An integrated approach to the treatment of cervical osteochondrosis is used, aimed at reduction
Severity of pain, hardness.Drugs of various clinical and pharmacological groups, physiotherapy, classical and acupuncture massage, exercise therapy and acupuncture are used in the therapy.If conservative treatment methods are ineffective, surgical operations are performed.
Symptoms of the disease
At the initial stage of development, osteochondrosis is asymptomatic.After a long stay with a bent head or intense physical activity, a slight discomfort appears in the back of the neck.The patient is in no hurry to go to the doctor, mistaking them for the results of muscle strain.Pathology progresses slowly but persistently.
Discomfort in the neck gradually changes to pain, dull pain in the neck, which intensifies after lifting heavy loads, hypothermia or weather changes.Other specific symptoms of cervical osteochondrosis are manifested:
- Cramping, clicking when bending or turning the head;
- limited mobility in the cervical spine;
- Acute, severe pain during exacerbation.
When the intervertebral discs and spine are deformed, the patient's condition worsens.The course of osteochondrosis is complicated by neurogenic symptoms caused by compression by osteophytes or herniated growth of spinal roots and vertebral artery.Headache, dizziness, changes in blood pressure appear, visual and hearing acuity decreases.
Methods of treatment of cervical osteochondrosis
There are no drugs, the use of which restores the structures of the spine.But it is quite possible to improve the patient's well-being and stop the spread of the disease.It is not enough just to take pills or apply ointments - you need to do daily physical therapy, visit the massage room and physical therapy activities.
drug therapy
Pharmacological drugs are used to eliminate the symptoms of cervical osteochondrosis, including by improving blood circulation and partial regeneration of intervertebral discs.Due to the absence of characteristic signs at the initial stage, patients refer to a vertebrologist or neurologist with pathology of 2 and even 3 degrees of severity.Often they already develop complications - intervertebral hernia, protrusion, vertebral artery syndrome.Therefore, doctors combine not only analgesics in therapeutic regimens, but also means to improve innervation, relax skeletal muscles, and restore trophism.
Nonsteroidal anti-inflammatory drugs
In stage 2-3 osteochondrosis, patients complain of sharp, piercing pain that occurs when bending or turning the head.In such cases, they are prescribed non-steroidal anti-inflammatory drugs.In case of severe pain, intramuscular injection of solutions - diclofenac, meloxicam, lornoxicam, ketorolac is used.The drugs have not only pain-relieving, but also anti-inflammatory and anti-swelling effects.This is especially true when the soft tissues of the neck are damaged by a displaced disc or osteophyte.
If the pain is not very intense and appears from time to time, then non-steroidal anti-inflammatory drugs in tablets or capsules are used:
- nimesulide;
- ketorolac;
- diclofenac;
- celecoxib;
- Etoricoxib.
Systemic nonsteroidal anti-inflammatory drugs are quite toxic to the stomach because they provoke the formation of hydrochloric acid.To eliminate the possibility of damage to the mucous membrane, it is necessary to take proton pump inhibitors together with non-steroidal drugs.
Ointments and gels are used to eliminate mild pain that the patient experiences during weather changes or hypothermia.Most often, treatment regimens include diclofenac, ketoprofen, arthrosilin, piroxicam, ibuprofen.
hormones
Even if the intramuscular administration of nonsteroidal anti-inflammatory drugs does not have a proper analgesic effect, then hormonal drugs are used - methylprednisolone, triamcinolone, betamethasone, dexamethasone.Glucocorticosteroids are characterized by pronounced analgesic, anti-inflammatory and exudative action.Hormonal drugs are commonly used for drug blockade along with anesthetics lidocaine and procaine.This method of administration of the drug ensures the maintenance of the pain-relieving effect for several days and sometimes weeks.
But glucocorticosteroids are not intended for frequent use.They are toxic to the internal organs and damage the cartilage, bones and ligamentous-muscular apparatus.Hormonal drugs also have an immunosuppressive effect, which negatively affects the immune system.
anesthetics
Anesthetics lidocaine and novocaine (procaine) are most often used for drug blockade in the treatment of cervical osteochondrosis.The latter is characterized by a pronounced pain-relieving effect and a wide range of uses.Novocaine is prescribed to block peripheral nerves and nerve ganglia in the treatment of degenerative-dystrophic pathologies.This is a violation of the roots of the spine by osteophytes or hernial protrusions, which causes acute pain.
Lidocaine is used not only for blockades.It is one of the active ingredients in tolperisone injection solution, a muscle relaxant that prevents muscle spasms.Lidocaine is also included in preparations containing B vitamins.
local irritants
Ointments, gels, balms with a warming and local irritating effect are very often prescribed for the treatment of cervical osteochondrosis, but only in the absence of soft tissue inflammation.They may contain camphor, menthol, turpentine, red hot pepper extract, nicoboxyl, nonivamide, snake or bee venom.These ingredients irritate the sensitive nerve endings located in the subcutaneous tissue, relieving pain.
Such agents have a vasodilating effect, which is accompanied by an intense, long-lasting sensation of heat.And by improving the blood supply of tissues with nutrients, their recovery is accelerated.
Patients are often prescribed local irritant drugs to reduce the dose of systemic analgesics and reduce the pharmacological burden on the body.
Medicines to improve blood microcirculation
Means for improving blood circulation are used to treat osteochondrosis of any location.But specifically for pathology of the cervix, they are more often in demand.In this part of the spine, the artery that supplies nutrients and oxygen to the brain is often compressed.The following drugs help restore blood supply:
- xanthine nicotinate, which improves microcirculation, oxygen, nutrition of cartilage tissue and all parts of the brain;
- Pentoxifylline, which reduces blood viscosity and aggregation of platelets and red blood cells, improves the rheological properties of blood (fluidity);
- Aminophylline, which reduces the tension in the vascular walls and promotes the expansion of peripheral vessels.
Medicines containing thioctic acid are often used to improve microcirculation.They have a vasodilating effect, restore the function of the spinal roots, improve trophism and innervation.
vitamins
Balanced complexes of vitamins and microelements are prescribed to patients to improve human well-being, strengthen the body's defenses and replenish the reserves of substances necessary for tissue regeneration.It is enough to take one tablet a day of any medicine to eliminate the deficiency.
But drugs containing B vitamins are more often used to treat cervical osteochondrosis.In addition to pyridoxine, thiamine, cyanocobalamin, anesthetic lidocaine is included in the composition of injection solutions.B vitamins in tablets may also be prescribed.Their course use helps to improve the transmission of nerve impulses and stimulate natural mechanisms aimed at recovery.
Chondroprotectors
This is the only group of drugs used for the pathogenetic treatment of cervical osteochondrosis.At the initial stage of pathology development, chondroprotectors are used for partial restoration of intervertebral discs.This effect is due to the ability of chondroitin and glucosamine to activate the synthesis of proteoglycans, increase the production of hyaluronic acid, activate all the functions of cartilage cells (chondrocytes) and inhibit their premature destruction.
Chondroprotectors are also prescribed to patients with 2nd and 3rd degree osteochondrosis.At this stage, cartilage tissue is no longer subject to regeneration.But taking drugs in doses up to 800 mg prevents further destructive and degenerative changes.The duration of the therapeutic course is from 3 months.After 2 weeks of using the products, their pronounced anti-inflammatory and pain-relieving effect appears.
Active ingredients of drugs with chondroprotective action for the treatment of cervical osteochondrosis:
- Glucosamine sulfate or hydrochloride;
- chondroitin sulfate;
- glucosamine and chondroitin;
- Components of plant or animal origin.
surgical intervention
Indications for surgical intervention include ineffectiveness of conservative treatment, as well as complications of cervical osteochondrosis, for example, discogenic myelopathy, vertebral artery syndrome, and radicular syndrome.The following operations are performed to decompress the spinal cord, blood vessels and spinal roots:
- laminectomy;
- laminotomy;
- foraminotomy;
- festectomy;
- Discectomy.
During the operation, it is possible to excision of bone fragments and ligaments and complete or partial removal of intervertebral discs.For small herniated disc herniations, laser ablation of the disc nucleus is often performed.
After excision of the spinal structures, stabilization of the motion segments of the spine is often required with spinal fusion or bone and skin autografts.
Massage and self-massage
There are many types of these treatment procedures, but classical, acupressure, vacuum (including equipment) and segmental massage are more often used in cervical osteochondrosis.Mechanical action on the back of the neck, shoulders, forearms and back allows you to activate lymphatic drainage, eliminate venous congestion, strengthen muscles and relax skeletal muscles.Massage is used not only to treat the disease, but also to prevent its recurrence.
Self-massage can be done for 10-15 minutes by compressing and rubbing the back of the neck.But it is better to buy special electrical devices in a pharmacy or medical equipment store - massagers equipped with comfortable long handles and speed controllers.
Exercise therapy complex
Physiotherapy doctor selects exercises for the patient individually, taking into account the severity of the pathology and developed complications.One of the criteria is the frequency of neurological manifestations.As a rule, the complex includes the following exercises:
- Bend your fingers and place your palms on your forehead.Press your hands on your head, trying to bend it back, which provides resistance due to the tension of the neck muscles;
- Bend your fingers and place your palms on the back of your head.Press on it with your hands as if you are trying to bend your head down.At the same time, strain the muscles of the neck and shoulders, try to maintain the original position of the head;
- Put your hand on your cheek.Try to lean your head on your shoulder, resisting with your hands.Repeat the exercise on the other side.
Regular exercise therapy is the most effective way to get rid of the symptoms of cervical osteochondrosis and prevent it from spreading to healthy structures of the spine.Daily exercise stimulates the strengthening of the muscular corset, which stabilizes the discs and vertebrae.And by improving the blood circulation in the tissues, the supply of nutrients is replenished.
manual therapy
The chiropractor always prepares the patient for future manipulations, starting the session with a relaxing massage.Then, with smooth movements, he stretches the muscles and removes their excess tension.As a result, muscle spasms disappear, which causes pain when pressing the roots of the back.Compression of the vertebral artery is eliminated, along with neurological symptoms.If necessary, the chiropractor adjusts the cervical vertebrae.This can be accompanied by a crackling, crunching, clicking and an increase in the severity of painful sensations.
One way to avoid surgery is to stretch (traction) the spine to increase the distance between the vertebral bodies and the damaged discs.The procedure is carried out by a chiropractor on special tables.But the most popular is underwater traction in baths or pools.
Acupuncture
This is one of the types of reflexology that is recommended for patients to restore the mobility of the cervical spine structures and improve blood circulation.Very thin needles of different lengths made of steel, silver and gold are used during the session.They are installed in biologically active points located not only on the back of the neck, but also on the back, shoulders and forearms.
After placing the needles, weak pain impulses begin in the central nervous system.The body's reaction is the release of bioactive substances with analgesic and anti-inflammatory effects into the systemic circulation.The production of endorphins increases, which significantly improves the patient's well-being.
Orthopedic treatment methods
From the first days of treatment, patients are advised to wear orthopedic devices - Schanzi collars.They need to be worn for several hours and should be removed before going to bed or during the day.Collars can be flexible with plastic or metal inserts, rigid or inflatable.Devices differ in height, quality of fixation and design of fasteners.The size of the collar for the patient is determined only by a vertebrologist, who takes into account the severity of the symptoms of osteochondrosis and the likelihood of displacement of the spinal structures.
Patients are advised to purchase an orthopedic mattress of medium density.When resting on it, the blood circulation of bones, cartilages and soft tissues does not deteriorate.Doctors also recommend sleeping on an orthopedic pillow that has a special recess for the head.
Folk remedies and recipes
Folk remedies are used after basic therapy and elimination of all symptoms.The feasibility and safety of their use at home should be discussed with a doctor.
Honey ointment
Place a tablespoon of aloe juice and lanolin in a mortar and grind until a homogeneous mass is obtained.Add a teaspoon of gum turpentine, a drop of essential oils of eucalyptus, pine, rosemary, 30 g of thick flower honey, mix.Apply 100 g medical vaseline in small portions without stopping rubbing.The ointment is rubbed into the skin of the neck when discomfort occurs.
Rabbit leaves
Knead a large fresh rabbit leaf well, smear it with thick honey and apply it on the back of the neck.Secure the compress with plastic wrap, a warm cloth, and a gauze pad.The duration of the procedure is 1-2 hours.
Other herbal compresses
In a mortar, grind fresh leaves of grass, dandelion, burdock, zinc foil and elecampane to a thick paste.Without stopping stirring, add a few drops of juniper and thyme essential oils, a tablespoon of almond cosmetic oil.Put the obtained mass on the neck, fasten the compress with a plate and a medical bandage and wait for an hour.
Ways of disease prevention
Osteochondrosis is a recurrent degenerative pathology that occurs against the background of gradual destruction of intervertebral discs and bone deformation.It is necessary to exclude factors from the usual lifestyle that lead to the deterioration of cartilage tissue trophism.These are low physical activity, overweight, excessive physical exertion and lack of food rich in microelements and vitamins in the diet.