Joron aur patthon mein dard

Joron mein dukhan, dard aur akran, aur un ke aas paas ke patthon mein dard, jo perimenopause (mahwari band hone ke aas paas ka waqt) ke aas paas shuru ho ya barh jaye. NICE ki hidayat NG23 inhein musculoskeletal symptoms, yani haddiyon, joron aur patthon ki alamaat kehti hain. Roshara ka alamaat ka score inhein aik hi sawal mein ginta hai: dukhte jor aur patthe.

Yeh aik jor mein bhi ho sakta hai aur kai mein aik saath bhi. NHS ghutne, koolhe, kandhe, haath aur kalaiyan, pair aur takhne, kohniyan aur gardan ginwata hai.

Subah ka aata goondhte hue haath akre hue. Ghar walon ke saath farsh par baithne ke baad uthne mein do koshishein aur deewar ka sahara. Raat ko koolhon mein halka halka dard, to aap karwatein badalti rehti hain. Patthe aise dukhte hain jaise warzish ki ho, halanke ki nahin.

Ise menopause ke siwa har cheez par daal diya jata hai: ghar ka kaam, wazan, umar. Kabhi kabhi un ka bhi haath hota hai. Kabhi kabhi hormone bhi is ka hissa hote hain, aur kisi ne bataya hi nahin. Asia-Pacific Menopause Federation to yeh bhi kehti hai ke Asiai auraton mein jism aur joron ka dard hot flush se zyada aam hai.

NHS ka joron ke dard wala safha kehta hai ke perimenopause aur menopause mein estrogen kam hone se jor dukh sakte hain aur un mein dard ho sakta hai. Pakistan Menopause Society joron aur patthon ke dard ko shuru ke perimenopause ki alamaat mein rakhti hai, sar dard, chhaati mein dard aur pait phoolne ke saath.

Yeh kam hi wahid wajah hoti hai. NHS kuch aur wujoohat bhi ginwata hai jinhein dekh lena chahiye, jaise chot, osteoarthritis (joron ka ghisna, jo 45 saal ke baad zyada aam hai), rheumatoid arthritis aur gout, jo sab gathiya ki qismein hain. PMS ki sifarishaat doctors ko yeh bhi khabardaar karti hain ke darmiyani umar ke har masle ko sirf estrogen ka nateeja na batayen, kyunke umar, rehan sehan aur doosri beemariyon ka bhi haath hota hai. Yeh baat aap ke haq mein jati hai: is ka matlab hai poora checkup, kandhe uchkana nahin.

• NICE ki hidayat NG23 doctors se kehti hain ke woh menopause se guzarne wali auraton ko samjhayen ke chalne phirne aur jismani sargarmi se patthon ko aur un ki taaqat ko qaim rakhna aham hai (1.2.5).
• PMS ki sifarishaat doctors se kehti hain ke woh muzahmat wali warzish, jism ka wazan uthane wali sargarmi, kaafi protein aur behtar neend par zor dein (Table 2). Wazan uthana aur yoga mein is ki tafseel hai.
• Yehi sifarishaat vitamin D ki waseeh kami ko Pakistan ke bare masail mein se aik kehti hain, ise ghar ke andar guzarti zindagi aur parde se jorti hain, aur Pakistan ki auraton ke liye apne mashware ke taur par, jahan mumkin ho, vitamin D baqaidagi se check karwane ko kehti hain (4.1, Table 5). Vitamin D aur calcium mein NHS ki woh hidayat ka link hai ke kitna lena hai.
• NHS ka joron ke dard wala safha yeh ginwata hai: dukhte jor ko aaraam dein magar hilana bilkul band na karein, tauliye mein lipta barf ka pack, pharmacist ya GP se poochein ke kaun si dard ki dawa lein, sehat mand wazan, mutawazin khana, baqaida warzish aur cigarette na peena.

Na NICE ki hidayat NG23 aur na PMS ki sifarishaat menopause mein sirf joron ke dard ke liye kisi dawa ka naam leti hain. NHS kehta hai ke ilaaj wajah par munhasir hai, aur is mein dard ki dawaein, physiotherapy, steroid ke injection, ya X-ray, scan ya specialist ke liye referral shamil ho sakte hain.

Agar aap doosri alamaat ke liye doctor se HRT (hormone ki dawa) ki baat kar rahi hain, to joron ka bhi zikr karein. The Menopause Society kehti hai ke Women's Health Initiative aur doosri tehqeeqon mein HRT lene wali auraton ko be asar goli (placebo) lene wali auraton ke muqable mein joron ka dard ya akran kam thi, aur woh in shawahid ko achha darja deti hai. NICE NG23 joron ke dard ke liye HRT ka naam nahin leta, is liye doctor se poochein ke aap ke maamle mein woh kya tawaqqo rakhte hain.

NHS kehta hai ke GP ko dikhayen agar joron ka dard aap ke roz ke kaam rok de ya neend kharab kare, agar dard ya soojan barh rahi ho ya baar baar laut aaye, agar ghar par do hafte dekh bhaal ke baad bhi behtar na ho, ya agar jaagne ke baad aadhe ghante se zyada jor akre rahein.

Fauri appointment maangein agar jor sooja ho aur us ke gird ki jild garam lage, ya joron mein dard ho aur tabiyat aam taur par kharab ho, bukhar ho, ya garmi sardi aur kapkapi lage.

Fauran emergency madad lein agar girne ya chot ke baad jor mein bohat shadeed dard ho, agar jor par wazan na daal sakein, agar jor apni jagah se hata hua lage, ya chot ke baad us ke aas paas sansanahat ho ya woh jagah sunn ho jaye.

Din ki paanch namazon ka matlab hai kai baar zameen tak jhukna aur phir uthna. Jab ghutne aur koolhe dukhein, to auratein poochti hain ke kya woh baith kar namaz parh sakti hain, aur kitna zor lagayen. Yeh sawal kisi mustanad aalim se poochne ke hain, aur bohat si auratein poochti hain. Aap pehli nahin hongi.

Ghar mein yeh dard umooman kaam ki shikayat samjhe jate hain. Inhein in ke naam se pukarna, aur yeh jaanna ke NICE inhein ginta hai, madad aur checkup maangna aasaan bana deta hai.