In the treatment of cervical osteochondrosis, an integrated approach is used, the goal of which is to reduce it
severity of pain, stiffness.During the therapy, drugs from different clinical and pharmacological groups, physiotherapy, classical and acupuncture massage, movement therapy and acupuncture are used.If conservative treatment methods are ineffective, surgical interventions are performed.
Symptoms of the disease
In the initial stages of development, osteochondrosis is asymptomatic.After a long stay with the head down or intense physical activity, a slight discomfort appears in the back of the neck.The patient does not rush to the doctor, mistaking them for the consequences of muscle tension.The pathology develops slowly but continuously.
Neck discomfort is gradually replaced by an aching, dull pain in the neck, which intensifies after heavy lifting, hypothermia or weather changes.Other specific symptoms of cervical osteochondrosis appear:
- crunching, clicking when tilting or turning the head;
- limited mobility in the cervical spine;
- sharp, severe pain during exacerbations.
The patient's condition worsens with the deformation of the intervertebral discs and vertebrae.The course of osteochondrosis is complicated by neurogenic symptoms caused by compression of osteophytes or hernial protrusion of the spinal roots and vertebral artery.Headache, dizziness, changes in blood pressure appear, visual and hearing acuity decreases.
Treatment methods of cervical osteochondrosis
There are no drugs, the use of which restores the vertebral 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, visit a massage room and do physical therapy activities every day.
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 lack 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 complications have already developed - intervertebral hernia, protrusion, vertebral artery syndrome.Therefore, doctors include not only painkillers, but also improvement of innervation, relaxation of skeletal muscles and restoration of trophism in therapeutic treatments.
NSAIDs
In the case of radiographic stage 2-3 osteochondrosis, patients complain of sharp, penetrating pain that occurs when tilting or turning the head.In such cases, nonsteroidal anti-inflammatory drugs are prescribed.In case of severe pain, intramuscular injections are used - Diclofenac, Meloxicam, Lornoxicam, Ketorolac.Medicines not only have pain-relieving, but also anti-inflammatory and anti-edema effects.This is especially true if 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, then 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 mucosal damage, proton pump inhibitors should be taken together with NSAIDs.
Ointments and gels are used to eliminate mild pain that bothers the patient in case of weather changes or hypothermia.The most common treatment regimens include Diclofenac, Ketoprofen, Artrosilene, Piroxicam, Ibuprofen.
Hormones
Even if the intramuscular administration of NSAIDs does not have an adequate analgesic effect, then hormonal drugs are used - methylprednisolone, triamcinolone, betamethasone, dexamethasone.Glucocorticosteroids are characterized by pronounced analgesic, anti-inflammatory and anti-exudative effects.Hormonal drugs are usually used for drug blockades in combination with Lidocaine and Procaine anesthetics.This drug administration method ensures that the pain-relieving effect is maintained for several days, sometimes even weeks.
But glucocorticosteroids are not intended for frequent use.They are toxic to internal organs and damage cartilage, bones and ligaments.Hormonal drugs also have an immunosuppressive effect, which negatively affects the immune system.
Anesthetics
Lidocaine and Novocaine (Procaine) anesthetics are most often used for drug blockades in the treatment of cervical osteochondrosis.The latter is characterized by a pronounced pain-relieving effect and wide application.In the treatment of degenerative-dystrophic pathologies, novocaine is prescribed to block peripheral nerves and nerve ganglia.Protrusion of osteophytes or hernias of the spinal roots causes acute pain.
Lidocaine is not only used for blockades.It is one of the active ingredients in Tolperisone solution for injection, a muscle relaxant that stops muscle spasms.Lidocaine is also included in preparations containing vitamin B.
Local irritants
Warming and local irritant ointments, gels, balms are very often prescribed for the treatment of cervical osteochondrosis, but only in the absence of soft tissue inflammation.They may contain camphor, menthol, turpentine, red pepper extract, nicoboxil, nonivamide, snake or bee venom.These ingredients irritate the sensitive nerve endings in the subcutaneous tissue, eliminating pain.
Such agents have a vasodilating effect, accompanied by an intense, long-lasting feeling of warmth.And by improving the blood supply of tissues with nutrients, their healing is accelerated.
Patients are often prescribed local irritant medications to reduce the dose of systemic pain relievers and reduce the pharmacological burden on the body.
Medicines that improve blood microcirculation
Means for improving blood circulation are used to treat osteochondrosis of any location.But specifically for the pathology of the cervix, they search more often.Compression of the artery that supplies the brain with nutrients and oxygen often occurs in this part of the spine.The following drugs help to restore blood supply:
- Xanthinol-nicotine, which improves microcirculation, oxygen supply, nutrition of cartilage tissue and all parts of the brain;
- Pentoxifylline, which reduces the viscosity of blood and the aggregation of platelets and red blood cells, improves the rheological properties (fluidity) of blood;
- Aminophylline, which reduces the tension of the vascular walls and promotes the expansion of peripheral blood vessels.
Preparations containing thioctic acid are often used to improve microcirculation.They have a vasodilating effect, restore the function of spinal roots, improve trophism and innervation.
Vitamins
In order to improve human well-being, strengthen the body's defenses, and replenish reserves of substances necessary for tissue regeneration, patients are prescribed balanced vitamin and microelement complexes.It is enough to take one tablet of any medicine per day to eliminate the resulting deficiency.
But drugs containing B vitamins are more often used to treat cervical osteochondrosis.In addition to pyridoxine, thiamine, and cyanocobalamin, the composition of the injection solutions also includes the anesthetic Lidocaine.B vitamins can also be prescribed in tablets.Their course use improves the transmission of nerve impulses and stimulates natural mechanisms aimed at healing.
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 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 2nd and 3rd degree osteochondrosis.At this stage, the cartilage tissue no longer regenerates.But taking drugs up to a dose of 800 mg prevents further destructive and degenerative changes.The duration of the therapy course is 3 months.After 2 weeks of using the products, their pronounced anti-inflammatory and pain-relieving effects appear.
Active ingredients of drugs with chondroprotective effect for the treatment of cervical osteochondrosis:
- glucosamine sulfate or hydrochloride;
- chondroitin sulfate;
- Glucosamine and chondroitin;
- Ingredients of vegetable or animal origin.
Surgical intervention
Indications for surgical intervention include ineffectiveness of conservative treatment and complications of cervical osteochondrosis, such as discogenic myelopathy, vertebral artery syndrome, and radicular syndrome.In order to decompress the spinal cord, blood vessels and roots of the spine, the following operations are performed:
- laminectomy;
- laminotomy;
- foraminotomy;
- facetectomy;
- discectomy.
During the operation, pieces of bone and ligaments can be excised, and the intervertebral discs can be completely or partially removed.In the case of small herniations, laser vaporization of the core of the disc is often performed.
After excision of the vertebral structures, it is often necessary to stabilize the spinal motion segments by spinal fusion or the installation of bone and dermal autografts.
Massage and self-massage
There are many variations of these healing procedures, but classical, acupressure, vacuum massage (including hardware) and segmental massage are more often used for cervical osteochondrosis.The mechanical effect on the back of the neck, shoulders, forearms and back enables the stimulation of lymphatic drainage, elimination of venous congestion, strengthening of muscles and relaxation of skeletal muscles.Massage is used not only to treat the disease, but also to prevent 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 buy special electrical devices in a pharmacy or medical equipment store - massagers equipped with comfortable long handles and speed controls.
Exercise therapy complex
The physiotherapist selects the exercises individually for the patient, taking into account the severity of the pathology and the complications that have developed.One criterion is the frequency of neurological manifestations.The complex usually includes the following exercises:
- interlace your fingers and place your palm on your forehead.Press your hands on your head, try to tilt it back, providing resistance due to the tension of the neck muscles;
- interlock your fingers and place your palms on the back of your head.Press down with your hand as if to lower your head.At the same time, tighten the muscles of the neck and shoulders, trying to maintain the original position of the head;
- place your palm on your face.Try to lean your head on your shoulder and use your hands to resist.Repeat the exercise on the other side.
Regular exercise is the most effective way to get rid of the symptoms of cervical osteochondrosis and prevent its spread to healthy vertebral structures.Daily training stimulates the strengthening of the muscular ligament, which stabilizes the discs and vertebrae.And by improving the blood circulation of the tissues, the 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 smooth movements, he stretches the muscles and eliminates their excessive tension.As a result, muscle spasms disappear, which causes increased pain when the roots of the spine are pinched.The compression of the vertebra of the artery ceases, and with it the neurological symptoms.The chiropractor will adjust the cervical vertebrae if necessary.This can be accompanied by crunching, cracking, clicking and increasing painful sensations.
One way to avoid surgery is to stretch (tract) the spine to increase the distance between the vertebral bodies and the damaged discs.The procedure is performed by a chiropractor on special tables.But the most popular is underwater towing in a bathtub or pool.
Acupuncture
This is one reflexology that is recommended to patients to restore the mobility of the cervical vertebrae and improve blood circulation.During the session, very thin needles made of steel, silver and gold of different lengths are used.They are located in biologically active points 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 to the central nervous system.The body's response is the release of pain-relieving and anti-inflammatory bioactive substances into the systemic circulation.Endorphin production increases, significantly improving the patient's well-being.
Orthopedic treatment methods
From the first days of treatment, patients are recommended to wear orthopedic devices - Shants collar.It should be worn for several hours and removed before going to bed or during the day.Collars can be flexible with plastic or metal inserts, rigid or inflatable.The height, degree of fixation and fastening elements of the devices are different.The size of the patient's collar 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.
It is recommended for patients to purchase an orthopedic mattress of medium hardness.During rest, the blood circulation of the bones, cartilage and soft tissues does not deteriorate.Doctors also advise sleeping on an orthopedic pillow with a special recess.
Folk remedies and recipes
After basic therapy 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
Put a tablespoon of aloe juice and lanolin in a mortar and grind until a homogeneous mass is obtained.Add a teaspoon of rubber turpentine, a drop of eucalyptus, pine, rosemary essential oil, 30 g of thick flower honey, mix.Without stopping rubbing, add 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 compress with plastic wrap, a warm cloth, and a gauze bandage.The duration of the procedure is 1-2 hours.
Other herbal poultices
Grind the fresh leaves of plantain, dandelion, burdock, cinquefoil and elecampane into a thick paste in a mortar.Without stopping mixing, add a few drops of juniper and thyme essential oil, a tablespoon of almond cosmetic oil.Apply the mass to the back of the neck, fix the compress with film and medical bandage and leave it for an hour.
Ways to prevent the disease
Osteochondrosis is a recurrent degenerative pathology that occurs against the background of gradual destruction of the intervertebral discs and bone deformation.Factors that cause deterioration of cartilage tissue trophism should be excluded from the usual lifestyle.These are low physical activity, overweight, excessive physical activity, and lack of foods high in micronutrients and vitamins.