How to treat a hernia of the cervical spine

Pathology of the spinal column is widespread among people of various ages. This is due to the constant load and lack of motor activity. In this case, the cervical and lumbar regions are most often affected, due to their anatomical and physiological characteristics.

When patients complain of neck pain, many of them are diagnosed with intervertebral hernia. This situation requires increased attention from the patient and the doctor, as it can lead to undesirable and even dangerous consequences. Therefore, it is necessary first of all to understand the causes of the hernia and the available methods for its cure.


A hernia of the cervical spine does not develop in a perfectly healthy body – this requires certain conditions. The spine itself is a very strong and stable structure. Its stability is provided including intervertebral discs. Due to their elasticity, they also perform a shock-absorbing function, which is extremely important when walking or running.

The disk consists of a dense capsule and soft core. When fibrous fibers are damaged, the internal contents begin to protrude outward, which is a sign of a hernia. At the same time, compression of the nerve roots extending from the spinal cord is observed, and clinical symptoms of the disease appear. Most often this happens under the influence of the following factors:

  • Increased load.
  • Sharp and prolonged movements in the neck.
  • Spinal deformities.
  • Injuries to the cervical spine.
  • Violation of posture.
  • Low motor activity (lack of exercise).

In addition, the condition of the disk depends on the metabolic processes of the body. It does not have its own vessels, and therefore receives the necessary substances from neighboring tissues by diffusion. If there is a lack of certain components or water, then the disk gradually loses its natural properties. But most often this happens under the influence of several factors.

It is possible to establish the causes of a cervical hernia after a comprehensive examination.


To have an idea of ​​the clinical picture of the disease, it is necessary to identify all the symptoms associated with it. Since pain is the most striking sign of a hernia, its features should be considered. Most often, it has the following characteristics:

  • Type: aching, stitching or shooting.
  • Localization: in the neck, shoulder, upper thoracic spine.
  • Irradiation: in the head, hands.
  • Duration: short or long.
  • Frequency: periodic or continuous.
  • Influence of external factors: amplified by turning the head, tilting.

When the root compression occurs, there is a violation of the transmission of a nerve impulse from the spinal cord to organs and tissues. This is accompanied by the appearance of other symptoms. They can be in the form of signs of irritation or loss of function. Depending on the affected fibers, such manifestations are noted:

  1. Motor: increase or loss of reflexes, muscle twitching, weakness.
  2. Sensitive: tingling, numbness, then a decrease in superficial sensations.
  3. Vegetative-vascular: increased sweating or dry skin, a change in dermographism.

On palpation, you can notice tension of the vertebral muscles and soreness of the nerve entry points. Movement is significantly limited. But hernia symptoms may not be limited only to the neck area. Quite often, such patients are also concerned about headaches. This is due to the commonality of innervation and blood supply. In addition, the disease can lead to other consequences:

  • Cervical instability.
  • Dizziness.
  • Deteriorating memory and attention.
  • Paresis and paralysis.

Symptoms of the disease are not strictly specific – they are also characteristic of another pathology of the spinal column. Therefore, great importance is given to the differential diagnosis of conditions with a similar clinical picture.

It is necessary to treat the hernia of the cervical spine with increased caution, since it can cause dangerous phenomena.


A hernia of the cervical spine is a diagnosis that cannot be made on the basis of only a clinical examination. For this, it is necessary to use additional methods, primarily instrumental. Patients are shown the following procedures:

  • Radiography.
  • Magnetic resonance imaging.
  • CT scan.
  • Rheoencephalography.
  • Electromyography.

Mandatory consultation of a neurologist and traumatologist. Only after receiving complete information about the disease can a final conclusion be made.


It is necessary to treat the intervertebral hernia in a comprehensive manner. In the arsenal of modern medicine there are various methods that allow you to normalize the condition of the disk without surgery. But it all depends on the degree of pathology. When there is a complete loss of particles of the pulpous nucleus, it is almost impossible to cure the disease with conservative means. A hernia of the cervical spine requires, above all, timely exposure, which will eliminate not only the manifestations of the disease, but also its causes.

In order for the treatment to be as effective as possible, the efforts of not only the doctor, but also the patient are necessary. Success even more depends on the organization and determination of the person himself.

Medication Therapy

The basis for the treatment of hernia at the stage of prolapse or protrusion of the disc is the use of medications. But the pronounced nature of the pathological process is not complete without taking medication. This allows not only to reduce or completely eliminate the symptoms, but also to improve the condition of the disk itself: strengthen its capsule and restore normal nutrition of the nucleus. For this, the following drugs are recommended:

  • Anti-inflammatory and analgesics (Dicloberl, Movalis).
  • Muscle relaxants (Midokalm).
  • Vitamins of group B (Milgamma, Neuromax).
  • Chondroprotectors (Teraflex).
  • Vascular (Actovegin, Cerebrolysin).
  • Antioxidants (Mexidol).

Treatment should begin with injection forms of drugs, and after the abatement of acute phenomena, you can take pills in combination with topical drugs (ointment, gel, patch).

You need to treat a herniated disc with medication only on the recommendation of a doctor. Taking drugs on their own, patients can significantly harm their health.


When prescribing physiotherapy in combination with drugs, the doctor tries to achieve a more pronounced effect. These methods have analgesic, anti-inflammatory effect, contribute to muscle relaxation and improve blood circulation in the neck. Most often used such procedures:

  • Electrophoresis.
  • Laser treatment.
  • Reflexology.
  • Wave therapy.
  • Hirudotherapy.
  • Balneotherapy.

The physiotherapist will tell you which of the methods can be used in a particular patient, since this also depends on the accompanying pathology.


An important role in the treatment of hernia is given to physiotherapy exercises. In order to restore the normal motor activity of the spine, relieve its affected segments and improve the condition of the disk, it is necessary to regularly perform special exercises. In many cases, properly selected gymnastics avoids surgery. With a hernia of the cervical spine, the following exercises are recommended:

  1. Tilts the head to the sides, forward and backward.
  2. Slow rotational head movements.
  3. From a standing position with arms raised and clasped above the head, rotate the body to the side.
  4. Leaning forward, set your back parallel to the floor and stretch your arms forward in front of you and raise them up.
  5. From the same position, raise arms spread apart.
  6. From a wide rack, spreading your arms to the sides, lean forward so that you touch the floor with one hand and raise it with the other. In this case, deploy the torso and neck, trying to look up.

Gymnastics with post-isometric relaxation is very popular when certain movements are performed, accompanied by static muscle tension and their subsequent relaxation. In addition, kinesiotherapy exercises are used when special simulators are used to stretch and strengthen muscles.

Gymnastics for the treatment of disc herniation should be performed at a slow pace so as not to provoke the appearance of a pain syndrome.

Massage and manual therapy

It is also possible to treat pathology of the cervical spine using massage and manual therapy techniques. First, you need to provide muscle relaxation, which helps stroking, rubbing, kneading. To improve the mobility of the spine, the specialist performs the following elements: extension, extension, rotation and bending of the neck. This eliminates muscle blocks and subluxations of facet joints. All manipulations are carried out carefully and if there is evidence.


With the pronounced nature of the pathology, when conservative agents do not have the expected effect, it is extremely difficult to do without surgery. Surgical intervention is aimed at removing hernial protrusion and stabilization of the vertebral segments. Recently, mini-invasive procedures have been used for this, which have less trauma and a low risk of adverse events. After removal of the hernia, a rehabilitation course is necessary.

It is necessary to timely treat the pathology of the cervical discs. This will help modern diagnostic and treatment measures that have a positive effect in any clinical situation.

What is a hernia of the cervical spine: symptoms, diagnosis and consequences

An intervertebral hernia appears as a result of a rupture at the junction of the vertebrae; it occurs due to excessive loads.

Most often, signs of a hernia of the cervical spine are pain in the neck and numbness of the shoulder girdle and upper free limbs.

This problem is faced by people aged 30 to 60 years.

A rather unpredictable disease that occurs quickly and most often imperceptibly. The patient, with the onset of the first symptoms, may refer to fatigue, strain or drafts. Meanwhile, a hernia of the cervical spine progresses very quickly and can cause a number of complications. In this case, operations cannot be avoided.

Read the article:  How to treat a hernia in the cervical spine

A hernia of the cervical spine may appear in the presence of such factors:

  1. Physiological predisposition. If initially the patient is prone to diseases of the musculoskeletal system.
  2. Weak muscles. A very large load is superimposed on the spine, it holds our entire body in an upright position. He is helped by an equally important muscle corset, which is responsible for movement and to some extent removes the load from the spine. Therefore, it should be strong enough.
  3. Age. Aging is an inevitable process. With age, the bones become fragile, the amount of collagen in the body decreases. This increases the risk of skeleton injuries, the spine is no exception.
  4. A poor lifestyle, bad habits, poor diet – all this accelerates the aging process.
  5. Injuries to the spine during sharp turns of the body or slopes, excessive sports loads on the spine and cervical spine.
  6. Musculoskeletal diseases, for example osteochondrosis. Violations of posture, congenital or acquired.

The onset of the disease is signaled by the appearance of the following symptoms:

  1. When tilting the head, a person feels pain. Also, pain in the shoulder girdle, upper arm, shoulder blade.
  2. Unreasonable, frequent numbness of the upper limb, a feeling of weakness. Severe burning sensation, temporary loss of sensation.
  3. The feeling of stiffness, motor limitation of the fingers, loss of sensitivity.
  4. Problems with the emotional background of a person, frequent bouts of anger, irritability, depression, crying. Also, headaches, constant causeless dizziness, jumps in blood pressure, arise due to impaired blood supply to the brain.
  5. Unreasonable cough that does not respond to treatment.

Symptoms are divided into acute and chronic. At the first stages of the development of the disease, the symptoms may appear inconstantly and be more aching and bring discomfort. If the patient does not consult a doctor when the first symptoms appear, the disease begins to progress, the frequency of manifestation and the strength of the symptoms increases.

Symptoms may manifest in different ways, depending on which particular disk is damaged:

  • C4 – C5 (between 4 and 5 vertebra) – is accompanied by weakness and pain in the shoulder. Numbness of the extremities is not observed.
  • C5 – C6 is the most common case. Weakness in the muscles is observed, there are problems with the movement of the hands and fingers, they may not bend at all. In the area of ​​the thumb, numbness and pain are noted.
  • C6 – C7 – pain in the triceps muscle of the shoulder, which passes along the forearm and gives to the m ;The relationship of the cervical discs with the proper functioning of the internal organs h2 1,0,0,0,0 -;

How to treat spinal hernia correctly and effectively?

You need to start treatment only after an accurate diagnosis is confirmed by a doctor. For this, the doctor needs to do a lot of research, he must accurately indicate the location and size of the intervertebral hernia. Only after this, treatment methods are selected. Doctors often resort to surgical treatment, but you can do without it.

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If there is no desire to do the operation, you can choose from many other methods that are most effective and acceptable for the patient.

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Then the treatment is aimed at relieving pain, stopping the development and complication of the disease, and preventing the appearance of new hernias.

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The very first stage of treatment will be the relief of pain symptoms. The patient should for some time observe bed rest and take drugs that prevent the onset of inflammation and have an analgesic effect. They do everything to remove the pain.

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Painkillers do not relieve pain, they only temporarily mask, at this time anti-inflammatory drugs act that relieve inflammation, which, in turn, reduces pressure on the nerve endings or even removes it.

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If you manage to remove the symptoms, the first stage of treatment is over. You can move on to the second.

The second stage consists directly in the direct effect on the disease, prevention and prevention of disease progression. Here, most often, you can do without medication. It is enough to regularly visit a massage therapist and do preventive gymnastics at home. Then the intervertebral hernia will no longer bother the patient.

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You can also use additional methods:

  1. Acupuncture – it relieves tension and pain, acts well on the joints, strengthens them and tone. Prevents the appearance of inflammatory processes.
  2. Manual procedures. In a short time, the doctor painlessly returns the disks to their places.

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With hernia treatment, it is better not to pull, then the patient will be able to do without surgical intervention. If you use only pills, you should not forget that they only relieve pain without eliminating the cause, while the disease continues to progress, the consequences are disappointing. And the operation is needed not one, which is very common. And even if the patient still resorts to surgical treatment, he will need a recovery course.

How to treat spinal hernia operatively?

It is possible to cure the intervertebral hernia of the cervical spine without surgery, this treatment option is considered the most extreme. But the choice remains with the patient.

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A hernia is operated on when conservative methods are inactive. And this happens, it depends on the characteristics of the body and the state of the hernia. If the combat symptom is not removed or the hernia becomes larger and causes a disruption to the work of other organs, then it is operated on.

Surgical measures depend on the location of the hernia:

  1. The front surface of the wild – an incision is made in the problem area and the part that interferes with the nerve is removed, then a substance is introduced that helps to accelerate tissue regeneration, the vertebrae are fused and its mobility is lost.
  2. The back surface – as with the front, only on the other side.
  3. Cervical disc replacement is practiced. The damaged disk is removed, an artificial one is installed in its place. This method helps maintain vertebral mobility.
  4. Micro endoscopic discoectomy is a special method of spinal surgery. The cuts are made minimal for the device to enter, carefully and alternately remove growths, and clean the canals of the vertebrae. Such an operation lasts about an hour, depending on the complexity.

Consequences to be prepared for:

Inactivity or improper treatment of a hernia of the spine can provoke a number of consequences, and even the occurrence of other diseases.

  • The most common disease, a hernia companion is radiculitis. It occurs due to inflammatory processes that occur on the nerve endings. Severe pain appears, lowers the motor ability of the arms and neck.
  • A hernia presses on the blood vessels. And in the neck there are very important arteries and veins through which blood enters the brain. If this happens, oxygen starvation begins in the brain, its functions are disturbed, this can cause a stroke.
  • There is pressure and infringement of the nerve roots. If you limit the work of nerves, radicular syndrome appears, then paralysis of the upper extremities occurs, with complications, complete immobility and disability occurs.

How to treat a hernia of the cervical spine

Article author: Nadezhda Nikolaevna

A hernia of the cervical spine is a protrusion, usually resulting from an uneven load on the spinal column. In patients there is a rupture of the fibrous ring located in the intervertebral disc. At the rupture site, a pulpous substance is formed, which is called a hernia.

Treatment of a hernia of the cervical spine begins with anesthesia of the patient. This disease is accompanied by severe pain, which can immobilize the upper body. In the stage of active growth, protrusion can have a negative effect on adjacent vessels and arteries, because of which the patient’s blood supply to the brain is disturbed.

If at such a moment a person does not receive medical attention, then he may have a stroke.


The causes of a hernia of the cervical spine include:

  • lack of physical activity;
  • weight lifting;
  • rachiocampsis;
  • past injuries;
  • bruises and falls;
  • the development of degenerative processes in the spinal column;
  • advanced age;
  • poor heredity;
  • alcohol abuse;
  • smoking;
  • harmful work;
  • inflammatory processes, etc.

The reasons for the appearance of a hernia can also include weak muscles located in the cervical spine. As a result of any physical activity, the patient is disturbed by the biomechanics of the spinal column. This can be prevented only by timely prophylaxis of this disease.


The following symptoms may appear in patients:

  • headache;
  • increasing pain in the neck and shoulders (in the initial stage of development of a hernia, patients benefit from drug blockade, which eventually ceases to relieve pain);
  • loss of mobility in the cervical spine;
  • numbness of the upper limbs;
  • weakness in the forearm;
  • tingling fingers that appear when raising hands;
  • muscle weakness;
  • dizziness;
  • lack of coordination;
  • the appearance of signs of compression of the brain (trunk);
  • pain in the region of the heart, etc.

If any symptom of this disease appears, the patient should seek help from a medical institution where he will be diagnosed and prescribed medication or surgery.


At a specialist appointment, the patient will be examined and palpated the cervical spine, the purpose of which is to determine the size and location of the protrusion. During a conversation with the patient, the doctor collects an anamnesis of the disease, due to which he determines the cause of the appearance of a hernia.

To confirm his initial diagnosis, the specialist directs his patient to a hardware examination:

  • X-ray;
  • computed tomography;
  • magnetic resonance imaging, etc.

To determine blood flow in the arteries of the cervical spine, the patient undergoes an ultrasound examination of blood vessels using a special sensor – Doppler. Without fail, the patient undergoes a laboratory examination, during which the following is done:

  • general urine analysis;
  • clinical blood test;
  • blood chemistry.


Photo: corset for cervical vertebrae with hernia

Today, modern medicine can offer two main methods of treating hernias localized in the cervical spine. The choice of treatment methods depends on the general condition of the patient, the stage of development of the disease, etc. In the case when the protrusion is small, specialists prescribe conservative treatment to patients, which includes a course of drugs and physiotherapy. Without fail, medications that can stop the pain syndrome are included in this course.

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The course of physiotherapy usually includes:

  • electrophoresis;
  • reflexology;
  • leech treatment;
  • physiotherapy exercises (the rehabilitation complex of physical exercises is called kinesiotherapy), etc.

Acupuncture is prescribed by many specialists, which is of great benefit in the treatment of hernia of the cervical spine. During conservative treatment, patients need to regularly expose their bodies to physical activity in order to form a muscle corset. Well-developed muscles will support the spine and will not allow it to deform.

In the event that the protrusion has become too large or the drug therapy did not bring the desired result, doctors perform surgical treatment of hernias for patients.

Today, there are a large number of surgical techniques through which surgical intervention can be performed (for example, laser operations).

During surgery, specialists perform a radical or partial excision of muscle tissue in which pathological changes have occurred. Using special medical instruments (endoscopes), surgeons remove the hernia. After surgery, patients need rehabilitation, which should be carried out under the supervision of specialists.


With a hernia of the cervical spine, massage, which should be performed by highly qualified specialists, is of great benefit. In most cases, a visit to a massage room by patients coincides with a course of complex physiotherapy. Specialists categorically forbid their patients to visit massage therapists during an exacerbation of the disease, since any effect on the protrusion can lead to a deterioration in the general condition.

A high-quality massage of the cervical spine can help the patient avoid surgical intervention, as during the manipulations, specialists manage to correct small protrusions. Regular visits to the massage room will allow the patient to correct his posture over time and restore the previous position of the spine. The professional actions of a massage therapist will help patients who are diagnosed with a hernia to avoid relapse of this disease.


Photo: 3D animation of the vertebrae in the neck

Patients who have identified a hernia of the cervical spine may experience various complications, some of which are fatal. The most dangerous complication of this disease is compression of the spinal cord, against the background of which the infringement of the dentoid process occurs. Patients may have too deep upper limb sensitivity. In some cases, complications of a hernia of the cervical spine lead patients to disability.

The following are the main complications of a hernia:

  • growing pain syndrome;
  • multiple sclerosis;
  • paresis of the upper limbs;
  • damage to the pelvic organs;
  • dorsopathy in the cervical spine;
  • paralysis of the lower extremities, etc.


To prevent the appearance of a hernia of the cervical spine, it is necessary to timely prevent this disease:

  • regularly visit your local doctor, especially if there is discomfort and pain in the cervical spine;
  • to live an active lifestyle;
  • go in for sports (moderate loads should be given to the body);
  • lead a healthy lifestyle (completely abandon addictions, start eating right, etc.);
  • take physiotherapy courses (massage, etc.);
  • take walks, etc.

The cost of surgical treatment of hernias

Prices for hernia treatment in Russian medical institutions are set individually, depending on the stage of development of lipoma. On the pages of specialized Internet resources you can find reviews on the surgical treatment of hernias performed in Russian state and private clinics.

Hernia of the cervical spine: treatment

Hernia of the cervical spine: treatment and symptoms.

A hernia of the cervical spine is one of the modern diseases of a rapidly developing society.

Among the hernial formations of the entire spine, this department is second in frequency. Men are statistically affected after 25 years.

The cervical spine is seven vertebrae and the same number of discs located between them.

With destructive changes surrounding the vertebrae and their joints, the ligamentous apparatus (fibrous capsule), a prolapse occurs of a part of the disk with compression phenomena of the nerve fibers of the spinal cord.

This explains the specific sensations in the upper body with this type of pathology.

Morphologically, the disc with contents is protruded and squeezed.

Its subsequent ischemia and impaired conduction of nerve fibers.

In the future, dysfunction of innervation, outflow of blood and lymph from the head develops.

Oxygen starvation and subsequent disruption of the centers of the brain.

Symptoms of a hernia of the cervical spine

Symptoms are very characteristic, but often other diseases are simulated – tumors of various origins and diseases of the peripheral nervous system.

All sensations, their intensity and localization, depend directly on which particular roots of the nerves are pinched – radicular syndrome.

The general signs of the disease are as follows:

  • Aching pain and limitation of mobility in the neck and shoulder girdle, aggravated by turning and tilting the head (symptom of Neri and Laseg), raising the arm, sneezing and coughing.
  • Dizziness, tinnitus, headaches and uncontrolled pressure surges. Impaired memory and speed of mental reactions.
  • Outwardly noticeable deformation of the back of the neck – cervical lordosis and limitation of the range of motion of this part of the spine
  • Sleep disturbance, as a result of irritability and reduced concentration of attention and poor coordination of movements.
  • Paresthetic phenomena – numbness of the hands from the tips of the fingers to the shoulders, a sensation of tingling, heaviness and “goose bumps”.

The causative factors are: ostechondrosis, spondylosis, the consequences of domestic injuries and occupational hazards, leading to a prolonged stay in an uncomfortable non-physiological position.

An indirect effect is exerted by overweight. In young people who incorrectly or too intensely distribute sports loads, a hernia develops as a result of chronic or acute sports injury.

Complications of a hernia of the cervical spine

Complications of this long-developing and apparently non-dangerous disease can be pathological conditions critical for life:

  • Ischemic stroke due to a lack of blood in the brain.
  • Infringement or microtrauma of the membranes of the spinal cord – myelopathic syndrome – complete or spastic paralysis of the lower extremities and hands to the elbow joint, paralysis of the respiratory system, flaccid paralysis of the hands.

Therefore, having noticed most of the symptoms, it is necessary to consult a doctor in a timely manner in order to diagnose or exclude the presence of the discussed problem in the spine.

Palpation and visual inspection after interrogation of the main complaints and observation of the usual postures of the body.

Diagnosis of a hernia of the cervical spineCurrently, the main, best and progressive method for determining the presence of a hernia, its location, magnitude and degree of pressure on the nerve processes is MRI – magnetic resonance imaging.

Determine the degree of circulatory disorders of the organs of the head will help Doppler study of cerebral vessels.

For differential diagnosis, the exclusion of concomitant diseases can be carried out additionally – X-ray diagnostics, electrocardiogram (ECG), electromyography (EMG).

Less commonly, due to trauma and high radiation exposure, contrast computed tomography (CT) is used.

In situations of difficult diagnosis with atypical symptoms, laboratory tests are prescribed.

When making a final diagnosis, those vertebrae that were involved in the pathological process of hernia formation are always indicated.

They are labeled with the capital letter “C”, from the word cervicum – in translation from Latin – neck. Be sure to register the number of the vertebra.

For example, the most frequent localization of hernias is found in areas C5-C6 and C6-C7.

Treatment of a hernia of the cervical spine

Treatment always begins with conservative methods:

  1. General drug treatment includes taking:
  • herbal remedies – anti-inflammatory, decongestant and for the regeneration of nerve fibers and connective tissue.
  • non-steroidal anti-inflammatory drugs for analgesic effect due to the effect on the focus of inflammation.
  • muscle relaxants for muscle relaxation.
  1. Topically applied various ointments based on diclofenac and ibuprofen, arnica and gastrointestinal.
  2. Cervical corset and maximum restriction of movements in this department.
  3. Various physiotherapeutic procedures.
  4. Therapeutic massage, with the complete exclusion of procedures that cause temperature contrasts – sauna, bath, warming and compresses.
  5. Reflexotherapy and acupuncture – point or special needles are stimulation of biologically active points on the body.
  6. Kinesiotherapy and the classical complex of exercise therapy are specific exercises for the relaxation of muscles and ligaments conducted by the instructor or directly by the patient.
  7. Hirudotherapy is a leech with their enzymes, with a bite: improves blood rheology, local blood circulation, reduces local edema and inflammation, as a result pain and sensory disturbances disappear.
  8. In the acute period, bed rest is prescribed for a week, rehabilitation after treatment will take 2-3 months.

With the ineffectiveness of prolonged palliative treatment, acute pain, or signs of future complications, surgical intervention is recommended.

Often, it is performed according to vital indications and consists in eliminating the compression factor and indirectly improving blood circulation and innervation.

Shishkevich Vladimir
Shishkevich Vladimir
Orthopedic doctor, traumatologist
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An orthopedic traumatologist is involved in the diagnosis, treatment, and prevention of pathologies of bones, muscles, ligaments, and joints. He owns the methods of applying gypsum for fractures, correcting acquired or congenital pathologies of the limbs. Anatoly Kudravets specializes in the treatment of various types of injuries: bruises, sprains, fractures, subluxations, dislocations. The doctor deals with the consequences of radioactive, thermal, electrical, chemical lesions.