An integrated approach to the treatment of cervical osteochondrosis is applied, the aim of which is to reduce it
pain intensity, stiffness.Medicines from different 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
In the initial stage of development, osteochondrosis is asymptomatic.After a long stay with the head down or intense physical activity, mild discomfort occurs in the back of the head.The patient is not in a hurry to see the doctor, mistaking it for the consequences of muscle strain.The pathology progresses slowly but steadily.
Discomfort in the neck is gradually replaced by aching, dull pain in the neck, which intensifies after lifting a heavy load, hypothermia or change of 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 spinal roots and vertebral artery.Headache, dizziness, changes in blood pressure appear, and the sharpness of vision and hearing decreases.
Methods of treatment of cervical osteochondrosis
There are no drugs whose application 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 to just drink 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 symptoms of cervical osteochondrosis, including improving blood circulation and partial regeneration of intervertebral discs.Due to the absence of characteristic signs in the initial stage, patients turn to a vertebrologist or neurologist with a pathology of 2 or even 3 degrees of severity.Often, complications have already developed - intervertebral hernia, protrusion, vertebral artery syndrome.Therefore, doctors include not only analgesics in therapeutic regimens, but also means for improving innervation, relaxing skeletal muscles, and restoring trophism.
NSAIDs
In radiographic stage 2-3 osteochondrosis, patients complain of sharp, piercing pain that occurs when leaning or turning the head.In such cases, they are prescribed non-steroidal anti-inflammatory drugs.For severe pain, intramuscular injection of solutions - diclofenac, meloxicam, lornoxicam, ketorolac - is practiced.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 non-steroidal anti-inflammatory drugs in tablets or capsules are used:
- nimesulide;
- Ketorolac;
- Diclofenac;
- Celecoxib;
- Etoricoxib.
Systemic NSAIDs are quite toxic to the stomach, as they cause 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 torments the patient during a change in weather or hypothermia.Most often, treatment regimens include diclofenac, ketoprofen, arthrosilen, piroxicam, ibuprofen.
Hormones
Even if intramuscular administration of NSAIDs does not have an appropriate analgesic effect, then hormonal agents are used - methylprednisolone, triamcinolone, betamethasone, dexamethasone.Glucocorticosteroids are characterized by pronounced analgesic, anti-inflammatory and anti-exudative effects.Hormonal drugs are usually used for blocking drugs in combination with the anesthetics lidocaine and procaine.This method of administering the drug ensures the preservation of the analgesic effect for several days, and sometimes even weeks.
But glucocorticosteroids are not intended for frequent use.They are toxic to internal organs and damage cartilage, bones and ligamentous-tendon apparatus.Hormonal drugs also have an immunosuppressive effect, which negatively affects the immune system.
Anesthetics
In the treatment of cervical osteochondrosis, the anesthetics lidocaine and novocaine (procaine) are most often used to block drugs.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.Injury to the spinal roots by osteophytes or hernial protrusion 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 B vitamins.
Local irritants
For the treatment of cervical osteochondrosis, ointments, gels, balms with a warming and local irritating effect are often prescribed, but only in the absence of soft tissue inflammation.May contain camphor, menthol, turpentine, red hot 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 an intense, prolonged feeling of warmth.And by improving the supply of tissues with nutrients by blood, their accelerated recovery occurs.
Patients are often prescribed local irritant drugs in order 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 in the treatment of osteochondrosis of any location.But especially for the pathology of the cervix, they are more often requested.In this part of the spine, the artery that supplies the brain with nutrients and oxygen is often compressed.The following medications help restore the 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 the rheological properties of blood (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 spinal roots, improve trophism and innervation.
Vitamins
In order to improve a person's well-being, strengthen the body's defenses and replenish 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 medicine a 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 injections, in addition to pyridoxine, thiamine, cyanocobalamin, includes the anesthetic Lidocaine.B vitamins in tablets may also be prescribed.Their regular use helps improve the transmission of nerve impulses and stimulates natural recovery mechanisms.
Chondroprotectors
This is the only group of drugs used for the pathogenetic treatment of cervical osteochondrosis.In 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 stimulate the synthesis of proteoglycans, increase the production of hyaluronic acid, activate all the functions of cartilage cells (chondrocytes) and prevent their premature destruction.
Chondroprotectors are also prescribed to patients with osteochondrosis 2 and 3 degrees.At this stage, cartilage tissue is no longer susceptible 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 2 weeks of using the products, their pronounced anti-inflammatory and analgesic 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 vegetable 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;
- facetectomy;
- discectomy.
During surgery, bone fragments and ligaments may be cut, and the intervertebral discs may be completely or partially removed.For small herniated protrusions, laser vaporization of the disc core is often performed.
After excision of the vertebral structures, stabilization of the mobile segments of the spine is often required by spinal fusion or the installation of bone and dermal autografts.
Massage and self-massage
There are many variants of these procedures, but classical, acupressure, vacuum (including hardware) and segmental massage are more 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, caressing, 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 comfortable long handles and speed regulators.
Exercise therapy complex
The doctor of physical therapy selects 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:
- put your fingers together and place your palms on your forehead.Press your hands on your head, trying to tilt it back, resisting due to the tension in the neck muscles;
- put your fingers together 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, 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 lean your head on 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, which stabilizes the discs and vertebrae.And by improving the blood circulation in the tissues, the reserves of nutrients are renewed.
Manual therapy
The chiropractor always prepares the patient for the upcoming 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, causing increased pain when the spinal roots are compressed.Compression of the vertebral artery is eliminated, along with neurological symptoms.A chiropractor adjusts the cervical vertebrae if necessary.This may be accompanied by creaking, cracking, clicking and increasing intensity 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 chiropractor.But the most popular is underwater towing in bathtubs or swimming pools.
Acupuncture
This is one of the types of reflexology recommended to patients to restore the mobility of the structures of the neck vertebrae 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 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, which significantly improves the patient's well-being.
Orthopedic methods of treatment
From the first days of treatment, patients are advised to wear orthopedic aids - Shants collars.They must be worn for several hours and must be removed before going to bed or during the day.Collars can be elastic with plastic or metal inserts, rigid or inflatable.The devices differ in height, degree of fixation and design of the closure.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 probability of displacement of the vertebral structures.
Patients are recommended to purchase an orthopedic mattress of medium hardness.While resting on it, the blood circulation of bones, cartilage and soft tissues does not deteriorate.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.
Honey ointment
Place a spoonful of aloe juice and lanolin in a plate and grind until a homogeneous mass is formed.Add a teaspoon of gum turpentine, a drop of essential oils of eucalyptus, pine, rosemary, 30 g of thick floral honey, mix.Without stopping rubbing, enter 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 kneaded well, smeared with thick honey and applied to the back of the head.Secure the wrap with plastic wrap, a warm cloth, and a gauze bandage.The duration of the procedure is 1-2 hours.
Other herbal dressings
In a mortar, fresh leaves of plantain, dandelion, thistle, five-leaf clover and elecampane are ground into a thick paste.Without stopping to mix, add a few drops of juniper and thyme essential oils, a spoonful of almond cosmetic oil.Apply the mass to the back of the neck, secure the wrap with foil and a medical bandage and leave 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.From the usual way of life, it is necessary to exclude factors that cause deterioration of cartilage tissue trophism.These are low physical activity, excess weight, excessive physical activity, and lack of food rich in microelements and vitamins.