An integrated approach to the treatment of cervical osteochondrosis is practiced, aimed at reducing it
Severity of pain, stiffness.Therapy includes drugs from various clinical and pharmacological groups, physiotherapy, classical and acupuncture massage, exercise therapy and acupuncture.If conservative treatment methods are ineffective, surgical interventions are performed.
Symptoms of the disease
At the initial stage of development, osteochondrosis is asymptomatic.After spending a long time with your head down or doing intensive physical activity, you may experience slight discomfort in the neck area.The patient is in no hurry to see a doctor, confusing it with the consequences of a muscle strain.The pathology progresses slowly but persistently.
Discomfort in the neck is gradually replaced by aching, dull pain in the neck, which increases after heavy lifting, hypothermia or a change in the weather.Other specific symptoms of cervical osteochondrosis occur:
- Crunching, clicking when tilting or turning the head;
- limited mobility of 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 herniated protrusion of the spinal roots and vertebral artery.Headaches, dizziness, changes in blood pressure occur, and visual and hearing acuity decrease.
Treatment methods for cervical osteochondrosis
There are no medications whose use would restore the vertebral structures.However, 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 tablets or apply ointments - you need to do physiotherapy every day, visit a massage room and do physiotherapy 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 in the initial stages, patients with pathology of 2 and even 3 degrees of severity turn to a vertebrologist or neurologist.Often they have already developed complications – intervertebral hernia, protrusion, vertebral artery syndrome.Therefore, doctors include in their therapeutic plans not only analgesics, but also means to improve innervation, relax skeletal muscles and restore trophism.
NSAIDs
With osteochondrosis in the 2-3rdX-ray stage, patients complain of sharp, stabbing pain that occurs when tilting or turning the head.In such cases, they are prescribed non-steroidal anti-inflammatory drugs.In case of severe pain, intramuscular injection of solutions is practiced – Diclofenac, Meloxicam, Lornoxicam, Ketorolac.The drugs have not only analgesic, but also anti-inflammatory and anti-edematous effects.This is especially true if the soft tissues of the neck are injured by a displaced disc or osteophyte.
If the pain is not too severe 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 exclude the possibility of damage to the mucous membrane, it is necessary to take proton pump inhibitors together with NSAIDs.
Ointments and gels are used to eliminate mild pain that bothers the patient during weather changes or hypothermia.Most commonly, treatment regimens include diclofenac, ketoprofen, artrosilene, piroxicam, and ibuprofen.
Hormones
Even if the intramuscular administration of NSAIDs does not have the correct analgesic effect, hormonal agents are used - methylprednisolone, triamcinolone, betamethasone, dexamethasone.Glucocorticosteroids are characterized by a pronounced analgesic, anti-inflammatory and anti-exudative effect.Hormonal medications are usually used in combination with the anesthetics lidocaine and procaine for drug blockades.This method of drug administration ensures the maintenance of the analgesic effect for several days and sometimes weeks.
However, glucocorticosteroids are not intended for frequent use.They are toxic to internal organs and damage cartilage, bones and the ligamentous tendon system.Hormonal medications also have an immunosuppressive effect, which has a negative impact on the immune system.
Anesthetics
The anesthetics lidocaine and novocaine (procaine) are most often used in the treatment of cervical osteochondrosis with drug blocks.The latter is characterized by a pronounced pain-relieving effect and a wide range of applications.Novocaine is prescribed for the treatment of degenerative-dystrophic diseases, to block peripheral nerves and nerve ganglia.It is the injury to the spinal roots caused by osteophytes or hernia bulges that causes acute pain.
Lidocaine is not only used for blockages.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 irritants
For the treatment of cervical osteochondrosis, ointments, gels, balms with a warming and local irritating effect are very often prescribed, but only if there is no inflammation of the soft tissues.They may contain camphor, menthol, turpentine, red pepper extract, nicoboxil, nonivamide, snake or bee venom.These ingredients irritate sensitive nerve endings in the subcutaneous tissue, thereby eliminating pain.
Such agents have a vasodilating effect, accompanied by an intense, persistent feeling of warmth.And by improving the blood supply of nutrients to the tissues, accelerated recovery occurs.
Patients are often prescribed local irritating drugs to reduce the dosage of systemic analgesics and reduce the pharmacological burden on the body.
Drugs to improve blood microcirculation
Means that improve blood circulation are used in the treatment of osteochondrosis of any localization.But specifically for the pathology of the cervix they are in demand more often.In this part of the spine, compression of the artery that supplies nutrients and oxygen to the brain often occurs.The following drugs help restore blood supply:
- Xanthinol nicotinate, which improves microcirculation, oxygenation and 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 tension in the vascular walls and promotes the dilation of peripheral vessels.
To improve microcirculation, preparations containing thioctic acid are often used.They have a vasodilating effect, restore the function 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 a drug daily to eliminate the resulting deficiency.
However, in the treatment of cervical osteochondrosis, drugs containing B vitamins are more often used.In addition to pyridoxine, thiamine and cyanocobalamin, the composition of injection solutions includes the anesthetic lidocaine.B vitamins can also be prescribed in tablet form.Their course application helps to improve the transmission of nerve impulses and stimulate natural mechanisms for recovery.
Chondroprotectors
This is the only group of drugs used for the pathogenetic treatment of cervical osteochondrosis.At the initial stage of pathological development, 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 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.However, taking medication in doses up to 800 mg prevents further destructive and degenerative changes.The duration of the therapy course is 3 months.After using the products for 2 weeks, their pronounced anti-inflammatory and pain-relieving effects become apparent.
Active ingredients of drugs with chondroprotective effects 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 and complications of cervical osteochondrosis, for example, discogenic myelopathy, vertebral artery syndrome and radicular syndrome.To relieve the load on 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 excised and intervertebral discs can be removed in whole or in part.For small hernia protrusions, laser vaporization of the disc nucleus is often performed.
After removal of vertebral structures, stabilization of the motion segments of the spine through spinal fusion or installation of bone and skin autografts is often required.
Massage and self-massage
There are many variations of these healing procedures, but for cervical osteochondrosis, classical massage, acupressure, vacuum (including hardware) and segmental massage are more often used.Mechanical action on 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 relapse.
Self-massage can be performed by rubbing, stroking and pressing the neck for 10-15 minutes.However, it is better to purchase special electrical devices in a pharmacy or medical equipment store - massagers equipped with comfortable long handles and speed controls.
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 arisen.One of the criteria is the frequency of neurological manifestations.Typically the complex includes the following exercises:
- Fold your fingers and place your palms on your forehead.Press your hands on your head and try to tilt it back to provide resistance by tensing the neck muscles.
- Fold your fingers and place your palms on the back of your head.Press it with your hands as if you were trying to tilt your head down.At the same time, tense your neck and shoulder muscles and try to maintain the original position of your head.
- Place your palm on your cheek.Try tilting your head toward your shoulder and providing resistance 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 vertebral structures.Daily training stimulates the strengthening of the muscle corset, which stabilizes the intervertebral discs and vertebrae.And the improved blood circulation in the tissue replenishes the nutrient reserves.
Manual therapy
The chiropractor always prepares the patient for the upcoming procedures and begins the session with a relaxing massage.Then, with gentle movements, he stretches the muscles and eliminates their excessive tension.This eliminates muscle spasms and increases pain when the spinal roots become pinched.The compression of the vertebral artery and thus the neurological symptoms are eliminated.If necessary, the chiropractor corrects the cervical vertebrae.This may be accompanied by crunching, crackling, clicking and an increase in pain 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 on special tables by a chiropractor.However, the most popular is underwater traction in bathtubs or pools.
acupuncture
This is one of the types of reflexology massage recommended to patients to restore mobility to the cervical vertebral structures and improve blood circulation.The session uses very thin needles of different lengths made of steel, silver and gold.They are placed on biologically active points not only on 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 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 recommended to wear orthopedic devices - Shants collars.They must be worn for several hours and removed before bed or during the day.Collars can be elastic with plastic or metal inserts, rigid or inflatable.The devices differ in height, degree of fastening and fastening design.The size of the collar for the patient is determined only by the vertebral doctor, 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.There is no deterioration in blood flow to bones, cartilage and soft tissue while lying down.Doctors also recommend sleeping on an orthopedic pillow with a special recess for the head.
Folk remedies and recipes
After basic therapy and elimination of all symptoms, folk remedies are used.The feasibility and safety of using them at home should be discussed with your doctor.
Honey ointment
Put a tablespoon of aloe juice and lanolin in a mortar and grind until a homogeneous mass is obtained.Add a teaspoon of balsam turpentine, a drop of eucalyptus, pine, rosemary essential oil and 30 g of thick floral honey and stir.Without stopping rubbing, add 100 g of medical petroleum jelly in small portions.In case of discomfort, the ointment is rubbed into the skin of the neck.
Horseradish leaves
A large fresh horseradish leaf is kneaded well, smeared with thick honey and applied to the neck.Secure the compress with plastic wrap, a warm cloth, and a gauze bandage.The duration of the procedure is 1-2 hours.
Other herbal compresses
Fresh leaves of plantain, dandelion, burdock, cinquefoil and elecampane are ground into a thick paste in a mortar.While stirring constantly, add a few drops of juniper and thyme essential oils and a tablespoon of cosmetic almond oil.Apply the mass to the neck, secure the compress with foil 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 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 low physical activity, overweight, excessive physical activity and a lack of foods high in microelements and vitamins.