An integrated approach to the treatment of cervical osteochondrosis is practiced, aimed at reducing
intensity of pain, stiffness.The therapy uses drugs of various clinical and pharmacological groups, physiotherapy, classical and acupuncture massages, physiotherapy and acupuncture.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 the head down or intense physical activity, slight discomfort occurs in the back of the neck.The patient is in no hurry to go to the doctor, confusing it with the consequences of a muscle strain.The pathology progresses slowly but persistently.
Discomfort in the neck is gradually replaced by a dull, aching pain in the neck, which intensifies after heavy lifting, hypothermia, or a change in weather.Other specific symptoms of cervical osteochondrosis appear:
- crackling, clicking when tilting or turning the head;
- limited mobility in the cervical spine;
- Acute and severe pain during exacerbations.
As the intervertebral discs and vertebrae deform, the patient's condition worsens.The course of osteochondrosis is complicated by neurogenic symptoms caused by compression by osteophytes or hernial protrusion of the spinal roots and vertebral artery.Headaches, dizziness, changes in blood pressure appear, and visual and auditory acuity decreases.
Treatment methods for cervical osteochondrosis.
There are no drugs whose use would restore spinal structures.But it is quite possible to improve the patient's well-being and stop the spread of the disease.It is not enough to take pills or apply ointments: it is necessary to carry out physiotherapy every day, visit a massage room and physiotherapy activities.
Drug therapy
Pharmacological drugs are used to eliminate the symptoms of cervical osteochondrosis, including improving blood circulation and partial regeneration of intervertebral discs.Due to the absence of characteristic signs at the initial stage, patients turn to a vertebrologist or neurologist with pathology of 2 or even 3 degrees of severity.Often they have already developed complications: intervertebral hernia, protrusion, vertebral artery syndrome.Therefore, doctors include in therapeutic regimens not only analgesics, but also means to improve innervation, relax skeletal muscles and restore trophism.
NSAIDs
With osteochondrosis of 2-3 radiographic stages, patients complain of sharp, stabbing pain that occurs when tilting or turning the head.In such cases, non-steroidal anti-inflammatory drugs are prescribed.For severe pain, intramuscular injection of solutions is practiced: diclofenac, meloxicam, lornoxicam, ketorolac.The drugs not only have analgesic, but also anti-inflammatory and anti-edematous effects.This is especially true when the soft tissues of the neck are injured by a displaced disc or osteophyte.
If the pain is not too intense and occurs from time to time, NSAIDs in tablets or capsules are used:
- nimesulide;
- ketorolac;
- diclofenac;
- celecoxib;
- Etoricoxib.
Systemic NSAIDs are quite toxic to the stomach because they cause increased production of hydrochloric acid.To eliminate the possibility of damage to the mucosa, it is necessary to take proton pump inhibitors together with NSAIDs.
Ointments and gels are used to eliminate minor pain that bothers the patient when the weather changes or hypothermia.Most often, treatment regimens include diclofenac, ketoprofen, artrosilene, piroxicam and ibuprofen.
hormones
Even if the intramuscular administration of NSAIDs does not have an adequate analgesic effect, hormonal agents are used: methylprednisolone, triamcinolone, betamethasone, dexamethasone.Glucocorticosteroids are characterized by pronounced analgesic, anti-inflammatory and anti-exudative activity.Hormonal drugs are usually used for pharmacological blockade in combination with the anesthetics lidocaine and procaine.This method of administering the drug guarantees the preservation of the analgesic effect for several days, and sometimes weeks.
But glucocorticosteroids are not intended for frequent use.They are toxic to internal organs and damage cartilage, bones and the ligamentous-tendinous apparatus.Hormonal drugs also have an immunosuppressive effect, which negatively affects the immune system.
anesthetics
The anesthetics lidocaine and novocaine (procaine) are most often used in the treatment of cervical osteochondrosis for pharmacological blocks.The latter is characterized by a pronounced analgesic effect and a wide range of applications.Novocaine in the treatment of degenerative-dystrophic pathologies is prescribed to block peripheral nerves and nerve ganglia.It is the infringement of the spinal roots by osteophytes or hernia protrusion that causes acute pain.
Lidocaine is used not only for blockages.This is one of the active ingredients in tolperisone injection solution, a muscle relaxant that eliminates muscle spasms.Lidocaine is also included in preparations containing vitamin B.
Local irritants
For the treatment of cervical osteochondrosis, ointments, gels and balms with a local warming and irritating effect are very often prescribed, but only in the absence of soft tissue inflammation.They may contain camphor, menthol, turpentine, red hot pepper extract, nicoboxil, nonivamide, snake or bee venom.These ingredients irritate sensitive nerve endings located in the subcutaneous tissue, eliminating pain.
These agents have a vasodilatory effect, accompanied by a sensation of intense and prolonged heat.And by improving the blood supply to tissues with nutrients, their accelerated recovery occurs.
Patients are often prescribed locally irritating medications to reduce the dose of systemic analgesics and reduce the drug load on the body.
Medicines to improve blood microcirculation.
Means to improve blood circulation are used in the treatment of osteochondrosis of any localization.But specifically for cervical pathology, they are in greater demand.In this part of the spine, compression of the artery that supplies nutrients and oxygen to the brain usually occurs.The following medications help restore blood supply:
- Xanthinol nicotinate, which improves microcirculation, oxygenation, nutrition of cartilage tissue and all parts of the brain;
- Pentoxifylline, which reduces blood viscosity and the aggregation of platelets and red blood cells, improves the rheological properties of blood (fluidity);
- Aminophylline, which reduces tension on vascular walls and promotes expansion of peripheral vessels.
To improve microcirculation, preparations containing thioctic acid are often used.They have a vasodilating effect, restore the functioning of the spinal roots, improve trophism and innervation.
vitamins
To improve a person's well-being, strengthen the body's defenses and replenish the reserves of substances necessary for tissue regeneration, patients are prescribed balanced complexes of vitamins and microelements.It is enough to take one tablet of any drug per day to eliminate the resulting deficiency.
But vitamin B drugs are most often used in the treatment of cervical osteochondrosis.The composition of injectable solutions, in addition to pyridoxine, thiamine and cyanocobalamin, includes the anesthetic lidocaine.B vitamins may also be prescribed in tablet form.Its continuous use helps to improve the transmission of nervous impulses and stimulates natural mechanisms aimed at recovery.
Chondroprotectors
This is the only group of drugs that are used for the pathogenetic treatment of cervical osteochondrosis.At the initial stage of the development of pathology, chondroprotectors are used for partial restoration of intervertebral discs.This effect is due to the ability of chondroitin and glucosamine to stimulate the synthesis of proteoglycans, increase the production of hyaluronic acid, activate all functions of cartilage cells (chondrocytes) and suppress their premature destruction.
Chondroprotectors are also prescribed to patients with osteochondrosis of grades 2 and 3. 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 3 months.After using the products for 2 weeks, their pronounced anti-inflammatory and analgesic effect appears.
Active ingredients of drugs with chondroprotective activity 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 the ineffectiveness of conservative treatment, as well as complications of cervical osteochondrosis, for example, discogenic myelopathy, vertebral artery syndrome and radicular syndrome.To decompress the spinal cord, blood vessels and spinal roots, the following operations are performed:
- laminectomy;
- laminotomy;
- foraminotomy;
- facetectomy;
- discectomy.
During surgery, fragments of bone and ligaments may be removed, and intervertebral discs may be completely or partially removed.For small hernial protrusions, laser vaporization of the disc nucleus is often performed.
After excision of vertebral structures, stabilization of the motion segments of the spine by spinal fusion or installation of bone and dermal autografts is often required.
Massage and self-massage
There are many varieties of these healing procedures, but for cervical osteochondrosis, classical massage, acupressure, vacuum (including hardware) and segmental massage are most often used.The mechanical action on the neck, shoulders, forearms and back stimulates lymphatic drainage, eliminates venous congestion, strengthens muscles and relaxes skeletal muscles.Massage is used not only to treat the disease, but also to prevent its relapse.
Self-massage can be done by rubbing, stroking and squeezing the back of the neck for 10 to 15 minutes.But it is better to purchase special electrical devices in a pharmacy or medical equipment store - massagers equipped with comfortable long handles and speed controllers.
Exercise therapy complex
The physiotherapist selects the exercises individually for the patient, taking into account the severity of the pathology and the complications that have developed.One of the criteria is the frequency of neurological manifestations.Typically the complex includes the following exercises:
- Put your fingers together and place your palms on your forehead.Press your hands above your head, trying to tilt it back, providing resistance due to tension in the neck muscles;
- Put your fingers together and place your palms on the back of your head.Press your hands on it, as if trying to tilt your head down.At the same time, stretch the muscles of the neck and shoulders, trying to maintain the original position of the head;
- Place your palm on your cheek.Try to tilt your head towards your shoulder, resisting with your hand.Repeat the exercise on the other side.
Regular exercise therapy is the most effective way to eliminate the symptoms of cervical osteochondrosis and prevent its spread to healthy spinal structures.Daily training stimulates the strengthening of the muscular corset, which stabilizes the discs and vertebrae.And by improving blood circulation in the tissues, nutrient reserves are replenished.
manual therapy
The chiropractor always prepares the patient for the upcoming manipulations, starting the session with a relaxing massage.Then, with gentle movements, stretch the muscles and remove excess tension.As a result, muscle spasms disappear, which causes increased pain when the roots of the spine are pinched.The compression of the vertebral artery is eliminated and, with it, the neurological symptoms.The chiropractor adjusts the cervical vertebrae if necessary.This may be accompanied by crackling, crackling, 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 performed by a chiropractor on special tables.But the most popular is underwater traction in bathtubs or swimming pools.
Acupuncture
This is one of the types of reflexology recommended to patients to restore the mobility of the cervical vertebral structures and improve blood circulation.During the session, very fine needles of various lengths made of steel, silver and gold are used.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 the needles are placed, weak pain impulses begin to flow into the central nervous system.The body's response is the release of bioactive substances with analgesic and anti-inflammatory effects into the systemic circulation.The production of endorphins increases, significantly improving the patient's well-being.
Orthopedic treatment methods.
From the first days of treatment, patients are recommended to use orthopedic devices - Shants collars.They should be worn for several hours and removed before bedtime or during the day.Collars can be elastic with plastic or metal inserts, rigid or inflatable.Devices vary in height, degree of fixation and fastener design.The size of the collar for the patient is determined solely by the vertebrologist, who takes into account the severity of the symptoms of osteochondrosis and the likelihood of displacement of the vertebral structures.
Patients are recommended to purchase an orthopedic mattress of medium hardness.While resting on it, blood circulation in bones, cartilage and soft tissues does not deteriorate.Doctors also recommend sleeping on an orthopedic pillow with a special recess for the head.
Popular remedies and recipes.
After basic therapy and elimination of all symptoms, folk remedies are used.You should discuss the feasibility and safety of its use at home with your doctor.
honey ointment
Place a tablespoon of aloe juice and lanolin in a mortar and grind until forming a homogeneous mass.Add a teaspoon of turpentine gum, a drop of essential oils of eucalyptus, pine, rosemary, 30 g of thick flower honey and stir.Without stopping rubbing, add 100 g of medicinal Vaseline in small portions.The ointment is rubbed into the skin of the neck when discomfort occurs.
horseradish leaves
A large, fresh horseradish leaf is kneaded well, smeared with thick honey and applied to the nape of the neck.Secure the compress with plastic wrap, a warm cloth, and a gauze bandage.The duration of the procedure is 1 to 2 hours.
Other herbal compresses
Fresh plantain, dandelion, burdock, cinquefoil and elecampane leaves are ground in a mortar until a thick paste is obtained.Without stopping stirring, add a couple of drops of juniper and thyme essential oils, a tablespoon of almond cosmetic oil.Apply the mass to the nape of the neck, secure the compress with film and a medical bandage and leave it to act for one hour.
Ways to prevent the disease.
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 from the usual lifestyle factors that provoke a deterioration in the trophism of cartilage tissue.These are little physical activity, excess weight, excessive physical activity and dietary deficiency of foods rich in microelements and vitamins.