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Osteoarthritis

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The commonest arthritis — cartilage wear in the thumb base, fingers, wrist and shoulder — its symptoms, management ladder and outlook.

Isang kamay na may mga buntong, pamamaga sa mga kasu-kasuan ng daliri na katangian ng osteoarthritis.
Ang osteoarthritis ay madalas na nagpapakita ng matigas, butong pamamaga sa mga kasukasuan ng daliri — Heberden's nodes sa mga dulo ng daliri at Bouchard's nodes sa mga gitnang kasukasuan. Drahreg01 / Wikimedia Commons, CC BY-SA 3.0

Ang pahinang ito ay isinalin ng makina at hindi pa nasusuri ng isang doktor. Ang bersyong Ingles ang siyang opisyal.

Ano ang nararamdaman mo

Ang osteoarthritis ay karaniwang dahan-dahang dumadating. Nagsisimula ang isang kasukasuan na masaktan, kadalasan kapag ginagamit at sa dulo ng araw, at nagpapagaan kapag nakapahinga. Maraming tao ang nakakapansin ng maikling panahon ng pagkatigas sa umaga na nagliluwag sa loob ng humigit-kumulang kalahating oras, o pagkatigas matapos manatiling tahimik sa pag-upo ng ilang panahon.

Sa itaas na bahagi ng katawan, karaniwan itong tumatayo sa ilang kilalang lugar: ang base ng hinlalaki (kung saan ito ay nagtatagpo sa pulso), ang mga dulo ng kasukasuan ng mga daliri malapit sa mga kuko, ang mga gitnang kasukasuan ng daliri, ang pulso, ang maliit na kasukasuan sa itaas ng balikat (ang AC joint), at ang sariling balikat o siko. Maaaring maranasan ang isang pagkagrasa o pag-click habang gumagalaw ang kasukasuan, makakita ng mga bonyong pagbubulbol na pag-ubo sa paligid ng mga kasukasuan ng daliri, at makakahanap na ang kasukasuan ay hindi yumuyuko o nagtatuwid nang kasing layo ng dati. Mahina ang hawak, at ang mga mahirap na gawain (pag-ikot ng susi, pagbubukas ng bote, pagkakabit ng mga pindutan) ay nagiging mas mahirap. Minsan, ang isang kasukasuan ay maaaring lumakas, nagiging mas masakit, namamaga, at mainit sa loob ng ilang araw o linggo bago bumalik sa normal.

Ano ang nangyayari talaga

Sa loob ng isang malusog na kasukasuan, ang mga dulo ng mga buto ay may takip na cartilage, isang makinis at madulas na patong na nagpapahintulot sa kanilang maglisan sa isa’t isa halos nang walang alitan. Sa osteoarthritis, unti-unting naninipis at nagiging magaspang ang cartilage na iyon, kaya nawawala ang paglisan at nagiging matigas at masakit ang galaw.

Ang buto sa ilalim nito ay tumutugon sa karagdagang bigat. Maaari itong makapal, at inilalagay ng katawan ang maliit na mga butong tumutubo (osteophytes) sa mga gilid ng kasukasuan; ang mga ito ang mga magaspang na bulubunduking nararamdaman mo sa paligid ng mga kasukasuan ng daliri (karaniwang tinatawag na Heberden's nodes sa mga dulo ng kasukasuan at Bouchard's nodes sa mga gitnang kasukasuan). Maaaring magkaroon ng pamamaga ang lining ng kasukasuan sa mga panahon, na ito ang nararamdaman kapag may flare.

Nakatutulong ang pag-alala na ang osteoarthritis ay hindi simpleng "pagkasira" ng iyong mga kasukasuan dahil sa paggamit. Mas mainam na intindihin ito bilang proseso ng pagkukumpuni ng kasukasuan na hindi ganap na nakakapanatili, at ito ay pinapagana ng halo-halong mga bagay na hindi mo maaaring baguhin: pagtanda, iyong mga gene at pamilyar na kasaysayan, at mga lumang sugat (isang fracture o dislocation noong nakaraan ay kinikilala), kasama kung gaano karaming bigat ang dala ng isang kasukasuan. Ang pagiging aktibo ay hindi nagdudulot ng pagkasira ng mga kasukasuan; sa katunayan, ang paggalaw ay tumutulong upang panatilihing malusog ang mga ito.

Ano ang maaari naming gawin dito

Karamihan sa mga taong may osteoarthritis ay maayos na pinamamahalaan nang walang operasyon. Ang layunin ay panatilihin ang galaw ng kasukasuan, bawasan ang sakit, at protektahan ang iyong kakayahan, at may malinaw na hakbang ng mga pagpipilian.

Panatilihin ang paggalaw at manatiling malakas. Ang banayad, regular na paggalaw at mga ehersisyo na nagpapalakas ng mga kalamnan sa paligid ng kasukasuan ay isa sa mga pinakaepektibong gamot. Ang isang hand therapist o physiotherapist ay maaaring bigyan ka ng tailored na programa at ipakita sa iyo kung paano mapapanatili ang range of movement.

Protektahan at i-pace. Ang mga maliit na pagbabago ay nagdudulot ng tunay na pagkakaiba: ang pagkakabahagi ng mas mabibigat na gawain sa loob ng araw, paggamit ng parehong kamay o mas malalaking hawakan, padded handles at jar openers, at mga splint (lalo na ang thumb-base splint) upang pahingahin at suportahan ang masakit na kasukasuan. Kung ang bigat ay naglalagay ng load sa isang kasukasuan, ang pagbawas ng kaunti ay makakatulong upang bawasan ang strain.

Simpleng pagpapagaan ng sakit. Ang paracetamol, at lalo na ang anti-inflammatory gels o creams na pinapahid sa kasukasuan, madalas na nakakatulong, kasama ang anti-inflammatory tablets na ginagamit sa mas maikling kurso kapag kinakailangan. Ang iyong doktor ay susukatin ito laban sa iyong ibang kalusugan.

Mga injection. Ang corticosteroid injection sa isang problematicong kasukasuan ay maaaring paiti ang flare at magbigay ng buwan ng pagpapagaan, na kapaki-pakinabang upang mapamahalaan ang masamang panahon.

Operasyon ay inihahanda para sa isang seryosong kasukasuan na nananatiling masakit at limitado kahit sa lahat ng nabanggit. Depende sa kasukasuan, maaaring ito ay nangangahulugan ng pagpapalit nito o pag-fuse nito (pagpapatigas nito upang alisin ang sakit). Ang mga ito ay magagandang operasyon kapag ang tamang oras ay dumating, ngunit sila ang huling hakbang, hindi ang unang hakbang.

Ano ang inaasahan

Ang osteoarthritis ay isang kondisyon na maaring pamahalaan, hindi isang patuloy na pagbaba. Para sa karamihan sa mga tao, ito’y may mga magandang panahon at obstruksyon, at ang larawan araw-araw ay nananatiling matatag sa loob ng mga taon. Maraming tao ang patuloy na gumagawa ng mga bagay na kanilang ginugustong gawin gamit ang ehersisyo, ang isang splint, at simpleng pagpapagaan ng sakit.

Ang mga buto sa paligid ng mga joint ng daliri ay karaniwang permanenteng magiging matigas kapag sila ay nabuo, ngunit ang sakit mula sa mga ito ay madalas na humihina sa loob ng panahon kahit na ang hugis ng knobbly ay nananatili. Kung ang isang joint (karaniwan ang base ng hinlalaki o ang AC joint sa balikat) ay nagiging isang problema, ang target na paggamot tulad ng isang injection o, sa huli, ang operasyon ay maaaring ayusin ang joint na iyon. Ang pangkalahatang mensahe ay isang mapagkumbaba: ito ay isang bagay na maaari namin tulungan kang mabuhay nang maayos.

Kailan kumonsulta sa doktor

  • Sakit sa kasukasuan na nakakapagpababa sa iyong kakayahang gawin ang mga pang-araw-araw na gawain, o hindi gumagaling sa simpleng hakbang: mainam na ipa-assess ito at gumawa ng plano.
  • Isang kasukasuan na biglaang naging mainit, pamula, at sobrang pamamaga: maaaring magpakita ng ganitong paraan ang paglala ng osteoarthritis, ngunit maaari ring magpakita ng ganito ang impeksyon o gout, kaya't kailangang suriin agad ang isang biglaang namamagang kasukasuan.
  • Kahinaan, pamamanhid, o pakiramdam ng "pins and needles" sa kamay o mga daliri, o sakit na nagpapagising sa iyo sa gabi.
  • Pagkakasara, pagbagsak, o biglaang pagkawala ng galaw sa isang kasukasuan.
  • Kapag ang osteoarthritis sa isang kasukasuan (karaniwan sa base ng hinlalaki) ang pangunahing hadlang sa iyo, upang masuri ang mga opsyon tulad ng paggamit ng splint, injeksyon, o operasyon para sa partikular na kasukasuan na iyon.

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