What injections can be prescribed for osteochondrosis

Osteochondrosis is accompanied by muscle spasms, facet joint dysfunction and progressive destruction of the intervertebral discs. Pathology is manifested by back pain, limitation of spinal mobility, sensory and motor disorders in the limbs. To combat all these symptoms, various groups of medications are used, which are most often administered parenterally.

Injections for osteochondrosis are faster and more effective than pills. With intramuscular and intravenous administration, drugs enter the bloodstream, bypassing the digestive tract. This allows you to quickly deliver drugs to damaged tissues.

Osteochondrosis can be complicated by intervertebral hernias and pinched spinal roots. A person develops unbearable pains that cannot be removed with conventional injections. To combat this pain syndrome, drug blockades are used. Patients may be given corticosteroids, NSAIDs, local anesthetics, or a mixture of several drugs. Drugs are injected into the soft tissue near the spine.

Intramuscular and intravenous injections

What injections do osteochondrosis do? The choice of medicine depends on the underlying syndrome. For example, for pain, doctors prescribe non-steroidal anti-inflammatory drugs, for muscle cramps – muscle relaxants, for pinching nerves – corticosteroids and neurotropic drugs. Since intervertebral discs and joints suffer from osteochondrosis, chondroprotectors are also injected into patients.

Alexander Bonin on the medical treatment of osteochondrosis:

Only a doctor is allowed to select medicines. If you have severe back pain, you suspect osteochondrosis, go to a specialist. In no case do not try to give yourself injections or ask relatives about it.

Table 1. Names of commonly used injections for osteochondrosis

PreparationActionPurpose and application features
DiclofenacAnalgesic and anti-inflammatoryIt is prescribed for the rapid relief of pain and inflammation. It is administered intramuscularly at 75 mg twice a day. To prevent complications from the digestive system, together with diclofenac, the patient is usually prescribed omeprazole
AnalginAnalgesic and mild antispasmodicIt is used for osteochondrosis, accompanied by myotonic muscle syndrome. It is administered in an amount of 500-1000 mg 2-3 times a day. The daily dose of Analgin should not exceed 2 g
MidokalmMuscle relaxantThe drug is prescribed with a feeling of stiffness in the neck and / or lower back. The medicine is administered intramuscularly or intravenously drip, 100 mg twice a day
AlflutopChondroprotectiveAccording to the manufacturer, the medicine improves spinal mobility, slows down the course of degenerative processes in the intervertebral discs and joints, and with prolonged use it has an anti-inflammatory effect. Alflutop is injected intramuscularly in a volume of 1 ml once a day. The course of treatment lasts 1 days
MilgammaNeurotropic, analgesic, regenerativeThe drug contains vitamins B1, B6, B12 and the local anesthetic lidocaine. Milgamma improves trophic nerve fibers, increases muscle strength, has a moderate analgesic effect. Intramuscularly administered in an amount of 2 ml 1 time per day
AmbeneAnalgesic, anti-inflammatory, intipyretic, uricosuric, neurotropicThe medicine is available in the form of two sets of ampoules. Before administration, the solutions are mixed in a syringe. Ambene is administered intramuscularly 1 time in 2-3 days. Due to the presence of corticosteroids, the drug should be used with extreme caution and only if absolutely necessary.

Nonsteroidal anti-inflammatory drugs

Medications are used to combat pain and inflammation in cervical, thoracic and lumbosacral osteochondrosis. Drugs of this group are injected deep into the muscles, since some of them, when administered intravenously or subcutaneously, can cause necrosis of blood vessels or subcutaneous fat. Only drugs containing metamizole sodium (Analgin, Baralgin, Spazmalgon, Pentalgin) are injected into the vein.

Metamizole has antispasmodic activity, which distinguishes it from other NSAIDs. For the treatment of osteochondrosis, injections with this substance are most often prescribed. Diclofenac, Meloxicam, Ketoprofen, Ketolorak are used to combat unpleasant symptoms.

Drugs that are used for injection

During treatment with non-steroidal anti-inflammatory drugs, it must be remembered that some of them cause serious side effects. The most common are gastritis, peptic ulcer exacerbation, gastrointestinal bleeding. Therefore, you must use NSAIDs very carefully and only with the permission of a doctor.

What do you think, how many injections of Diclofenac can be done with osteochondrosis without risking gastritis or an ulcer? For young healthy people, the drug can be used no longer than two weeks. After 65 years, Diclofenac is not recommended for pricking for more than 2 days.

Shishkevich Vladimir, orthopedic and traumatologistShishkevich Vladimir, orthopedic and traumatologist, project editor-in-chief ExpertNews.

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Muscle relaxants

In 70-80% of patients, back pain occurs due to muscle tension. Therefore, along with anti-inflammatory injections for osteochondrosis, muscle relaxants are prescribed. These drugs have an antispasmodic effect, stopping the pain syndrome. These drugs do not affect the intervertebral discs and joints, are suitable only for the symptomatic treatment of osteochondrosis.

Most muscle relaxants are available in tablet form (Sirdalud, Baclofen, Tizanidine). Intramuscularly, only Midokalm is injected into patients. The composition of the solution for injection includes the muscle relaxant tolperisone and the local anesthetic lidocaine.

Vitamins and Multivitamin Complexes

With osteochondrosis, patients are prescribed injections of nicotinic acid and B vitamins. These substances help get rid of neurological disorders, partially stop the pain syndrome.

In clinical practice, multivitamin complexes are used predominantly containing several active components at once (Neurovitan, Milgamma, Neuromultivit, Neurorubin, etc.). Such injections are used to treat osteochondrosis of the thoracic, cervical, lumbar spine.

Chondroprotectors

The scientific community continues to debate about the effectiveness of chondroprotectors in the fight against osteochondrosis. Some scientists believe that these drugs improve the condition of cartilage and slow down the development of the disease. Others are convinced that chondroprotectors are completely useless. But many doctors prescribe these drugs for degenerative diseases of the spine.

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Chondroprotectors are available in the form of tablets and solutions for intra-articular administration. Intramuscularly, Alflutop is injected into patients. It is designed specifically for the treatment of osteochondrosis of the spine and arthrosis of small joints.

Steroid hormones

With systemic use, corticosteroids cause a lot of side effects, because of which doctors prescribe these drugs only in case of emergency. Intramuscularly, steroids can be administered when all other drugs have been ineffective.

For the treatment of severe pain with osteochondrosis, the combined preparation Ambene is used. It includes dexamethasone, lidocaine, vitamin B12. Due to the low content of corticosteroids, the medicine is relatively safe to use, however, it is allowed to enter it no more than 3 times a week.

With osteochondrosis of the lumbosacral, thoracic and cervical spine, doctors usually prescribe the same injections. The choice of medication does not depend on the localization of painful sensations, but on their cause and severity.

Medicinal blockade

The need for drug blockages arises with the development of complications of osteochondrosis. More often it is a hernia of the intervertebral discs and pinching of the spinal nerve roots. Pathologies are accompanied by a pronounced pain syndrome, which cannot be stopped by conventional methods. Less commonly, blockades are used to combat non-compression pain and reflex syndromes.

The essence of drug blockade is the local administration of drugs. A mixture of corticosteroids with local anesthetics is injected into the patient (Dexamethasone + Lidocaine, Diprospan + Lidocaine; Kenalog + Bupivacaine, etc.). Injections provide fast analgesic and anti-inflammatory effects.

Blockade with complications of osteochondrosis

Local administration of drugs is required for people with complications of cervical or lumbosacral osteochondrosis. Injections are prescribed for lumbago, sciatica, cervicobrachial radiculitis. With osteochondrosis of the thoracic region, such injections are rarely done.

  • paravertebral. They are performed most often. The doctor introduces the medicine at special points near the spine, corresponding to the exit site of the spinal roots. The injected drugs block pain impulses, relieve soft tissue swelling, and stop the inflammatory process. This helps to quickly relieve pain and other unpleasant symptoms;
  • epidural. They are used only in severe forms of lumbosacral radiculitis, accompanied by multiple lesions of the nerve roots. Performing an epidural block is a complex manipulation that only a doctor can do.

Video of paravertebral blockade:

Blockade in pain and reflex syndromes

Medical blockades are increasingly used in the treatment of non-compression syndromes in osteochondrosis. Doctors use mostly non-steroidal anti-inflammatory drugs (Lornoxicam, Xefocam). Before administration of the drug, they are diluted with Novocaine or Lidocaine.

Clinical studies have shown that drug blockades can reduce or eliminate pain in 95% of patients. Patients note an improvement in well-being in the first minutes after the manipulation. In 84% of patients undergoing blockades, the pain syndrome completely disappears within the first three days after the procedure. In a more distant period, patients have improved spinal mobility, improved quality of life.

Types of blockade in cervical osteochondrosis:

  • sub-deltoid blockade;
  • paravertebral block of the cervical spine;
  • infiltration therapy of the pectoralis minor muscle, nodes in the deltoid and / or pectoralis major muscle;
  • blockade of vertebral arteries, scapula muscle, lower oblique and anterior scalene muscles.

Blockade of the lumbosacral osteochondrosis:

  • sacrospinal block;
  • paravertebral intramuscular block;
  • infiltration therapy of soft tissues of the spine and periarticular tissues of the lower extremities;
  • blockade of the interspinous ligaments, piriformis, square muscle of the lower back and muscles of the divided triangle.

The listed drugs are only suitable for the symptomatic treatment of osteochondrosis. They do not affect the pathogenesis of the disease, do not slow down its development. An exception is only chondroprotectors, the effectiveness of which is still being questioned.

Collagen hydrolyzate as an alternative to injections

What injections from osteochondrosis help slow down the development of the disease? Unfortunately, such injections do not exist. But!

Recently, FORTIGEL drinking collagen hydrolyzate has been introduced into clinical practice. The drug has passed all the necessary clinical studies and has been used for several years to treat deforming osteoarthritis. FORTIGEL affects the metabolism of proteoglycans, helps to restore the normal structure of cartilage. It helps slow down the development of osteochondrosis and prevent the destruction of intervertebral discs.

Today you can find the German drug CH-Alpha, which contains collagen hydrolyzate. The medicine does not need to be injected anywhere; it is enough to drink 1 time per day with meals. CH-Alpha helps increase the amount of proteoglycans in cartilage and slow down or even stop the development of osteochondrosis.

Anatoly Kudravets

Anatoly Kudravets, Orthopedic Traumatologist. He works with severe cases, practices operative methods of treating connective tissues

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