An integrated approach to the treatment of cervical osteochondrosis, aimed at reduction, is practiced
intensity of pain, stiffness.Medicines from various clinical-pharmacological groups, physiotherapy, classical and acupuncture massage, physical therapy and acupuncture are used in the therapy.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 the head bent or intense physical exertion, a slight discomfort appears in the back of the neck.The patient is in no hurry to go to the doctor, confusing them with the consequences of muscle tension.The pathology slowly but persistently progresses.
Discomfort in the neck is gradually replaced by an aching, dull pain in the neck area, which intensifies after lifting weights, hypothermia or a change in weather.Other specific symptoms of cervical osteochondrosis also appear:
- crunching, clicking when tilting or turning the head;
- limited mobility in the cervical spine;
- sharp, 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.Headache, dizziness, changes in blood pressure appear, visual and hearing acuity decrease.
Methods of treatment of cervical osteochondrosis
There are no drugs, the use of which would restore the 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 just to take pills or apply ointments - you need to do physiotherapy every day, visit a massage room and physiotherapy activities.
Drug therapy
Pharmacological drugs are used to eliminate the symptoms of cervical osteochondrosis, including by improving blood circulation and partial regeneration of the intervertebral discs.Due to the lack of characteristic signs in the initial stage, patients turn 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.That is why doctors include in therapeutic schemes not only analgesics, but also means to improve innervation, relax skeletal muscles and restore trophism.
NSAIDs
With osteochondrosis at 2-3 radiographic stages, patients complain of sharp, piercing pain that occurs when tilting or turning the head.In such cases, non-steroidal anti-inflammatory drugs are prescribed.In case of 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 injured by a displaced disc or osteophyte.
If the pain is not too intense and occurs from time to time, then NSAIDs in tablets or capsules are used:
- Nimesulide;
- ketorolac;
- Diclofenac;
- Celecoxib;
- Etoricoxib.
Systemic NSAIDs are quite toxic to the stomach because 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 pain that bothers the patient with a change in weather or hypothermia.Most often, treatment regimens include diclofenac, ketoprofen, arthrosilen, piroxicam, ibuprofen.
Hormones
Even if the intramuscular administration of NSAIDs does not have a suitable analgesic effect, then 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 drug blockades in combination with the anesthetics Lidocaine and Procaine.This method of administration of the drug ensures preservation of the analgesic 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 tendon-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 application.Novocaine in the treatment of degenerative-dystrophic pathologies is prescribed to block peripheral nerves and nerve ganglia.It is the damage to the spinal roots by osteophytes or hernial protrusion that causes sharp pain.
Lidocaine is used not only for blockades.It is one of the active ingredients in tolperisone injection solution, a muscle relaxant that relieves muscle spasms.Lidocaine is also included in preparations containing B vitamins.
Local irritants
For the treatment of cervical osteochondrosis, ointments, gels, balms with a warming and locally irritating effect are often prescribed, but only in the absence of soft tissue inflammation.They may contain camphor, menthol, turpentine, red pepper extract, nicoboxyl, nonivamid, snake or bee venom.These ingredients irritate the sensitive nerve endings located in the subcutaneous tissue, eliminating pain.
Such means have a vasodilating effect, accompanied by an intense, long-lasting sensation of heat.And by improving the blood supply to the tissues with nutrients, their accelerated recovery is obtained.
Patients are often prescribed topical irritants to reduce the dosage of systemic analgesics and reduce the pharmacological burden on the body.
Medicines to improve blood microcirculation
Means for improving blood circulation are used in the treatment of osteochondrosis of any localization.But especially for the pathology of the cervix, they are more often sought after.In this part of the spine, the artery that supplies nutrients and oxygen to the brain is often compressed.The following drugs help to restore blood supply:
- Xanthinol nicotinate, which improves microcirculation, oxygenation, nutrition of cartilage tissue and all parts of the brain;
- Pentoxifylline, which reduces the viscosity of blood and the aggregation of platelets and red blood cells, improves the rheological properties of blood (flowability);
- 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 trophicity 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 drug daily to eliminate the resulting deficiency.
But drugs with B vitamins are more often used in the treatment of cervical osteochondrosis.The composition of the injection solutions, in addition to pyridoxine, thiamine, cyanocobalamin, includes the anesthetic lidocaine.Tablet B vitamins may also be prescribed.Their regular use helps improve the transmission of nerve 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.In the initial stage of development of the pathology, chondroprotectors are used to partially restore 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, the 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 is manifested.
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 the 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;
- facetectomy;
- discectomy.
During the operation, bone fragments and ligaments can be cut out, and the intervertebral discs can be completely or partially removed.For small herniated protrusions, laser vaporization of the disc core is often performed.
After excision of vertebral structures, stabilization of spinal motion segments by spinal fusion or installation of bone and dermal autografts is often required.
Massage and self-massage
There are many varieties of these treatment procedures, but classical, acupressure, vacuum (including apparatus) and segmental massage are more often used for cervical osteochondrosis.The mechanical effect on the back of the neck, shoulders, forearms and back allows you to stimulate lymphatic drainage, remove venous congestion, strengthen muscles and relax skeletal muscles.Massage is used not only to treat the disease, but also to prevent relapse.
Self-massage can be done by rubbing, stroking, squeezing the back of the neck for 10-15 minutes.But it is better to buy special electrical devices in a pharmacy or medical equipment store - massagers equipped with convenient long handles and speed regulators.
Complex of exercises for therapy
The doctor of physical therapy chooses 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.Usually 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 it with your hands as if you are trying to tilt your head down.At the same time, tense the muscles of the neck and shoulders, trying to keep the initial position of the head;
- place a 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 get rid of the symptoms of cervical osteochondrosis and prevent its spread to healthy spinal structures.Daily training stimulates the strengthening of the muscular corset that stabilizes the discs and vertebrae.And by improving the blood circulation in the tissues, the reserves of nutrients are replenished.
Manual therapy
The manual therapist always prepares the patient for the upcoming manipulations by 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, causing increased pain when pinching the spinal roots.The compression of the vertebral artery is eliminated, and along with it, the neurological symptoms.The chiropractor adjusts the cervical vertebrae as needed.This can be accompanied by crunching, 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 on special tables by a manual therapist.But the most popular is underwater traction in bathtubs or pools.
Acupuncture
This is one of the types of reflexology recommended to patients to restore the mobility of the cervical spinal 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 into the central nervous system.The body's response is the release of bioactive substances with analgesic and anti-inflammatory action into the systemic circulation.The production of endorphins increases, which significantly improves the patient's well-being.
Orthopedic methods of treatment
From the first days of treatment, patients are advised to wear orthopedic devices - Shants collars.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 differ in height, degree 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 with medium firmness.When resting on it, there is no deterioration of the blood circulation of the bones, cartilages and soft tissues.Doctors also advise sleeping on an orthopedic pillow with a special recess for the head.
Folk remedies and recipes
After basic therapy and removal 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 one tablespoon of aloe juice and lanolin in a mortar and rub until a homogeneous mass is formed.Add a teaspoon of turpentine gum, a drop of essential oils of eucalyptus, pine, rosemary, 30 g of thick flower honey, mix.Without stopping to rub, in small portions add 100 g of medical petroleum jelly.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 back of the head.Secure the compress with plastic wrap, a warm washcloth, and gauze.The duration of the procedure is 1-2 hours.
Other herbal compresses
Fresh leaves of plantain, dandelion, burdock, cinquefoil and comfrey are ground in a mortar to a thick paste.Without stopping stirring, add a few drops of juniper and thyme essential oils, a tablespoon of almond cosmetic oil.Apply the mass to the back of the neck, secure the compress with a film and a medical bandage and leave for an hour.
Ways to prevent the disease
Osteochondrosis is a recurrent degenerative pathology that occurs against the background of the gradual destruction of the intervertebral discs and bone deformation.It is necessary to exclude from the usual lifestyle factors that provoke a deterioration of cartilage tissue trophism.These are low physical activity, overweight, excessive physical activity and lack of foods with a high content of trace elements and vitamins in the diet.