An integrated approach to the treatment of cervical osteochondrosis is practiced, aimed at reduction
severity of pain, stiffness.The therapy uses drugs from different clinical and pharmacological groups, physiotherapy, classical and acupuncture massage, physical 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 your head bowed or intense physical activity, you feel a slight discomfort in the back of your neck.The patient is in no hurry to consult a doctor, mistaking it for the consequences of muscle strain.The pathology is progressing slowly but persistently.
Neck discomfort is gradually replaced by a dull, aching pain in the neck, which intensifies after heavy lifting, hypothermia or a change in the weather.Other specific symptoms of cervical osteochondrosis appear:
- creaking, clicking sounds when you tilt or turn your head;
- limited mobility in the cervical spine;
- sharp, severe pain during flare-ups.
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 drugs whose use can restore 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 take pills or apply ointments: you need to do physiotherapy every day, visit a massage parlor and physiotherapeutic 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 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, piercing pain that occurs when tilting or turning the head.In these cases, nonsteroidal anti-inflammatory drugs are prescribed.For severe pain, intramuscular injection of solutions is performed: Diclofenac, Meloxicam, Lornoxicam, Ketorolac.The drugs 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 osteophyte.
If the pain is not too 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 an increase in the production of hydrochloric acid.To eliminate the possibility of damage to the mucosa, it is necessary to take proton pump inhibitors along 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 the correct analgesic effect, hormonal agents are used: methylprednisolone, triamcinolone, betamethasone, dexamethasone.Glucocorticosteroids are characterized by pronounced analgesic, anti-inflammatory and anti-exudative activity.For drug blocking, hormonal drugs are usually used in combination with the anesthetics lidocaine and procaine.This method of administration of the drug 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 tendon-ligament system.Hormonal drugs also have an immunosuppressive effect, which negatively affects the immune system.
Anesthetics
The anesthetics lidocaine and novocaine (procaine) are often used in the treatment of cervical osteochondrosis for pharmacological 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 the violation of the spinal roots by osteophytes or hernial protrusion that causes acute pain.
Lidocaine is used not only 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 very often prescribed for the treatment of cervical osteochondrosis, but only in the absence of inflammation of the soft tissues.They may contain camphor, menthol, turpentine, chili pepper extract, nicoboxil, nonivamide, snake or bee venom.These ingredients irritate sensitive nerve endings located in the subcutaneous tissue, eliminating pain.
These agents exert 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.
Patients are often prescribed locally irritating drugs to reduce the dosage of systemic analgesics and reduce the pharmacological burden on the body.
Drugs to improve blood microcirculation
Means to improve blood circulation are used in the treatment of osteochondrosis of any location.But it is precisely for cervical pathologies that they are most often required.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, nutrition of cartilaginous 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 expansion of peripheral vessels.
Preparations containing lipoic acid are often used to improve microcirculation.They have a vasodilator 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 microelements.It is enough to take one tablet of any drug per day to eliminate the resulting deficiency.
But drugs 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 tablet form may also be prescribed.Their natural use helps improve the transmission of nerve impulses and stimulate natural mechanisms aimed at recovery.
Chondroprotectors
This is the only group of drugs used for the pathogenetic treatment of cervical osteochondrosis.At the initial stage of the development of the pathology, 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 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 of 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 appears.
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.
Surgery
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 removed and intervertebral discs can be completely or partially removed.For small hernial protrusions, laser vaporization of the disc nucleus is often performed.
After excision of vertebral structures, stabilization of spinal motion segments is often required by spinal fusion or 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.The mechanical action on the back of the neck, shoulders, forearms and back helps 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 relapses.
Self-massage can be done by rubbing, stroking, compressing 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 regulators.
Physical therapy complex
The physiotherapy doctor 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.Typically the complex includes the following exercises:
- clench 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 of the neck muscles;
- clench your fingers and place your palms on the back of your head.Press 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;
- place the palm of your hand on your cheek.Try tilting your head towards your shoulder, resisting with your hand.Repeat the exercise on the other side.
Regular physical 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 the tissues, nutrient reserves are replenished.
Manual therapy
The chiropractor always prepares the patient for subsequent manipulations, starting the session with a relaxing massage.Then, with smooth movements, stretch the muscles and eliminate 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 creaks, crackles, clicks and an increase in the severity of painful sensations.
One way to avoid surgery is to lengthen (pull) 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 of the 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 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 painful 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.
Methods of orthopedic treatment
From the first days of treatment, patients are advised to wear orthopedic devices: Shants collars.They should be worn for several hours and removed before going to bed or during the day.Collars can be elastic with plastic or metal inserts, rigid or inflatable.Fixtures vary in height, degree of fastening, 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 likelihood of displacement of the vertebral structures.
Patients are advised to purchase an orthopedic mattress of medium hardness.During rest, no deterioration in blood circulation of bones, cartilage and soft tissues occurs.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
Place a spoonful of aloe juice and lanolin in a mortar and grind until a smooth mass is formed.Add a teaspoon of 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 kneaded well, smeared with thick honey and applied to the back of the neck.Secure the compress with cling film, 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, cinquefoil and elecampane are ground into a thick paste.Without stopping stirring, add a couple of drops of juniper and thyme essential oils, a spoonful of almond cosmetic 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 intervertebral discs and bone deformation.It is necessary to exclude from the usual lifestyle factors that cause deterioration of the trophism of the cartilaginous tissue.These are low physical activity, excess weight, excessive physical activity and a deficiency in the diet of foods rich in microelements and vitamins.