyo kwiMbuyiselo yokubuyisela e-El Paso, TX"Ayenzelwanga ukuthatha indawo yobudlelwane obubodwa kunye nomntu oqeqeshiweyo wezempilo, okanye ugqirha onelayisenisi, kwaye akusiyo ingcebiso yezonyango. Siyakukhuthaza ukuba wenze izigqibo zakho zokhathalelo lwempilo ngokusekelwe kuphando lwakho kunye nentsebenziswano kunye nengcali yezempilo eqeqeshiweyo. .

Ulwazi lweBlog kunye neengxoxo zoMda

Umda wethu wolwazi ilinganiselwe kwiChiropractic, i-musculoskeletal, amayeza omzimba, impilo, igalelo le-etiological ukuphazamiseka kwe-viscerosomatic ngaphakathi kweentetho zeklinikhi, ezinxulumene ne-somatovisceral reflex clinical dynamics, i-subluxation complexes, imiba yezempilo ebuthathaka, kunye / okanye amanqaku amayeza asebenzayo, izihloko kunye neengxoxo.

Sibonelela kwaye sibonise intsebenziswano yeklinikhi neengcaphephe kuluhlu olubanzi lwamacandelo. Ingcali nganye ilawulwa ngumsebenzi wabo wobugcisa kunye negunya labo lokufumana iphepha-mvume. Sisebenzisa iiprothokholi ezisebenzayo zempilo kunye nempilo entle ukunyanga nokuxhasa ukhathalelo kumonzakalo okanye ukuphazamiseka kwenkqubo ye-musculoskeletal.

Iividiyo zethu, iiposti, izihloko, izifundo, kunye nokuqonda kugubungela imicimbi yeklinikhi, imiba kunye nezihloko ezinxulumene nokuxhasa, ngokuthe ngqo okanye ngokungathanga ngqo, umda weklinikhi yethu yokusebenza.

Iofisi yethu yenze iinzame ezifanelekileyo zokubonelela ngeziqendu ezixhasayo kwaye ichonge uphando olufanelekileyo okanye izifundo ezixhasa izithuba zethu. Sinikezela ngeekopi zophando ezixhasayo ezifumanekayo kwiibhodi ezilawulayo nakuluntu ngesicelo.

Siyaqonda ukuba sigubungela imicimbi efuna inkcazo eyongezelelweyo yokuba inganceda njani kwisicwangciso esithile sokhathalelo okanye inkqubo yonyango; ke, ukuqhubeka nokuxoxa ngombandela ongentla, nceda ukhululeke ukubuza UDkt Alex Jimenez DC okanye qha ga mshelana nathi 915-850-0900.

Silapha ukunceda wena kunye nosapho lwakho.

Iintsikelelo

UDkt Alex Jimenez DC, I-MSACP, I-CCST, IFMCP*, I-CIFM*, I-ATN*

email: qeqeshi@elpasofunctionalmedicine.com

Ilayisenisi kwi: Texas & New Mexico*

UGqr. Alex Jimenez DC, MSACP, CIFM*, IFMCP*, ATN*, CCST
Ikhadi lam loShishino lweDijithali

thenga ivermectin ebantwini ivermectin iyathengiswa