An integrated approach to the treatment of cervical osteochondrosis is practiced, aimed at reduction
severity of pain, stiffness.Therapy uses drugs from various clinical and pharmacological groups, physiotherapy, classical and acupuncture massage, exercise therapy and acupuncture.If conservative treatment methods are ineffective, surgical operations are performed.
Symptoms of the disease
In 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 see a doctor, confusing them about the consequences of muscle strain.The pathology is progressing slowly but steadily.
Discomfort in the neck is gradually replaced by pain, dull pain in the neck, which intensifies after heavy lifting, hypothermia or change of weather.Other specific symptoms of cervical osteochondrosis appear:
- creaking, clicking when you tilt or turn your head;
- limited mobility in the cervical spine;
- sharp pains, strong during irritations.
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 spinal roots and vertebral artery.Headaches, dizziness, changes in blood pressure appear, and the sharpness of vision and hearing decreases.
Methods of treatment of cervical osteochondrosis
There are no drugs, the use of which would restore the vertebral structures.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 physical therapy every day, visit the massage room and physiotherapeutic activities.
Drug therapy
Pharmacological drugs are used to eliminate the symptoms of cervical osteochondrosis, including improving blood circulation and partial regeneration of the intervertebral discs.Due to the lack of characteristic signs in the initial stage, patients are referred to a vertebrologist or neurologist with pathology of 2 and 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 radiographic stage 2-3 osteochondrosis, patients complain of sharp, piercing pain that occurs when they lean or turn their head.In such cases, they are prescribed non-steroidal anti-inflammatory drugs.For severe pain, intramuscular injection of solutions is practiced - Diclofenac, Meloxicam, Lornoxicam, Ketorolac.Medicines have not only analgesic, but also anti-inflammatory and anti-edematous effects.This is especially true when the soft tissues of the neck are damaged by a displaced disc or osteophytes.
If the pain is not very intense and appears from time to time, then NSAIDs are used in tablets or capsules:
- Nimesulide;
- Ketorolac;
- Diclofenac;
- Celecoxib;
- Etoricoxib.
Systemic NSAIDs are quite toxic to the stomach, as they provoke increased production of hydrochloric acid.To eliminate the possibility of mucosal damage, it is necessary to take proton pump inhibitors together with NSAIDs.
Ointments and gels are used to eliminate mild pains that disturb the patient when the weather changes or hypothermia.Most often, treatment regimens include Diclofenac, Ketoprofen, Artrozilen, Piroxicam, Ibuprofen.
Hormones
Even if the intramuscular administration of NSAIDs does not have the appropriate analgesic effect, then hormonal agents are used - Methylprednisolone, Triamcinolone, Betamethasone, Dexamethasone.Glucocorticosteroids are characterized by pronounced analgesic, anti-inflammatory and antiexudative activity.Hormonal drugs are usually used for drug blockades in combination with the anesthetics Lidocaine and Procaine.This method of drug administration ensures 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 ligamento-tendon apparatus.Hormonal drugs also have an immunosuppressive effect, which negatively affects the immune system.
Anesthetics
Anesthetics Lidocaine and Novocaine (Procaine) are most often used in the treatment of cervical osteochondrosis for drug blockades.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 damage to the spinal roots by osteophytes or hernial protrusion that causes acute pain.
Lidocaine is used not only for blockades.This is one of the active ingredients of Tolperisone injection solution, a muscle relaxant that eliminates muscle spasms.Lidocaine is also included in preparations containing B vitamins.
Local bullies
Ointments, gels, balms with a local warming and 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, cayenne pepper extract, nicoboxil, nonivamide, snake or bee venom.These ingredients irritate the sensitive nerve endings located in the subcutaneous tissue, eliminating pain.
Such agents have a vasodilating effect, accompanied by a feeling of intense and prolonged warmth.And by improving the blood supply of tissues with nutrients, their accelerated recovery occurs.
Local irritant drugs are often prescribed to patients to reduce the dose of systemic analgesics and reduce the pharmacological load on the body.
Drugs for improving blood microcirculation
Means for improving blood circulation are used in the treatment of osteochondrosis of any location.But specifically for cervical pathology, they are more often in demand.In this part of the spine, compression of the artery that supplies the brain with nutrients and oxygen often occurs.The following drugs 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 aggregation of platelets and red blood cells, improves blood rheological properties (fluidity);
- Aminophylline, which reduces the tension in the vascular walls and promotes the expansion of peripheral vessels.
Preparations containing thioctic acid are often used to improve microcirculation.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 trace elements.It is enough to take one tablet of each medicine per day to eliminate the resulting deficiency.
But drugs with B vitamins are more often used in the treatment of cervical osteochondrosis.The composition of solutions for injection, in addition to pyridoxine, thiamine, cyanocobalamin, includes the anesthetic Lidocaine.B vitamins may also be prescribed in tablets.Their course use helps improve the transmission of nerve impulses and stimulates natural mechanisms aimed at recovery.
Chondroprotectors
This is the only group of drugs used for the pathogenetic treatment of cervical osteochondrosis.In the initial stage of the development of the pathology, chondroprotectors are used for the partial restoration of the 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 the functions of cartilage cells (chondrocytes) and suppress their premature destruction.
Chondroprotectors are also prescribed to patients with grade 2 and 3 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 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;
- Ingredients 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.To decompress the spinal cord, blood vessels and spinal roots, the following operations are performed:
- laminectomy;
- laminotomy;
- foraminotomy;
- facetectomy;
- discectomy.
During surgery, bone fragments and ligaments can be removed and the intervertebral discs can be removed completely or partially.For small herniated protrusions, laser vaporization of the disc core is often performed.
After removal of the vertebral structures, stabilization of the motion segments of the spine is often required by spinal fusion or installation of bone and dermal autografts.
Massage and self-massage
There are many types of these healing procedures, but classical massage, acupressure, vacuum (including hardware) and segmental massage are most often used for cervical osteochondrosis.Mechanical action on the back of the neck, shoulders, forearms and back allows you to stimulate 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 performed by rubbing, stroking, squeezing the back of the neck for 10-15 minutes.But it is better to buy special electrical equipment in a pharmacy or medical equipment store - massagers equipped with long comfortable 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:
- squeeze your fingers and place your palms on your forehead.Press your hands on your head, trying to tilt it back, providing resistance due to the tension in the neck muscles;
- squeeze your fingers and place your palms on the back of your head.Press with your hands on it, as if trying to tilt your head down.At the same time, strain the muscles of the neck and shoulders, trying to maintain the original position of the head;
- put your palm on your cheek.Try to tilt your head to the shoulder, resisting with your hand.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 its spread to healthy vertebral structures.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 reserves of nutrients are replenished.
Manual therapy
The chiropractor always prepares the patient for the upcoming manipulations, starting the session with a relaxing massage.Then, using smooth movements, he stretches the muscles and eliminates their excess tension.As a result, muscle spasms disappear, causing increased pain when the spinal roots are pressed.The disappearance of the vertebral artery is eliminated and along with it the neurological symptoms.The chiropractor adjusts the cervical vertebrae if necessary.This may be accompanied by creaking, creaking, clicking and increased severity of painful sensations.
One way to avoid surgery is to stretch (retract) the spine to increase the distance between the vertebral bodies and the damaged discs.The procedure is performed on separate tables by a chiropractor.But the most popular is the underwater attraction in bathtubs or swimming pools.
Acupuncture
This is one of the types of reflexology that is recommended for patients to restore the mobility of the cervical vertebral 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 the needles are inserted, weak pain impulses begin to flow to the central nervous system.The body's response is to release bioactive substances with an analgesic and anti-inflammatory effect into the systemic circulation.Endorphin production increases, significantly improving the patient's well-being.
Orthopedic treatment methods
From the first days of treatment, patients are advised to wear orthopedic equipment - Shants collar.They should be worn for several hours and should be removed before going to bed 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 only by the vertebrologist, who takes into account the severity of the symptoms of osteochondrosis and the possibility of displacement of the vertebral structures.
Patients are recommended to buy an orthopedic mattress with medium firmness.While staying in it, there is no deterioration of the blood circulation of bones, cartilage and soft tissues.Doctors also advise sleeping on an orthopedic pillow with a special cut for the head.
Folk remedies and recipes
After basic therapy and elimination of all symptoms, folk remedies are used.The feasibility and safety of their use at home should be discussed with your doctor.
Ointment with honey
Put a tablespoon of aloe juice and lanolin in a mortar and grind until a homogeneous mass is created.Add a teaspoon of gum turpentine, a drop of essential oils of eucalyptus, pine, rosemary, 30 g of thick flower honey, mix.Without stopping rubbing, introduce 100 g of medical petroleum jelly in small portions.The ointment is rubbed into the skin of the neck when discomfort occurs.
Horseradish leaves
A large fresh horseradish leaf is mixed well, smeared with thick honey and applied to the back of the neck.Secure the compress with plastic wrap, warm cloth and gauze bandage.The duration of the procedure is 1-2 hours.
Other herbal compresses
In a mortar, fresh leaves of plantain, dandelion, burdock, chalk and elecampane are ground into a thick paste.Without stopping mixing, add a few drops of essential oils of juniper and thyme, a tablespoon of cosmetic almond oil.Apply the mass to the back of the neck, secure the compress with film and medical bandage and leave for an hour.
Ways to prevent the disease
Osteochondrosis is a recurrent degenerative pathology that occurs against the background of gradual destruction of the intervertebral discs and bone deformation.It is necessary to exclude from the usual lifestyle the factors that provoke deterioration of cartilage tissue trophism.These are low physical activity, excess weight, excessive physical activity and lack of foods rich in microelements and vitamins in the diet.