Wanasayansi wamegundua njia tofauti ya kuashiria ujasiri ambayo inaweza kusaidia kupona kutokana na maumivu yanayoendelea baada ya jeraha.
Sisi wote tunajua maumivu - hisia zisizofurahi zinazosababishwa na kuchoma au maumivu ya kichwa. Aina yoyote ya maumivu katika mwili wetu inahusisha mwingiliano tata kati ya maalum neva, our spinal cord and our brain. In our spinal cord, specialized neva receive messages from specific peripheral neva and they control message transmission to our brain. Whether the signal to the brain is important depends upon the severity of the pain. In the case of sudden burn, the message is transmitted as urgent while for a scratch or minor bruise, the messages are not tagged as urgent. These messages then travel to the brain and brain will respond by sending out messages to enable healing which could be either to our nervous system or brain might release pain-suppressing chemicals. This experience of maumivu ni tofauti kwa kila mtu na maumivu yanahusisha kujifunza na kumbukumbu.
Kwa ujumla, maumivu yanaweza kugawanywa kama maumivu ya muda mfupi au ya papo hapo na ya muda mrefu au ya muda mrefu. Maumivu makali ni maumivu makali au ya ghafla yanayotokea kutokana na ugonjwa au jeraha au upasuaji. Wakati maumivu ya muda mrefu ni ambayo yanaendelea kwa muda mrefu zaidi na kuwa ugonjwa au hali yenyewe.
Maumivu ya muda mrefu
Kwa mfano, baada ya kidole gumba au mchomo kwenye mguu au kiganja au kugusa kitu chenye joto sana, baada ya hisia ya mshtuko, mwili hutafakari kutoka kwa shughuli au chanzo cha hatari. Hii hutokea mara moja lakini reflex ina nguvu ya kutosha kutusukuma mbali na hatari zaidi. Hili linafafanuliwa kama jibu la mageuzi ambalo huhifadhiwa katika spishi nyingi ili kuongeza maisha lakini njia kamili bado hazijaeleweka. Maumivu ya kudumu au maumivu kisha huanza baada ya mshtuko wa awali wa jeraha kupita. Na maumivu haya ya kudumu huchukua muda kupunguza ambayo inaweza kuwa sekunde, dakika au hata siku. Mtu anaendelea kujaribu kupunguza maumivu kwa kusema kuweka shinikizo, compress ya moto, njia za kupoeza nk.
Wanasayansi katika Shule ya Matibabu ya Harvard waliazimia kuchanganua njia mbalimbali za kichocheo cha maumivu kutoka mahali pa kiwewe au jeraha la mwili hadi kwenye ubongo. Kichocheo cha kiwewe hutokana na neurolojia changamano inayohusisha neva za hisi zinazoitwa nociceptors na kuna njia mbalimbali zinazopeleka ishara kwenye uti wa mgongo na maeneo ya ubongo. Maelezo ya kisa hiki bado hayajaeleweka vyema. Wanasayansi wanafikiri "matrix ya maumivu" katika ubongo inawajibika kwa maumivu lakini kunaweza kuwa na kitu kingine pia.
Kuelewa utaratibu wa maumivu
Katika utafiti uliochapishwa katika Nature, scientists looked into spinal ujasiri cells which are associated with noxious stimuli. A gene called Tac1 expressed on these cells was seen to have a critical role in neuron functions. And their research shows that there might be different pathways followed by two different types of pain. They identified a new pathway of neva in mice which look like chiefly responsible for persistent pain or ache which occurs after the initial shock of pain has gone by. Upon switching off this gene, mice still exhibit a response to sudden acute pain. And when their feet were pricked or they were pinched etc they showed signs of aversion. However, mice did not show any later signs of persistent discomfort which tells that the brain was not informed of this damage conveying that these spinal neva might play a role in informing the brain.
Kwa hiyo, kuna njia mbili tofauti za kupasuka kwa maumivu ya awali na kwa usumbufu unaoendelea. Hii inaweza kuwa sababu pekee kwa nini dawa nyingi za kutuliza maumivu ni nzuri kwa maumivu ya awali lakini haziwezi kukabiliana na maumivu ya kudumu, kuuma, kuuma nk ambayo inaweza kufafanuliwa kama njia ya kukabiliana. Matokeo pia yanaeleza kwa nini watahiniwa wengi wa dawa walitafsiri vibaya kutoka kwa masomo ya kliniki hadi matibabu madhubuti ya maumivu.
Utafiti huu kwa mara ya kwanza umepanga jinsi majibu yanavyotokea nje ya ubongo wetu na ujuzi huu hutoa dalili muhimu na inaweza kusaidia kuelewa mizunguko mbalimbali ya neva ambayo huwajibika kwa maumivu ya muda mrefu na usumbufu. Uwepo wa majibu mawili tofauti ya ulinzi ili kuepuka majeraha ambayo yanadhibitiwa na njia tofauti za kuashiria neva. Ni wazi kwamba mstari wa kwanza wa ulinzi ni reflex ya uondoaji wa haraka na pili ni majibu ya kukabiliana na maumivu ambayo yameamilishwa ili kupunguza mateso na kuzuia uharibifu wa tishu kutokana na jeraha. Katika mzozo unaoendelea wa opioid, ni hitaji kubwa la kukuza matibabu mapya ya maumivu. Maumivu ya kudumu yanapokuwa hali na ugonjwa yenyewe, imekuwa muhimu kushughulikia kipengele hiki cha udhibiti wa maumivu.
***
Chanzo (s)
Huang T na al. 2018. Kutambua njia zinazohitajika kwa tabia za kukabiliana zinazohusishwa na maumivu endelevu. Nature. https://doi.org/10.1038/s41586-018-0793-8
***
