I-Carpal Tunnel Syndrome

Abantu abaningi bavuka phakathi kwamabili benesithukuthezi noma beluma ezandleni zabo, bengazi ukuthi bangase babe ne-carpal tunnel syndrome. Lesi simo esivamile sithinta izigidi emhlabeni wonke, ikakhulukazi labo abachitha amahora amaningi bebhala, besebenzisa amathuluzi, noma benyakazisa izandla ngokuphindaphindiwe. Lo mhlahlandlela ophelele uhlola isifo somhubhe we-carpal, kusukela ezimbangela nezimpawu zayo kuya ezinketho zokwelapha namasu okuvimbela.

Iyini i-Carpal Tunnel Syndrome?

Kuyisimo esivamile esihlobene nemizwa nethambo esithinta isandla nesihlakala, okubangela izimpawu ezihlukahlukene ezingakhululekile. Lesi simo senzeka lapho i-nerve median, egijima ngendlela ewumngcingo esihlakaleni (umhubhe we-carpal), icindezelwa noma icasukile.

Umhubhe we-carpal uyindlela ekhethekile esihlakaleni, efana nomhubhe onqamula entabeni. Umhubhe we-carpal udala indlela yezakhiwo ezibalulekile:

• Imisipha eyisishiyagalolunye yokunyakaza kweminwe
• Inzwa ephakathi
• Imithambo yegazi ehlukahlukene
• Imisipha kanye nezicubu ezithambile

I-median nerve idlala indima yokuqala ekusebenzeni kwesandla, ihlinzeka ngokuzwa kweminwe eminingi futhi ilawule ukunyakaza kwezithupha. Le nerve isiza kuyo yomibili imisebenzi yezinzwa (umuzwa) kanye nemisebenzi yemoto (ukunyakaza) esithupheni naseminweni emithathu yokuqala.

Lapho le nerve icindezeleka ngaphakathi komhubhe we-carpal, ingaholela ezimpawu nezinkinga ezahlukahlukene. Kucabange njengepayipi lengadi linyathelwa - lapho kufakwa ingcindezi, ukugeleza kuvinjelwe, okubangela izinkinga ezansi nomfula. Ngokufanayo, lapho i-nerve median icindezelekile, ayikwazi ukusebenza kahle, okuholela ezimpawu zesici se-carpal tunnel syndrome.

Izimpawu zeCarpal Tunnel Syndrome

Lesi simo singase sibe uhlangothi olulodwa (okubandakanya isihlakala esisodwa) noma i-carpal tunnel syndrome yamazwe amabili (ehlanganisa zombili izihlakala). Izimpawu zokuqala zihlanganisa:

• Ukuba ndikindiki esihlakaleni, esandleni naseminweni
• Imizwa yokuluma, efana nezikhonkwane nezinaliti
• Ubuhlungu bezinzwa esihlakaleni, esandleni, noma eminweni
• Ubuthakathaka lapho ubamba izinto
• Ubunzima ngokunyakaza okuqondile

Lezi zimpawu zivame ukukhula kancane kancane ngokuhamba kwesikhathi, nezimpawu zokuqala zivame ukuvela ebusuku. Abantu abaningi babika ukuthi bavuswa ukungaphatheki kahle, okungase kuzwakale njengokugwazwa okubukhali, okushisayo noma ukuqaqamba okungapheli. Njengoba isimo siqhubeka, le mizwa ingase iqale ukwenzeka phakathi nemisebenzi yasemini.

Abantu bangase badinge usizo ngemisebenzi evamile efana nokubamba ifoni, ukubamba isondo lokushayela, noma ukuthayipha ikhibhodi. Ukungakhululeki kuvame ukuzwakala sengathi kuvela ngaphakathi esandleni noma esihlakaleni kunobuhlungu obuphezulu. Abanye abantu bazwa umuzwa ofana nezandla zabo “ezilalayo,” okuholela ekutheni baxhawule njengokungathi bazama ukubaphuca amanzi.

Isici esisodwa esihlukile siwumthelela wamandla esandla kanye nobuciko. Imisebenzi edinga ukunyakaza kweminwe okunembile, njengokubopha izinkinobho zehembe, ingase ibe nzima nakakhulu. Lokhu kuncipha kokuxhumana namandla kungenza ngisho nemisebenzi elula yansuku zonke ibe inselele futhi ikhungathekise.

Izimbangela Nezingozi Ze-Carpal Tunnel Syndrome

Ucwaningo lwakamuva lubonisa ukuthi izakhi zofuzo zidlala indima ebaluleke kakhulu kunalokho obekucatshangwa ngaphambili, umlando womndeni uyisici esiyingozi esiyingozi.

• Izimo eziningana zezokwelapha zandisa kakhulu ingozi yokuthuthukisa i-carpal tunnel syndrome:
  • Isifo sikashukela (cishe ama-20% eziguli ezinesifo sikashukela ziba nalesi simo)
  • rheumatoid arthritis
  • I-Hypothyroidism
  • Ukukhuluphala
  • ukukhulelwa
• Imisebenzi enobungozi obukhulu:
  • Ukunyakaza okuphindaphindiwe kwesandla nesihlakala
  • Ukusetshenziswa kwamathuluzi amandla adlidlizayo
  • Ukunwebeka isikhathi eside noma ukunwetshwa kwesihlakala
  • Umsebenzi womugqa wokuhlanganisa
  • Ukucubungula nokupakisha ukudla

Izinkinga zeCarpal Tunnel Syndrome

Ukulimala kwezinzwa unomphela kungenye yezinkinga ezimbi kakhulu. Lapho i-nerve median ihlala icindezelekile isikhathi eside, ingabangela umonakalo ongenakulungiseka. Lokhu kungaholela kokuthi:

• Ukulahlekelwa unomphela umuzwa eminwe nasesithuphani
• Ukunciphisa ukusebenzisana kwezandla
• Ubunzima bokwenza imisebenzi eyisisekelo
• Ubuthakathaka bemisipha esandleni esithintekile
• Ukulahlekelwa unomphela kokusebenza kwesandla

Sifo

Ngesikhathi sokuhlolwa komzimba, odokotela bahlola amandla esandla nokuzwa ngenkathi befuna izinkomba ezithile. Bangase benze izivivinyo ezimbalwa ezikhethekile ukuze bahlole isimo:

• Ukuhlolwa Kwezimpawu zika-Tinel: Udokotela uthepha umthambo omaphakathi wesandla ukuze ahlole ukuthi awuzwani nokuluma
• Ukuhlolwa kukaPhalen: Kubandakanya ukusunduza indawo engemuva yezandla ndawonye imizuzwana engama-30-60
• Ukuhlolwa kokucindezela kwe-Carpal: Ukufaka ingcindezi phezu kwenzwa emaphakathi imizuzwana engu-30 ukuhlola ukuba ndikindiki
• I-Electromyography (EMG): I-EMG ikala umsebenzi kagesi wemisipha kusetshenziswa ama-electrode enaliti encane, kuyilapho izifundo ze-nerve conduction zihlola ijubane lama-impulses kagesi ngokusebenzisa i-nerve median. Lezi zivivinyo zisiza ukunquma ubukhali bokucindezelwa kwezinzwa futhi zikhiphe ezinye izimo ezingase zidale izimpawu ezifanayo.

Ukwelashwa kwe-Carpal Tunnel Syndrome

Odokotela ngokuvamile baqala ukwelashwa komhubhe we-carpal ngezindlela zokulondoloza ngaphambi kokucabangela izinqubo ezihlaselayo.

• Ukwelashwa okungahlinzeki: Isigaba sokuqala sokwelashwa sigxile ekukhetheni okungezona ukuhlinzwa:
  • Ukuhlukaniswa Kwesihlaka: Isebenza kahle kakhulu uma igqokwa ebusuku ukugcina isihlakala siqondile
  • Ukwelashwa Kwemvelo: Kubandakanya ukuzivocavoca kwe-nerve ne-tendon gliding ukuze kukhululeke izimpawu
  • Ukuguqulwa kwendlela yokuphila: Izinguquko kumishini yokusebenza kanye nemisebenzi yansuku zonke
  • Imithi elwa nokuvuvukala: Izidakamizwa ezidambisa izinhlungu ezitholakala ngaphandle kwe-counter ukuze uthole ukukhululeka kwesikhashana
  • Imijovo ye-Corticosteroid: Nikeza ukukhululeka kwesikhashana futhi unciphise ukuvuvukala
• Ukuhlinzwa: Lapho ukwelapha okulondolozayo kunganikezi impumuzo, odokotela bangase batuse ukungenelela kokuhlinzwa. Izindlela ezimbili eziyinhloko zokuhlinzwa ukuhlinzwa okuvulekile nokuhlinzwa kwe-endoscopic. Phakathi nalezi zinqubo, odokotela abahlinzayo bakhulula ingcindezi ku-nerve median ngokuhlukanisa i-carpal ligament eguquguqukayo.

Indlela ye-endoscopic ngokuvamile iholela ebuhlungwini obuncane ngemva kokuhlinzwa kanye nokululama ngokushesha uma kuqhathaniswa nokuhlinzwa okuvulekile. 

Uzoyibona Nini Udokotela

Izimpawu eziyisixwayiso ezidinga ukunakekelwa kwezempilo:

• Ukuba ndikindiki okuqhubekayo ezandleni naseminwe
• Ubuhlungu obuphindaphindayo noma imizwa elumayo
• Ubuthakathaka obuthinta imisebenzi yansuku zonke
• Izinguquko ekusebenzeni kwesandla noma ekuzweni
• Izimpawu eziphazamisa ukulala

Prevention

Ukuvimbela kugxile ekuvikeleni izihlakala nezandla ngokubeka ngendlela efanele kanye namasu okunyakaza.

I-Ergonomics yendawo yokusebenza: Abantu kufanele bagcine ukuma okufanele futhi baqinisekise ukuthi ukusethwa komsebenzi wabo kusekela izikhundla zezihlakala ezingathathi hlangothi. Lokhu kuhlanganisa ukusebenzisa amadivaysi e-ergonomic nokugcina ubude bedeski obufanelekile ukuze kubekwe isandla ngokunethezeka.

Ikhefu elivamile libalulekile ekuvimbeleni ubunzima. Ukuthatha ikhefu lemizuzu eyi-10-15 njalo ngehora kuvumela izandla nezihlakala ukuthi ziphumule futhi zilulame. Phakathi nalawa makhefu, abantu ngabanye bangenza izivivinyo ezilula ukuze balondoloze ukuguquguquka:

• Xuba izandla ngobumnene imizuzu engu-1-2
• Yenza izibhakela bese welula iminwe yakho
• Yenza ukwelula kwesihlakala okuthambile
• Prakthiza izivivinyo ze-tendon gliding

Izinyathelo Zokuvimbela Ezengeziwe:

• Gcina izihlakala ezingathathi hlangothi ngesikhathi semisebenzi
• Gwema ukunyakaza kwezandla okuphindaphindayo uma kungenzeka
• Sebenzisa amandla okubamba afanelekile emisebenzini
• Gcina izandla zifudumele ukuze uvimbele ukuqina
• Cabangela ukugqoka amasongo esihlakala ngesikhathi ulele

Isiphetho

I-Carpal tunnel syndrome ingase iqale ngokungaphatheki kahle, kodwa imiphumela yayo ingaba nomthelela omubi emisebenzini yansuku zonke nokusebenza komsebenzi. Amazinga empumelelo yokwelashwa ahlala ephezulu uma isimo sibanjwa kusenesikhathi. Izinguquko ezilula ezifana nokuma kwesihlakala okufanele, ukuphumula okuvamile, nokusetha indawo yokusebenza e-ergonomic kungavimbela noma kubambezele ukuqhubeka kwesimo. Ukwelashwa kwezokwelapha okusukela ekuhlakanipheni kuya ekuhlinzweni kunikeza izixazululo ezingokoqobo ezigulini eziningi lapho kudingeka.

Abantu ababhekana nokuba ndikindiki okungapheli kwesandla, ukuluma, noma ubuthakathaka akufanele balinde ukuthola usizo lwezokwelapha. Isenzo esisheshayo nezinyathelo ezifanele zokuvimbela zinikeza ithuba elihle lokuphatha i-carpal tunnel syndrome nokugcina impilo yesandla yesikhathi eside. Ukuzivivinya izandla okuvamile, i-ergonomics efanele, nokulungiswa kwendawo yokusebenza kudala isisekelo esiqinile sokuvikela izihlakala nezandla kulesi simo esivamile.

Imibuzo Evame Ukubuzwa

1. I-carpal tunnel syndrome inzima kangakanani?

I-Carpal tunnel syndrome ingabangela ukulimala okungapheli ku-nerve uma ishiywe ingalashwa. Isimo sivame ukuba sibi ngokuhamba kwesikhathi, okungase kubangele ukungasebenzi kahle kwesandla okungenakulungiseka, okuhlanganisa ukulahlekelwa ukuzwa nokuba buthakathaka. Ukungenelela kusenesikhathi kungavimbela izinkinga zesikhathi eside.

2. Iyiphi indlela esheshayo yokubuyisela emhubheni we-carpal?

Ukululama kuncike kubunzima nendlela yokwelashwa. Ezimweni ezithambile, izimpawu zingathuthuka phakathi nezinyanga eziyisithupha ngokunakekelwa okufanele. Izinto eziyinhloko zokutakula zihlanganisa:

• Ukugqoka isihlakala sesihlakala ngesikhathi sokulala kanye nemisebenzi ehlukumezayo
• Ukuthatha amakhefu avamile kusukela ekunyakazeni okuphindaphindayo
• Ukulandela izivivinyo ezibekiwe kanye nokwelula

3. Kungani umhubhe we-carpal ubi kakhulu ebusuku?

Ukukhathazeka ebusuku kwenzeka ngenxa yezizathu eziningana:

• Izindawo zokulala ezigobayo noma ezinweba isihlakala
• Ukugeleza kwegazi okuncishisiwe kuya emaphethelweni ngesikhathi sokulala
• Izinguquko ze-hormonal ezithinta ukugcinwa koketshezi

4. Ingabe umhubhe we-carpal ubucayi?

Lesi simo sidinga ukunakwa njengoba sithinta amacala angu-1-3 kubantu abayi-1,000 ngonyaka. Nakuba kungekona ukuphila engozini, kungabangela umonakalo ophelele, ongenakulungiseka wezinzwa ezimaphakathi uma ingelashwa, ibe nomthelela omkhulu ekusebenzeni kwesandla.

5. Umhubhe we-carpal uqala iminyaka emingaki?

Ibanga lobudala elisengozini yokuthola i-carpal tunnel syndrome yiminyaka engama-45-60, kanti i-10% kuphela yeziguli ezingaphansi kweminyaka engama-31. Nokho, lesi simo singathinta abantu banoma iyiphi iminyaka.

6. I-carpal tunnel syndrome izizwa kanjani?

Iziguli ngokuvamile ziba nenhlanganisela yemizwa:

• Ukuba ndikindiki eminweni nasezintweni zeminwe
• Ubuhlungu obubukhali, obushisayo noma ukuqaqamba okungapheli
• Imizwa yokuluma efana "nezikhonkwane nezinaliti"
• Ubuthakathaka lapho ubamba izinto

7. Ingabe umhubhe we-carpal ungathinta imilenze yakho?

Nakuba i-carpal tunnel syndrome ithinta ngokucacile izandla nezihlakala, izimpawu ezifanayo zokucindezelwa kwezinzwa zingenzeka kwezinye izingxenye zomzimba. Nokho, izimpawu zomlenze ziphakamisa isimo esihlukile futhi zidinga ukuhlolwa okuhlukile kwezokwelapha.

UDkt. Sohael Mohammed Khan

I-MBBS, i-MS (i-Orthopaedics), iDiploma (Ukuvuselelwa komgogodla)
I-Ganga CARE Hospital Limited, eNagpur

Ukuze Ubhukhe Isikhathi, shayela:

+ 91 40-68106529