An integrated approach to the treatment of cervical osteochondrosis is practiced, aimed at reducing
severity of pain, stiffness.Therapy uses drugs from various clinical and pharmacological groups, physiotherapy, classical massage and acupuncture, exercise therapy and acupuncture.If conservative treatment methods are ineffective, surgical operations are performed.
Symptoms of the disease
At the initial stage of development, osteochondrosis is asymptomatic.After a long stay with your head down or intense physical activity, slight discomfort appears in the neck area.The patient is in no hurry to consult a doctor, taking it for the consequences of muscle tension.The pathology progresses slowly but persistently.
Discomfort in the neck area is gradually replaced by dull, aching neck pain, which intensifies after heavy lifting, hypothermia, or a change in the weather.Other specific symptoms of cervical osteochondrosis appear:
- crackles, clicks when tilting or turning the head;
- limited mobility in the cervical spine;
- sharp and 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 vertebral roots and vertebral artery.Headaches, dizziness, changes in blood pressure appear, and visual and hearing acuity decreases.
Methods for treating cervical osteochondrosis
There is no medication whose use would restore spinal structures.But it is entirely 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 undergo physical therapy every day, visit a massage room and engage in 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 or even 3 degrees of severity.Often they have already developed complications - intervertebral hernia, protrusion, vertebral artery syndrome.Therefore, doctors include in treatment regimens not only analgesics, but also means aimed at improving innervation, relaxing skeletal muscles and restoring trophism.
NSAIDs
With osteochondrosis of 2-3 radiographic stages, patients complain of sharp, piercing pain that occurs when tilting or turning the head.In such cases, they are prescribed nonsteroidal anti-inflammatory drugs.In case of severe pain, an 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 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 very toxic to the stomach because they cause increased production of hydrochloric acid.To eliminate the risk of damage to the mucosa, it is necessary to take proton pump inhibitors as well as NSAIDs.
Ointments and gels are used to eliminate mild pain that bothers the patient in case of weather changes or hypothermia.Most often, treatment regimens include diclofenac, ketoprofen, artrosilen, piroxicam and ibuprofen.
Hormones
Even if intramuscular administration of NSAIDs does not have the appropriate analgesic effect, hormonal agents are used - methylprednisolone, triamcinolone, betamethasone, dexamethasone.Glucocorticosteroids are characterized by pronounced analgesic, anti-inflammatory and anti-exudative activity.Hormonal medications are typically used to block medications 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 several weeks.
But glucocorticoids are not intended for frequent use.They are toxic to internal organs and damage cartilage, bones and the ligamentous-tendinous 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 due to drug blockages.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 damage to the spinal roots by osteophytes or hernial protrusion which causes acute pain.
Lidocaine is not used only for blockages.It 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 irritant effect are very 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, nicoboxil, nonivamide, snake or bee venom.These ingredients irritate sensitive nerve endings located in the subcutaneous tissue, eliminating pain.
Such agents have a vasodilator effect, accompanied by a feeling of intense and prolonged heat.And by improving the blood supply to the tissues of nutrients, their accelerated recovery occurs.
Locally irritating drugs are often prescribed to patients to reduce the dose of systemic analgesics and reduce the pharmacological load on the body.
Medicines to improve blood microcirculation
Means for improving blood circulation are used in the treatment of osteochondrosis, regardless of its localization.But specifically for cervical pathology, they are more often requested.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 cartilage 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 expansion of peripheral vessels.
Preparations containing thioctic 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 medication daily to eliminate the resulting deficiency.
But drugs containing B vitamins are more often used in the treatment of cervical osteochondrosis.The composition of solutions for injection, in addition to pyridoxine, thiamine and cyanocobalamin, includes the anesthetic lidocaine.B vitamin tablets may also be prescribed.Their ongoing 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 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 osteochondrosis grades 2 and 3. At this stage, 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 2 weeks of using the products, 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 the surgical procedure, bone fragments and ligaments can be excised and the intervertebral discs can be completely or partially removed.For small hernial protrusions, laser vaporization of the disc nucleus is often performed.
After excision of spinal structures, stabilization of spinal motion segments is often necessary by spinal fusion or by placement of bone and skin autografts.
Massage and self-massage
There are many varieties of these healing procedures, but for cervical osteochondrosis, classic massage, acupressure, vacuum (including hardware) and segmental massage are more often used.The mechanical action on 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 relapse.
Self-massage can be performed by rubbing, stroking, pressing the back of the neck for 10-15 minutes.But it is better to purchase special electrical devices at a pharmacy or medical equipment store - massagers equipped with long comfortable handles and speed regulators.
Exercise therapy complex
The physiotherapist doctor 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:
- Clasp your fingers 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;
- Clasp your fingers and place your palms at the back of your head.Press on it with your hands, as if trying to tilt your head down.At the same time, engage the neck and shoulder muscles, trying to maintain the original head position;
- place your palm on your cheek.Try tilting your head against 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 blood circulation in the 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, using fluid movements, it 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, as well as neurological symptoms.The chiropractor adjusts the cervical vertebrae if necessary.This may be accompanied by crackling, crackling, clicking sounds 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 chiropractor.But the most popular is underwater traction in bathtubs or swimming pools.
Acupuncture
It is one of the types of reflexology recommended to patients to restore mobility to the cervical spinal structures and improve blood circulation.During the session, very fine needles of different 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.
Once the needles are placed, weak pain impulses begin to flow to 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 must be worn for several hours and should 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 fixation and fixation 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 spinal structures.
Patients are recommended to purchase an orthopedic mattress of medium hardness.While 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 recess for the head.
Folk remedies and recipes
After basic treatment 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 tablespoon of aloe 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 thick flower honey, stir.Without stopping rubbing, introduce 100 g of medical vaseline in small portions.The ointment is rubbed into the skin of the neck if discomfort occurs.
Horseradish leaves
A large fresh leaf of horseradish is well kneaded, smeared with thick honey and applied to the back of 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
In a mortar, fresh leaves of plantain, dandelion, burdock, cinquefoil and elecampane are ground into a thick paste.While stirring constantly, 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 to act for an hour.
Ways to prevent disease
Osteochondrosis is a recurrent degenerative pathology that occurs against the background of progressive destruction of intervertebral discs and bone deformation.It is necessary to exclude from the usual lifestyle factors that cause deterioration in the trophism of cartilage tissue.These are low physical activity, excess weight, excessive physical activity and a deficiency in the diet of foods rich in microelements and vitamins.