Treatment of cervical osteochondrosis: drugs, massage, exercise therapy

An integrated approach to the treatment of cervical osteochondrosis is applied, with the aim of reducingpain severity, stiffness.Treatment uses drugs from various 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

In the initial stage of development, osteochondrosis is asymptomatic.After a long stay with a bent head or intense physical activity, a mild discomfort occurs at the back of the neck.The patient is in no hurry to see a doctor, misunderstanding him about the consequences of muscle strain.The pathology progresses slowly but persistently.

Discomfort in the neck is gradually replaced by pain, dull pain in the neck, which intensifies after lifting weights, hypothermia or change of weather.Other specific symptoms of cervical osteochondrosis appear:

• creaking, clicking when you tilt or turn your head.
• limited mobility in the cervical spine;
• sharp, intense pain during exacerbations;

As the intervertebral discs and vertebrae become deformed, 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 and reduced visual and auditory acuity appear.

Treatment methods for cervical osteochondrosis

There are no drugs, the use of which would restore the spinal structures.But it is very possible to improve the patient's well-being and stop the spread of the disease.It is not enough to just take pills or apply ointments - you need to do physical therapy every day, visit a massage parlor and physical therapy activities.

Pharmacotherapy

Pharmacological drugs are used to eliminate the symptoms of cervical osteochondrosis, including improving blood circulation and partial regeneration of the intervertebral discs.Due to the absence of characteristic signs at the initial stage, patients are referred to a spondylologist 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 the treatment regimens not only analgesics, but also means for improving the innervation, relaxing the skeletal muscles and restoring trophism.

NSAIDs

With radiographic osteochondrosis of 2-3 stages, patients complain of sharp, piercing pain that occurs when tilting or turning the head.In such cases, non-steroidal anti-inflammatory drugs are prescribed.For severe pain, intramuscular injection of solutions is applied - 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 very severe and occurs from time to time, then NSAIDs in tablets or capsules are used:

• Nimesulide;
• Ketorolakis?
• 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 the 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 the intramuscular administration of NSAIDs does not have the appropriate analgesic effect, then hormonal agents are used - Methylprednisolone, Triamcinolone, Betamethasone, Dexamethasone.Glucocorticosteroids are characterized by strong analgesic, anti-inflammatory and anti-exudative effects.Hormonal drugs are commonly used for drug blockades in combination with the anesthetics Lidocaine and Procaine.This method of drug administration ensures the maintenance 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 destroy cartilage, bones and ligament-tendon 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 for drug blockades.The latter is characterized by a strong 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 invasion of the spinal roots by osteophytes or herniated protrusion that causes acute pain.

Lidocaine is used not only for blockades.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

Very often, ointments, gels, balms with a warming and local irritant effect are prescribed for the treatment of cervical osteochondrosis, but only in the absence of soft tissue inflammation.They may contain camphor, menthol, turpentine, red hot pepper extract, nicoboxil, nonivamide, snake or bee venom.These ingredients stimulate the sensitive nerve endings located in the subcutaneous tissue, eliminating pain.

Such agents have a vasodilating effect, accompanied by a strong, prolonged feeling of warmth.And by improving the blood supply to the tissues with nutrients, their accelerated recovery occurs.

Topical irritant drugs are often prescribed to patients 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, it is more often in demand.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:

• Nicotinic xanthinol, 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 blood rheological properties (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 function of the roots of the spine, improve nutrition 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 trace elements.It is enough to take one tablet of any medicine daily 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 may also be prescribed in tablets.Their use along the way helps to improve the transmission of nerve impulses and to stimulate the natural mechanisms aimed at recovery.

Carboprotectors

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 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 to patients with osteochondrosis grade 2 and 3. At this stage, 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 treatment cycle is from 3 months.After using the products for 2 weeks, their intense anti-inflammatory and analgesic effect appears.

Active ingredients of drugs with a chondroprotective effect for the treatment of cervical osteochondrosis:

• Glucosamine sulfate or hydrochloride.
• Chondroitin Sulfate?
• Glucosamine and Chondroitin?
• Ingredients of vegetable or animal origin.

Surgery

Indications for surgery include ineffectiveness of conservative treatment, as well as complications of cervical osteochondrosis, for example, disc 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?
• faceectomy?
• discectomy.

During surgery, bone fragments and ligaments may be removed, and the intervertebral discs may be completely or partially removed.For small herniated protrusions, laser ablation of the disc core is often performed.

After resection of the vertebral structures, stabilization of the motion segments of the spine with spinal fusion or installation of bone and skin autografts is often required.

Massage and self-massage

There are many varieties of these healing procedures, but for cervical osteochondrosis, classical, acupuncture, vacuum (including material) and segmental massage are most often used.The 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 done by rubbing, stroking, pressing 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 controllers.

Exercise therapy complex

The physical therapist 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:

• clench your fingers and place your palms on your forehead.Press your hands to your head, trying to tilt it back, providing resistance due to the tension in the neck muscles.
• tighten your fingers and place your palms on the back of your head.Press down on it with your hands, as if trying to tilt your head down.At the same time, stretch the muscles of the neck and shoulders, trying to maintain the original position of the head.
• place 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 cervical osteochondrosis symptoms and prevent it from spreading to healthy spinal structures.Daily training stimulates the strengthening of the muscle corset, which stabilizes the discs and vertebrae.And with the improvement of blood circulation in the tissues, the reserves of nutrients are replenished.

Manual therapy

The chiropractor always prepares the patient for the upcoming manipulations by starting the session with a relaxing massage.Then, using smooth movements, it stretches the muscles and eliminates their excessive tension.As a result, muscle spasms disappear, causing increased pain when the roots of the spine are pressed.The compression of the vertebral artery is eliminated and with it the neurological symptoms.The chiropractor adjusts the cervical vertebrae if necessary.This may be accompanied by tingling, grinding, clicking 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 attraction in bathtubs or swimming pools.

Acupuncture

This is one of the types of reflexology recommended to patients to restore the mobility of the cervical spinal structures and improve blood circulation.Very fine needles of various lengths made of steel, silver and gold are used during the session.They are placed on 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 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 must be removed before going to 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 connector design.The size of the collar for the patient is determined only by the spondylologist, who takes into account the severity of the symptoms of osteochondrosis and the possibility of displacement of the vertebral structures.

Patients are advised 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 recess for the head.

Folk remedies and recipes

After the basic treatment and elimination 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 tablespoon of aloe juice and lanolin in a mortar and grind until a homogeneous mass is formed.Add a teaspoon of turpentine, a drop of essential oils of eucalyptus, pine, rosemary, 30 grams of thick flower honey, mix.Without stopping to rub, 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 plastic wrap, warm cloth and gauze bandage.The duration of the procedure is 1-2 hours.

Other herbal compresses

In a mortar, the fresh leaves of plantain, dandelion, burdock, cinquefoil and elecampane are ground into a thick paste.Without stopping to mix, add a few drops of juniper and thyme essential oils, a tablespoon of almond oil.Apply the mass to the back of the neck, fix the compress with a film and a medical bandage and leave it for an hour.

Ways to prevent the disease

Osteochondrosis is a recurrent degenerative pathology that occurs in the context of gradual destruction of the intervertebral discs and bone deformation.It is necessary to exclude from the usual lifestyle factors that cause deterioration of cartilage tissue trophism.These are low physical activity, overweight, excessive physical activity and deficiency in the diet of foods with a high content of microelements and vitamins.