An integrated approach to the treatment of cervical osteochondrosis is practiced, with the aim of reducing
pain intensity, stiffness.Therapy uses medicines from different clinical and pharmacological groups, physiotherapy, classical massage and acupuncture, exercise therapy and acupuncture.If conservative methods of treatment 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 see a doctor, confusing him with the consequences of a muscle strain.The pathology progresses slowly but persistently.
The discomfort in the neck is gradually replaced by a dull, dull pain in the neck, which intensifies after heavy lifting, hypothermia, or a change in weather.Other specific symptoms of cervical osteochondrosis appear:
- crunching, clicking when tilting or turning the head;
- limited mobility in the cervical spine;
- sharp and intense 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 hearing acuity decreases.
Treatment methods for cervical osteochondrosis
There are no medications whose use can restore vertebral structures.But it is quite possible to improve the patient's well-being and prevent the spread of the disease.It's not enough to just take pills or apply ointments - you need to do physiotherapy every day, attend a massage room and undergo physiotherapeutic 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 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 osteochondrosis of 2-3 radiographic stages, patients complain of sharp, stabbing pain that occurs when tilting or turning the head.In these cases, non-steroidal anti-inflammatory drugs are prescribed.For severe pain, intramuscular injection of solutions is practiced - Diclofenac, Meloxicam, Lornoxicam, Ketorolac.The medicines 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 very 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, as 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 mild pain that bothers the patient when the weather changes or hypothermia.Most often, treatment regimens include Diclofenac, Ketoprofen, Artrosilene, Piroxicam, Ibuprofen.
Hormones
Even if 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 generally used for drug blocks 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-tendon apparatus.Hormonal medications 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 drug 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 hernial protrusion that causes acute pain.
Lidocaine is not just used for blockages.This is one of the active ingredients in Tolperisone injectable solution, a muscle relaxant that eliminates muscle spasms.Lidocaine is also included in preparations containing B vitamins.
Local irritants
Ointments, gels, balms with a warming and local irritating effect are often prescribed for the treatment of cervical osteochondrosis, but only in the absence of inflammation of soft tissues.They may contain camphor, menthol, turpentine, red pepper extract, nicoboxyl, nonivamide, snake or bee venom.These ingredients irritate the sensitive nerve endings located in the subcutaneous tissue, eliminating pain.
These agents have a vasodilatory effect, accompanied by an intense and prolonged sensation of heat.And by improving the blood supply to tissues with nutrients, their accelerated recovery occurs.
Locally irritating medications are often prescribed to patients 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 specifically for cervical pathology, they are most in demand.In this part of the spine, compression of the artery that supplies nutrients and oxygen to the brain often occurs.The following medications help restore blood supply:
- Xanthinol nicotinate, which improves microcirculation, oxygenation, nutrition of cartilaginous 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 in 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
To improve a person's well-being, strengthen the body's defenses and replenish reserves of substances necessary for tissue regeneration, patients are given balanced complexes of vitamins and microelements.It is enough to take one tablet of any medicine daily to eliminate the resulting deficiency.
But medicines with B vitamins are most often used in the treatment of cervical osteochondrosis.The composition of injectable solutions, in addition to pyridoxine, thiamine, cyanocobalamin, includes the anesthetic Lidocaine.B vitamins in tablets may also be prescribed.Its use in the course helps to improve the transmission of nerve impulses and stimulate natural recovery mechanisms.
Chondroprotectors
This is the only group of drugs used in the pathogenetic treatment of cervical osteochondrosis.At the initial stage of the 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 for patients with grade 2 and 3 osteochondrosis. At this stage, cartilaginous tissue is no longer subject to regeneration.But taking medications in doses of 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 medicines 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, bone fragments and ligaments can be excised and intervertebral discs can be removed in whole or in part.For small hernial protrusions, laser vaporization of the disc nucleus is often performed.
After excision of the vertebral structures, stabilization of the spinal motion segments is often required by spinal fusion or the installation of bone and dermal autografts.
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.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 relapse.
Self-massage can be performed by rubbing, stroking and squeezing the back of the neck for 10-15 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 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:
- bring your fingers together and place your palms on your forehead.Press your hands on your head, trying to tilt it back, providing resistance due to tension in the neck muscles;
- bring your fingers together and place your palms on the back of your head.Press with your hands, as if you are trying to tilt your head down.At the same time, tense your neck and shoulder muscles, trying to maintain the original position of your head;
- place your palm on your cheek.Try tilting 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 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, he stretches the muscles and eliminates excess tension.As a result, muscle spasms disappear, causing increased pain when the spinal roots are pinched.Compression of the vertebral artery is eliminated and, with it, neurological symptoms.The chiropractor adjusts the cervical vertebrae if necessary.This may be accompanied by pops, pops, clicks and an increase in the severity of painful sensations.
One way to avoid surgery is to lengthen (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 traction in bathtubs or swimming pools.
Acupuncture
This is one of the types of reflexology recommended to patients to restore mobility to cervical vertebral structures and improve blood circulation.During the session, very thin needles of various lengths made of steel, silver and gold are used.They are installed on biologically active points located not only on the back of the head, 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 advised to wear orthopedic devices - Shants collars.They need to be worn for several hours and must be removed before bed or during the day.Collars can be elastic with plastic or metal inserts, rigid or inflatable.Devices vary in height, degree of attachment, and attachment 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 likelihood of displacement of the vertebral structures.
Patients are recommended to purchase an orthopedic mattress of medium hardness.When resting on it, there is no deterioration in the blood circulation of bones, cartilage and soft tissues.Doctors also advise sleeping on an orthopedic pillow with a special indentation for the head.
Folk remedies and recipes
After basic therapy and elimination of all symptoms, folk remedies are used.The feasibility and safety of its use at home should be discussed with your doctor.
Honey ointment
Place a tablespoon of aloe vera juice and lanolin in a mortar and grind until a homogeneous mass is formed.Add a teaspoon of turpentine gum, a drop of essential oils of eucalyptus, pine, rosemary, 30 g of coarse flower honey and stir.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 crushed well, smeared with thick honey and applied to the back of the head.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
In a mortar, fresh banana, dandelion, burdock, cinquefoil and elecampane leaves are ground into 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, fix the compress with 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 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 cartilaginous tissue.They are low physical activity, excess weight, excessive physical activity and a deficiency in the diet of foods rich in microelements and vitamins.