He aha te take o te mamae o te pokohiwi?

Ko te pakihiwi he wāhanga rarū o to tatou tinana e āwhina ana i a tātou ki te neke ngāwari i ō tātou ringa. Kei roto i te toru o ngā wheua matua: te iwi pakihiwi (clavicle), te kōpū pakihiwi (scapula), me te wheua o te ringa o runga (humerus). Ka mahi tahi ēnei wheua hei hanga i te hononga pakihiwi, e taea te neke i roto i ngā huarahi maha.

Ko ngā uaua kei te pakihiwi, inā te rotator cuff, he mea nui mō te pupuri i te pakihiwi kia pumau me te whakahohe i te nekehanga. E whā ngā uaua matua o te rotator cuff e mahi tahi ana ki te pupuri i te wheua o te ringa o runga i tetahi wāhi haumaru i te kōpū pakihiwi. Ka taea e tēnei whakarite te mahi i ngā mahi maha penei i te hāpai, te maka, me te toro atu. Heoi, ko tēnei āhei ki te neke ka taea hoki te whakawehi i te pakihiwi ki ngā whara me te mamae.

Ko ngā hononga, ko ngā kiko kaha e hono ana i ngā wheua, e tautoko ana i te hononga pakihiwi. Ka pupuri ratou i te hononga kia pumau engari ka taea te totoro atu, te pakaru rānei i te wa e whara ana. Hei tauira, ka taea e te whara te whakaoho i ngā take penei i te tendonitis, te kōpū rānei i te pakihiwi, ka arahi ki te mamae me te iti o te nekehanga. He mea nui te mārama ki te mahi o te pakihiwi mō te tiaki i a ia me te whakaora i ngā raruraru e puta mai ana.

Ngā Take Whānui o te Mamae Pakihiwi

Take	Ngā Taipitopito
Ngā Whara Rotator Cuff	Hei wāhanga o te tendonitis me ngā pakaru o ngā uaua me ngā hononga o te rotator cuff, i te nuinga mai i te nui o te whakamahinga, te pakaru rānei.
Te Syndrome Impingement Pakihiwi	Ko te pehi i ngā hononga o te rotator cuff e whakaoho ana i te mamae me te mumura i te wa e neke ana ki runga.
Pakihiwi Toki (Adhesive Capsulitis)	Ko te ngoikore me te mamae i te pakihiwi, i te nuinga i muri i te kore e neke, te whara rānei, ka whakaiti i te nekehanga o te pakihiwi.
Te Bursitis Pakihiwi	Ko te mumura o te bursa (ngā putea kapi i te wai) e whakaiti ana i te riri i waenganui i ngā hononga me ngā wheua.
Te Mate Wheua	Hei wāhanga o te osteoarthritis (te whakaheke o te cartilage) me te rheumatoid arthritis (te mumura autoimmune).
Pakihiwi Wehewehe	Ka puta mai ina puta te pōro o te hononga pakihiwi i te rua, i te nuinga na te pakaru, te whara rānei.
Ngā Pakaru	Ko ngā wheua pakaru i te clavicle, humerus, te scapula rānei, e whakaoho ana i te mamae nui me te uaua ki te neke i te pakihiwi.
Tendonitis me te Tendinopathy	Ko te mumura, te whakaheke rānei o ngā hononga pakihiwi, i te nuinga na te whakamahinga nui.
Te Kōpū Iwi	Ko te pehi i ngā iwi i te kaki, te tuara rānei, e whakaoho ana i te mamae, te ngenge rānei e horapa ana ki te pakihiwi.
Te Mamae i Tuhua mai i ētahi atu Āhuatanga	Ko te mamae e puta mai ana i ētahi atu wāhanga o te tinana, penei i te ngakau, ngā pūkahukahu, te kopu rānei, ka puta mai i te pakihiwi.

Ngā Tohutohu me te Taumata o te Mamae Pakihiwi

Ka rereke te mamae o te pakihiwi i tōna whakaaturanga i runga i te take e puta mai ana. Ko te taumata tika e whai ana i te mārama ki ngā tohu me te whakamahi i ngā taputapu taumata e tika ana hei tautuhi i te āhuatanga. Kei raro nei ngā kaupapa iti nui e pā ana ki ngā tohu me te taumata o te mamae pakihiwi.

1. Ngā Tohutohu Whānui o te Mamae Pakihiwi

• Mamae: Ka taea te wāhi o te mamae i te pakihiwi, te horapa rānei ki raro i te ringa. Ka taea te rereke mai i te mamae ngawari ki te mamae koi, kaha, inā te nekehanga.

• Ngoikore: Te uaua ki te neke i te pakihiwi, te iti rānei o te nekehanga, inā ngā āhuatanga penei i te pakihiwi toki.

• Pūngāwerewere: Te pūngāwerewere kei te taha o te hononga pakihiwi, e tohu ana i te mumura, te whara rānei ki ngā kiko penei i ngā hononga, ngā putea rānei.

• Ngoikore: Te ngoikore o te kaha, te kore rānei e taea te hāpai i ngā mea, te mahi rānei i ngā mahi o ia rā na te mamae, te whara rānei i te pakihiwi.

• Te tangi, te pakaru rānei: Ko ngā oro, ngā āhuatanga rānei i te pakihiwi i te wa e neke ana e hono ana ki ngā whara rotator cuff, te impingement rānei.

• Kore e pumau: He āhua kei te “ngāwari” te pakihiwi, te wehewehe rānei, he mea noa ki ngā pakihiwi wehewehe, ngā pakaru labral rānei.

• Te Mamae e Horapa Ana: Te mamae e horapa ana ki te kaki, te tuara o runga, ki raro rānei i te ringa, e kitea ana i ngā āhuatanga e pā ana ki te iwi, te mamae rānei e puta mai ana i te ngakau, ētahi atu rānei o ngā whekau.

2. Ngā Tikanga Taumata mō te Mamae Pakihiwi

• Te Tirohanga Tinana: Ka aromatawai te taote i te whānuitanga o te nekehanga, ka tirotiro i ngā tohu o te pūngāwerewere, te mamae, te ngoikore rānei, ka whakamātau i ngā nekehanga motuhake e taea te whakaoho i te mamae (hei tauira, ngā nekehanga ki runga mō ngā whara rotator cuff).

• Ngā X-rays: Ka whakamahia hei tirotiro i ngā wheua pakaru, ngā wehewehe, ngā huringa whakaheke rānei i te hononga pakihiwi (penei i te mate wheua).

• MRI (Magnetic Resonance Imaging): Ka whakarato i ngā whakaahua taipitopito o ngā kiko ngawari penei i ngā hononga, ngā hononga, te cartilage rānei, he whai hua mō te tautuhi i ngā pakaru rotator cuff, ngā pakaru labral, me te impingement pakihiwi.

• Ultrasound: He tikanga whakaahua kore-whakawehi e taea te aromatawai i te āhua o ngā kiko ngawari me te kite i ngā take penei i te tendonitis, bursitis, ngā pakaru uaua rānei.

• Te kara o te CT: i te nuinga ka whakamahia mō te whakaahua wheua taipitopito ake, inā ka whakapaetia ngā pakaru, ngā raruraru hononga rarū rānei.

• Arthroscopy: He tukanga iti te whakawehi e whakauruhia ana he kamera iti ki te hononga pakihiwi hei tiro atu tika me te ārai pea i ngā hanganga o roto, i te nuinga ka whakamahia mō te tautuhi i ngā pakaru rotator cuff, te pakaru labral rānei.

• Ngā Akoranga Arahina Iwi: Mena ka whakapaetia te kōpū iwi, ka taea te whakamātautau hei aromatawai i te mahi o te iwi me te kite i ngā āhuatanga penei i te radiculopathy o te kaki.

Ngā Kōwhiringa Whakaora mō te Mamae Pakihiwi

Ka taea te whakaoho i te mamae pakihiwi e ngā take maha, penei i te whara, te mate wheua, te nui rānei o te whakamahinga. Ka rereke ngā kōwhiringa whakaora i runga i te kaha me te take o te mamae.

1. Ngā Whakaora Tiaki

   • Te Okioki me te Hukapakū: Ko te okioki i te pakihiwi me te whakamahi i te hukapakū ka whakaiti i te mumura me te whakaora i te mamae.

   • Te Whakaora Tinana: Ka taea e ngā whakakori e whai take ana te whakapakari i ngā uaua kei te pakihiwi, te whakapai ake i te nekehanga me te pumau.

   • Ngā Rongoā Anti-Inflammatory Kore-Steroid (NSAIDs): Ka āwhina ēnei rongoā ki te whakaiti i te mamae me te pūngāwerewere.

2. Ngā Whakakī

   • Ngā Whakakī Corticosteroid: Ka taea e ēnei te whakaora i te mumura me te mamae, inā ngā take o te mate wheua, te tendonitis rānei.

   • Ngā Whakakī Hyaluronic Acid: Ka whakamahia mō te mate wheua, ka whakauruhia ēnei whakakī i te hononga me te whakaiti i te riri.

3. Ngā Whakaora Ma te Tā

   • Arthroscopy: He tukanga iti te whakawehi hei whakatika i ngā kiko pakaru, te tango rānei i ngā paru i te hononga.

   • Te Whakakapi Pakihiwi: Mō te mate wheua nui, ka hiahiatia pea te whakakapi pakihiwi katoa.

Whakarāpopoto

Ka taea te puta mai o te mamae pakihiwi i ngā take maha, tae atu ki ngā whara rotator cuff, te mate wheua, te kōpū iwi rānei. Ko ngā tohu whānui ko te mamae, te ngoikore, te ngoikore, te pūngāwerewere rānei. Ko te taumata e whai ana i ngā whakamātautau tinana me ngā whakamātautau whakaahua penei i ngā X-rays, ngā MRI rānei. Ko ngā kōwhiringa whakaora e rereke ana mai i te okioki me te whakaora tinana ki te tā, i runga i te kaha.