Injections and droppers are prescribed by the doctor during hospitalization of the patient during an exacerbation. During this period, an intensive course of therapy is carried out and all drugs are administered mainly parenterally.
Without exacerbation of the disease, injections of chondroprotectors and vitamins can be prescribed in courses to improve the condition of the intervertebral disc. This measure, along with non-drug treatment, will reduce the frequency of exacerbations of osteochondrosis.
Shishkevich Vladimir, orthopedic and traumatologist, project editor-in-chief ExpertNews.
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- Kinds and advantages
- What injections are best for treatment of the spine
- Nicotinic acid
- Blockade treatment
- What is prescribed for the treatment of the cervical spine
- The most effective injections for osteochondrosis
- A rational approach to the treatment of osteochondrosis with injections
- How to give injections for osteochondrosis: tips for patients
- What drugs are used in injections for osteochondrosis
- NSA >NSAIDs (non-steroidal anti-inflammatory drugs) are the broadest group of drugs for symptomatic treatment. That is, these agents cannot eliminate the cause (for example, degeneration or infection), but they can break the links of the inflammatory process. The mechanism of action of NSAIDs is based on the blocking of the enzyme cyclooxygenase or COX (it is involved in the formation of inflammatory prostaglandins). By reducing the effects of this enzyme, we reduce the activity of the combat syndrome and inflammation in general.
- Vitamins of group B – a new standard in the treatment of osteochondrosis
- Blockade with a powerful pain syndrome
- Muscle relaxants: eliminate muscle spasm
- Chondroprotectors – repair damaged discs
- What injections for osteochondrosis of the cervical spine are better, a list of drugs
- The benefits of injections
- Types of injections
- What injections are prescribed
- The danger of self-medication
- What is more effective: pills or injections?
- Cases of bygone days
- Prick me gently
- Modern, affordable tablet
- Exceptions to the rules
- A review of effective injections for pain in the joints of the hands, legs, knees. The list of funds for intramuscular and other methods of administration
- Pain Disorders
- What injections are given to relieve the condition?
- NSAIDs. Names of effective drugs
- Chondroprotectors – a list of the best drugs
- Muscle relaxants
- What injections, injections and droppers to do with osteochondrosis
- Anti-inflammatory drugs
- Muscle relaxants and antispasmodics
- Vitamins of group B and PP
- Intravenous vascular drug infusion
Kinds and advantages
In the treatment of osteochondrosis, the following types of injections are made:
- Intramuscular – the medicine is injected into the large muscles: gluteus, femur, biceps. Muscle tissue is equipped with a large number of vessels, so that the drug is rapidly absorbed into the blood and begins to act. Unlike injections into a vein, there is no risk of thrombosis and embolism (blockage of the vessel by air).
- Intravenous – the drug is injected directly into the vascular bed, so the effect develops in a matter of minutes. The fastest way to deliver the medicine to the place of application.
- Nerve blockade – the medicine is injected directly into the area of the pinched nerve root or the nerve branching from it. The most effective way to stop pain.
How to apply Revmalgon with otseochondrosis of different departments.
What helps Turpentine ointment: a complete list of indications for use.
How to use Voltaren ointment – read here.
What injections are best for treatment of the spine
Treatment of osteochondrosis is aimed at eliminating back pain and restoring intervertebral discs. Next, consider which drugs can help.
They combine analgesic, antipyretic and anti-inflammatory effects, due to which they not only eliminate pain, but also affect the cause of its appearance.
Most often, for the treatment of osteochondrosis is prescribed:
- Ketonal – has a pronounced analgesic effect, the anti-inflammatory and antipyretic effect is less pronounced. Negatively affects the mucous membrane of the stomach and intestines, provokes bleeding. The action lasts up to 6 hours.
- Movalis – has a pronounced anti-inflammatory effect, analgesic and antipyretic effect is less pronounced. It does not provoke the formation of ulcers in the stomach and duodenum, does not affect blood coagulation. Val >In cases where anti-inflammatory drugs can not cope with back pain, the doctor prescribes analgesics:
Analgin – belongs to the group of NSA >Milgamma is a combination drug that contains anesthetic (lidocaine) and vitamins B1,B6 and B12. Lidocaine has a local anesthetic effect, blocking the transmission of a nerve impulse from pain receptors. The effect develops quickly, but lasts about an hour.
B vitamins are involved in the metabolism of nerve cells. Milgamma injections activate the healing of the strangulated root of the spinal nerve. There is a restoration of its outer shell and a nerve impulse freely passes in the right direction.
A pinched nerve leads to a feeling of numbness, goosebumps, burning pain in the area of its innervation. Milgamma restores the nerve ending, thereby eliminating these unpleasant symptoms.
The drug is injected into the muscle for 7-10 days once a day.
Nicotinic acid has a beneficial effect on the vascular wall, dilates the capillaries and prevents the pathological formation of blood clots. It improves microcirculation in the intervertebral joints, thereby reducing the rate of degenerative processes in the intervertebral discs.
With cervical osteochondrosis, the blood supply to the brain is often disturbed, which leads to pain in the head, dizziness, and tinnitus. Nicotinic acid injections improve nerve cell nutrition and eliminate symptoms of ischemia.
It is administered intramuscularly, the average course of treatment lasts 2 weeks.
Chondroprotectors are drugs that protect and restore intervertebral discs.
They include substances that are contained in cartilage. They stimulate the restoration of the disc, eliminate pain and relieve inflammation in the joint.
For the treatment of osteochondrosis use:
They are administered intramuscularly daily or several times a week. The course lasts several weeks.
Paravertebral blockade is the introduction of a medicinal substance directly to the nerve root. For its use, a solution of local anesthetic (novocaine, procaine, trimecaine) in a mixture with an anti-inflammatory agent (hydrocortisone) is used.
Blockade eliminates pain in a matter of minutes, and hydrocortisone effectively relieves inflammation in the tissues. This allows you to extend the action of the injection up to several days. Blockades are carried out in a course of 3-5 procedures in 2-3 days.
Not in any case, you can carry out such an injection. Contraindications to blockade are:
- intolerance to local anesthetics;
- furunculosis of the skin of the back;
- ulcers, abscesses, phlegmon in the area of the blockade;
- acute infectious diseases.
In addition to B vitamins, with osteochondrosis, vitamins A, E, C are prescribed in the form of injections. They reduce inflammatory tissue damage, activate regenerative processes in the nervous tissue and joints, and improve microcirculation. Prescribe vitamins during the period of subsidence of the acute stage.
Vitamins A and E are fat-soluble, therefore, they are released in the form of oil solutions. You can enter them only intramuscularly, the course of treatment lasts several weeks.
Vitamin C is released in the form of an aqueous solution for intramuscular and intravenous injections. The duration of the course is determined by the attending physician.
What is prescribed for the treatment of the cervical spine
Cervical osteochondrosis usually leads to pain in the head, shoulders and upper limbs.
The pain syndrome is mild, and in the first place there is a violation of blood circulation, weakness in the muscles of the hand, a feeling of goosebumps and numbness.
Therefore, injections will be shown:
- milgamma or B vitamins;
- nicotinic acid;
- anti-inflammatory drugs.
The vertebrae in the thoracic spine are larger than in the cervical. Accordingly, their discs have a large thickness and area. Their destruction leads to severe pain during movement, so injections of chondroprotectors are prescribed without fail.
Most often, thoracic osteochondrosis is manifested by pain along the rib, since a process of the spinal nerve runs along its inner surface. Therefore, for the treatment they use blockades, injections of analgesics and anti-inflammatory drugs.
Milgamma and vitamin injections will speed recovery.
The lumbar vertebrae are massive and their discs are the largest. Here osteochondrosis leads to pinching of the sciatic nerve with the radiation of pain in the perineum and leg. Pain is pronounced, therefore, pain medications, anti-inflammatory injections and milgamum are prescribed.
Chondroprotectors help to restore the disc and reduce the inflammatory response. Blockade is often carried out if treatment with analgesics does not give a lasting effect.
Different groups of drugs have their contraindications, but any injection can not be carried out with inflammatory phenomena at the injection site, allergy to the drug and hemophilia.
The use of many drugs is prohibited during pregnancy and lactation.
NSAIDs are contraindicated in people with peptic ulcer of the stomach and duodenum, cirrhosis and impaired blood coagulation.
Opioid analgesics are contraindicated in drug addiction in a patient, impaired liver and kidney function.
The most effective injections for osteochondrosis
Osteochondrosis belongs to the group of degenerative-dystrophic diseases of the spine, as a result of which the MTD (intervertebral discs) is densified and they extend beyond the vertebral bodies.
This disease is often accompanied by severe pain.
Osteochondrosis is often accompanied by severe pain.
As the disease progresses, the intensity and frequency of exacerbations may vary. In recent years, a large number of studies have been made, based on which the best injections for the treatment of osteochondrosis were selected.
A rational approach to the treatment of osteochondrosis with injections
Along with physiotherapeutic techniques, massage, motor regimen, yoga and oriental medicine techniques, the central attention should be paid to medications, and to be precise, to their injectable forms.
The leading symptom in osteochondrosis is pain, which can be of various origins:
Much attention should be paid to compression syndrome (compression of nerve trunks with bone structures or disc).
Compression syndrome requires immediate treatment
This condition requires emergency and combined treatment.
With inflammatory genesis (origin), the pain responds well to treatment and, as a rule, is quickly stopped even by one drug.
For certain types of combat syndrome, only a course of injections from osteochondrosis is recommended:
- Quick effect. Bypassing the process of absorption (absorption) in the digestive tract, the drugs reach the target organs faster;
- Properties Some drugs can simply be destroyed in the digestive tract, as a result of which their effectiveness will decrease, unlike injections with osteochondrosis, which directly enter the bloodstream;
- Selectivity. To achieve maximum pharmacodynamic activity, some injections can be injected directly into the affected area.
Recommendations! Injectable drugs are better suited for the treatment of osteochondrosis – this is a measure of necessity.
How to give injections for osteochondrosis: tips for patients
An injection is a medical manipulation accompanied by a violation of the integrity of the skin, therefore it is very important to follow the principles of asepsis and antiseptics.
There are several types of injections for osteochondrosis:
If there is no assistant nearby who can give an injection for osteochondrosis, then this procedure can be performed independently:
- treat the upper outer half of the thigh with alcohol and iodine;
- type the drug into the syringe;
- fixing the syringe cannula with your finger, insert the needle 2/3 into the muscle (outer thigh).
How to learn how to put injections – see the video:
What drugs are used in injections for osteochondrosis
Osteochondrosis is based on a degenerative process that cannot be prevented.
With complex pharmacotherapy, it can be slowed down as much as possible.
The treatment of osteochondrosis with injections is based on the following important principles:
- eliminate pain and muscle spasm;
- normalize blood circulation;
- reduce the excitability of the nervous system;
- accelerate the recovery of nerve fibers;
- regeneration of damaged structures.
Below we will consider what injections are done for osteochondrosis in accordance with the EULAR recommendations.
NSA >NSAIDs (non-steroidal anti-inflammatory drugs) are the broadest group of drugs for symptomatic treatment.
That is, these agents cannot eliminate the cause (for example, degeneration or infection), but they can break the links of the inflammatory process.
The mechanism of action of NSAIDs is based on the blocking of the enzyme cyclooxygenase or COX (it is involved in the formation of inflammatory prostaglandins).
By reducing the effects of this enzyme, we reduce the activity of the combat syndrome and inflammation in general.
NSAIDs relieve symptoms
What you need to know about NSAIDs:
- non-selective drugs cause gastro- and neuropathy, but are highly effective;
- selective agents have fewer side effects, but their effect is weaker;
- these funds cannot be entered long-term.
The best names for NSAID injections for osteochondrosis:
- Diclofenac (cost from 37 rubles) is a key representative and the “gold standard” in the treatment of diseases of the musculoskeletal system. The course of admission is 7-10 days. One 3 ml ampoule contains 75 mg, with a maximum daily dose of 150 mg (2 ampoules);
- Ketonal (price from 186 rubles) is an effective injection for pain in osteochondrosis, which contains ketoprofen. The average course of treatment is 6-7 days. 1 ml of the solution contains 50 mg of the drug. It is recommended to do 2 injections per day;
- Meloxicam (from 113 rubles) is a selective agent with minimal side effects. From osteochondrosis, 15 mg of the drug is used in injections 2 times a day. The course of treatment is 10 days.
Vitamins of group B – a new standard in the treatment of osteochondrosis
About 80 studies were conducted, the results of which proved the high efficiency of combined preparations with B vitamins (B1 – thiamine, B5 – pyridoxine and B12 – cyanocobalamin).
Such injections can quickly eliminate the inflammatory process, severe pain, while all this means they improve conduction and accelerate the regeneration of nerve fibers.
Milgamma vitamins have proven themselves very well in the treatment of osteochondrosis
Over the years, Milgamma combined vitamins have proven themselves (average price 200 rubles) – one of the best anti-inflammatory injections for osteochondrosis.
The course of treatment is 10 days (1 ampoule per day).
Such an injection based on vitamins in osteochondrosis is not inferior in effectiveness to NSAIDs.
Nicotinic acid is considered to be a more affordable means, the injections of which are also used for osteochondrosis (1-2 injections per day for 2 weeks).
Blockade with a powerful pain syndrome
This method of treatment involves the administration of anesthetic drugs paravertebrally (these injections are made in the back with osteochondrosis) or epidurally. Most often used for severe pain (compression of nerve trunks).
Blockade with osteochondrosis is performed once, but if necessary, can be repeated after 3 days.
Blockades relieve severe pain
Most often, the paravertebral route of administration is used (into the muscle, translaminar, introligamentally). A combination of 2 ml of 0.5% novocaine and 60 mg of prednisone or dexamethasone is used – the best analgesic injection for osteochondrosis.
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Muscle relaxants: eliminate muscle spasm
Also, muscle relaxants should be included in the combined treatment of osteochondrosis. These are good injections from osteochondrosis, which disrupt neuromuscular transmission, as a result of which the muscle tone in the lumbar region decreases.
Some sources state that botulinum toxin may be used for this purpose.
The most effective drugs include Topiramat and Baclofen.
- Topiramata injections are made once a day for 1 days at 10 mg;
- Baclofen is administered 3 times a day at 10 mg for 7 days.
Chondroprotectors – repair damaged discs
Collagen, hyaluronic acid, hodroitin and glucosamine are plastic materials for cartilage repair.
Chondroprotectors restore cartilage between the discs of the spine
These substances are contained in sufficient quantities in food. But, passing through the digestive tract, they are destroyed. Popular chondroprotectors prevent further damage to the MTD (intervertebral disc) and facet joints, reduce the intensity of the pain syndrome and the inflammatory process as a whole.
What injections with chondroprotectors are prescribed for osteochondrosis:
- Chondrogard – inhibits degenerative processes and improves calcium delivery. The course of treatment is 14 days (2 injections per day). Each ampoule contains 200 mg of chondroitin sulfate. A dropper with chondrogard in osteochondrosis has a distinct effect;
- Elbona – normalizes metabolic processes in cartilage and bone tissue. One ampoule of the drug contains 200 mg of glucosamine. The course of treatment is from 3-5 weeks (3-4 times a week).
In addition, such injections as Chondrolon, DONA, Alflutop and others received positive reviews for osteochondrosis.
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For preventive purposes, it is recommended to repeat the course of treatment with these drugs.
What injections for osteochondrosis of the cervical spine are better, a list of drugs
At the chronic stage of osteochondrosis comes two periods – exacerbation and remission. The pain arising from an exacerbation is very severe and does not allow a person to move. In this situation, you should quickly stop the pain in any way. An ointment or tablets do not always have the necessary effect, then injections are used for osteochondrosis of the cervical spine.
The benefits of injections
When contacting a specialist in the first stages of development of cervical osteochondrosis, the treatment does not last long. For the treatment of the disease, not only physical education and oral medications are prescribed, but also special injections for osteochondrosis of the cervical spine.
Treatment with injections has a positive effect, since all the necessary substances in a short time fall into the affected areas. The main goal of injections is the rapid removal of pain that occurs at the time of the inflammatory process. The injections prescribed for osteochondrosis of the cervical spine have several advantages:
- rapid pain relief, since substances in a short time reach the focus of inflammation;
- exact dosage of the drug;
- direct impact on the epicenter of inflammation;
- use of intravenous droppers is possible.
The use of injections can not only relieve pain, but also eliminate all the key symptoms of osteochondrosis of the cervical spine. It is not recommended to administer the drug on one’s own; otherwise, nerve endings and blood vessels may be damaged, as a result of which severe consequences of a negative nature are possible.
Types of injections
At the time of the intensification of the disease, several types of injections are prescribed, they can be given singly or in a complex. Prescribed injections can be administered in several ways:
- under the skin;
Injections for osteochondrosis of the cervical spine, which are administered intramuscularly, are prescribed for severe exacerbation of the disease, and they consist of certain groups of drugs:
- antispasmodic meotropic;
- nonsteroidal anti-inflammatory drugs.
Antispasmodics are prescribed to relieve spasms that occur in the muscles of the spine. This group of drugs blocks the pain syndrome of muscle fibers that are affected by the disease. The most common drug prescribed for osteochondrosis is Midokalm.
An analgesic is prescribed only to relieve pain, since this group is not able to eliminate the development of a degenerative-dystrophic process. A popular analgesic is Baralgin or Analgin.
Nonsteroidal drugs can vary greatly. It all depends on the intensity of development and the severity of the disease. The group of these drugs includes Ibuprofen, Diclofenac.
These injections for cervical osteochondrosis have not only anti-inflammatory effects, but also relieve swelling. In addition, they restore the nerve endings, which in the process of developing the disease squeezed the affected tissue. The duration of the effect, after a full course of treatment, lasts up to six months.
Strong debate among doctors has spread around steroid hormones. The most appointed now has become Ambene. This is a complex drug with multilateral action. In addition to local action, it has a positive effect on the entire nervous system of the body. And due to Ledocaine, which is part of the drug, a person can easily tolerate it.
Injections in the neck with osteochondrosis is a blockade that has a specific direction. The injection is made directly into the affected area. Such injections are prescribed with a pronounced pain syndrome. The procedure itself is simple and has many positive processes:
- have a quick effect, since the injection enters the affected area, after which it blocks the pain;
- does not allow pain impulses to go beyond the boundaries of the affected area;
- instantly relieves spasm;
- eliminates inflammation;
- improves blood flow in the local system;
- relieves swelling.
The blockade is carried out using one or more drugs at the same time. It all depends on what injections are already assigned to the patient, this type of blockade is also used.
For these injections, the most commonly used corticosteroid hormone along with drugs of the analgesic group. The hormone is aimed at stopping and removing the process of inflammation, and analgesics relieve pain.
The blockade is divided into two types: paravertebral, when injections are placed at certain points in the vertebral region and epidural.
The blockade is highly effective, but there are a number of contraindications:
- suppuration and disease, which are accompanied by purulent discharge;
- allergy to the used anesthetic is possible;
- during visible deformity of the spinal column.
What injections are prescribed
For the treatment of cervical osteochondrosis, other types of medications can be prescribed that block pain, relieve inflammation, the names of which are given below.
Voltaren. This drug has a complex effect, relieves pain, reduces the process of inflammation, is able to relieve heat. After several injections, the patient’s feeling of stiffness disappears, swelling disappears, and the swelling disappears.
Milgamma. This drug is included in group “B”, and has a complex effect on the focus of inflammation and affected nerve fibers.
Ketonal and Ketorolac. Injections not only quickly relieve pain, but also stop the inflammatory process.
Elbon, Altufon and Don. These injections belong to the group of chondroprotectors. They not only remove all the unpleasant symptoms of the disease, but also trigger regenerative processes that restore the intervertebral discs, cartilage tissue located in the cervical spine.
The danger of self-medication
The cervical spine is the most traumatic place, for this reason osteochondrosis can be dangerous with a large number of complications, especially if improper treatment is performed.
Very often, people with osteochondrosis, after injections, begin to gymnastics and actively move their heads. Many sick people forget that with osteochondrosis of the cervical spine, injections have a temporary analgesic effect. After sudden movements of the head, the pain syndrome may return with more force. For this reason, doctors advise sick people at the time of treatment to wear special collars that limit sharp movements.
People involved in self-treatment, as a rule, still get to the doctor, but in a more complicated condition. With osteochondrosis, pain relief is not a key goal.
It is not recommended to start taking injections for the disease, without the recommendation of a doctor and a full examination. Analgesics are not recommended to be abused, since they perform only the analgesic effect of a temporary action.
Improper administration of various drugs for this disease can cause serious complications, these include the onset and exacerbation of gastritis, serious liver disease, possibly increased blood pressure.
Before starting injections with osteochondrosis, it is necessary to undergo an examination, after which the necessary treatment will be prescribed, which will depend on the complexity of the disease and the level of pain.
What is more effective: pills or injections?
When it was believed that injections are more effective than pills, and why it has long been out of date
Cases of bygone days
Pharmacology is a rapidly developing science. Over the past decades, the range of drugs has been replenished with many drugs that have significant, important differences from their “grandparents.” Today it’s even hard to imagine that some 50 years ago there were only a few antibiotics in the arsenal of doctors.
Moreover, the preparations in tablet form, the same ampicillin and phenoxymethylpenicillin, had a lot of disadvantages. They had to be taken several times a day in strict accordance with food intake, moreover, all of them were characterized by extremely low bioavailability, i.e., most of the active substance was excreted without any pharmacological effect.
But injection antibiotics, the same benzylpenicillin or ampicillin, did not have these disadvantages: if you are healthy, bypassing the gastrointestinal tract and don’t worry about bioavailability or food. Since then, both doctors and patients have gained an opinion on the great and unconditional effectiveness of injections.
And although today, in the XXI century, both the assortment and bioavailability of oral (that is, taken per os, by mouth) drugs have changed significantly, which is firmly entrenched in the heads of consumers and – what is there to hide – some doctors have a myth that lives on, unlike rock and roll. Meanwhile, the “vitality” of this legend may not be the best way to reflect on the condition of patients.
Prick me gently
First of all, an injection is painful. Plus, bluish-blue bumps after the procedure can remind you of a traumatic treatment for several more weeks. Moreover, unlike taking pills, intramuscular administration of drugs can be accompanied by a number of other unpleasant consequences, including:
- The formation of a hematoma due to damage to the capillaries by a needle.
- Embolism of the vessel. This can happen if, with the introduction of oil solutions, the needle enters the lumen of the blood vessel, which leads to its obstruction – clogging.
- Damage to the nerve trunks that occurs with the wrong choice of the injection site. It is accompanied by severe pain along the nerve and can lead to the development of neuritis.
- The development of an abscess is a purulent inflammation of the soft tissues, which is accompanied by the formation of a cavity filled with pus. It appears with infection of the infiltrate – cones, which is formed as a result of repeated injections at the same place or a violation of the technique of administration.
And, of course, one cannot fail to mention the fear of medical manipulation, which settles in the minds of many adults and almost all children who have experienced all the “charms” of treatment with injections. Injections, which all over the world have almost given way to no less effective oral medications.
Modern, affordable tablet
In order for consumers to be able to believe and get used to the idea of pills infringing upon the holy idea that tablets are not less effective than injections, evidence is needed, of course. And they are, just not everyone knows about their existence.
So, in a number of large-scale clinical trials conducted in accordance with all the requirements of evidence-based medicine, it was demonstrated that modern oral antibiotics are not inferior in effectiveness to injectable forms. The bioavailability of the vast majority of tabletted antibacterial drugs is not lower than injection.
It has been clinically proven that intramuscular administration of such a “favorite” ceftriaxone by many doctors in case of urinary tract infection in children is as effective as oral administration of a combination of trimethoprim and sulfomethoxazole (Biseptol). The rate of recovery and the risk of relapse with otitis media in children are exactly the same, regardless of whether the child is injected with the same ceftriaxone or given to it with sweet infant forms of amoxicillin.
Leading international health organizations claim that there is no point in treating pneumonia on an outpatient basis with injections. Pills will cope with the task no worse! It is also not necessary to prescribe injectable antibiotics for sinusitis and most community-acquired infections.
To give preference to antibacterial drugs in injections makes sense only in exceptional cases, among which:
- intramuscular injection of benzathine benzylpenicillin with syphilis;
- administration of ceftriaxone for gonococcal infections and pelvic diseases (4) and other, even more rare situations.
Comparison of the effectiveness of tablets and injections was carried out not only in relation to antibacterial drugs.
The results of the studies convincingly indicate that the result of treatment with hormonal drugs, B vitamins, in particular vitamin B12, some non-steroidal anti-inflammatory drugs, including the popular analgesic ketorolac, and many other drugs in tablets and injections are identical. But it should be noted that sometimes you really can not do without injections.
Exceptions to the rules
Blood test in children and vaccinations
There are not so many cases where the appointment of a traumatic treatment is justified. We list them:
- For some reason, a person cannot swallow a pill.
- The patient categorically refuses to take syrup or tablets.
- A person has severe, indomitable vomiting.
- The patient is unconscious.
- The necessary medicine exists only in the form of an injection solution (the same ceftriaxone).
- The doctor must be sure that the patient is receiving treatment.
In all other situations, injectable drugs should give way to a less painful route of administration – oral tablets or syrups. And if your doctor prescribes injections for you in the old fashion, it makes sense to ask if it is possible to replace them with tablets, syrups or suspensions, which are preferred in all civilized countries.
A review of effective injections for pain in the joints of the hands, legs, knees. The list of funds for intramuscular and other methods of administration
In the treatment of diseases associated with the musculoskeletal system, injections are considered the most promising method for reducing pain, eliminating the inflammatory process, restoring joint mobility. The basis of therapy is the injection of a medicinal product into a sore joint or intramuscularly. The choice of route of administration depends on the type of pathology used drug.
The main cause of joint pain is irritation of the nerve endings, which in large quantities stretch from the synovial articular bag. Due to the good blood supply to these endings, the joint is able to quickly respond to any irritation by the occurrence of pain.
Pathologies that can cause joint pain or arthralgia:
Rheumato >In addition to these diseases, the causes of pain can be such factors:
- presence of infection;
- diseases of the kidneys, liver;
- excessive physical exertion;
What injections are given to relieve the condition?
The elimination of joint pain is one of the methods of complex treatment of the disease that caused it. Pharmacological groups of drugs that are prescribed:
- non-steroidal anti-inflammatory drugs (NSAIDs);
- muscle relaxants;
Read more about the best drugs in injections for pain in the back and joints, read here.
NSAIDs. Names of effective drugs
NSAIDs are administered intramuscularly or intravenously. Inside the joint, only Xefocam (lornoxicam) is administered.
NSAID injections help with pain in the joints of the knees, ankle, elbows, wrists. Such drugs are capable of:
- eliminate pain;
- relieve swelling and increase in local temperature;
- reduce inflammation.
About 40 types of NSAIDs are known that have analgesic and anti-inflammatory properties (what are the groups of anti-inflammatory drugs in injections?). Most often, doctors prescribe injections with such active ingredients:
Representatives of injections with diclofenac in the composition:
- Voltaren, NOVARTIS PHARMA, Switzerland;
- Diclogen, AGIO PHARMACEUTICAL, India;
- Naklofen, KRKA, With fishing.
Representatives of injections with ketorolac:
- WATORLAC, NOVATOR PHARMA, UK;
- Dolak, CADILA PHARMACEUTICALS, India;
- Ketalgin, PHARMSTANDART-UFIMSK VITAMIN FACTORY, Russia.
Representatives of ketoprofen injections:
- Arthrosilen, DOMPE FARMACEUTICI, Italy;
- Artrum, BIOSYNTHESIS PAO, Russia;
- Ketonal, LEK dd, Slovenia.
Chondroprotectors – a list of the best drugs
Chondroprotectors are considered one of the most important groups of drugs prescribed for diseases of the joints of the legs and hands. Due to the content of chondroitin sulfate and glucosamine, which are also part of the synovial fluid, these drugs contribute to the development of new cartilage and bone tissue, and also contribute to the treatment of many diseases associated with joint pain.
The use of such drugs has a cumulative effect, they should be used for six months or longer.
- Artravir-Incampharm – solution for intramuscular administration. The active substance is chondroitin sodium sulfate. Manufacturer – ARMAVIR BIOFABRIC, Russia.
- Don – a solution for intramuscular administration. The active substance is glucosamine. Manufacturer – BIOLOGICI ITALIA LABORATORIES, Italy. Each package contains 2 types of ampoules (with solution A and B).
- Ampoules with solution A contain glucosamine sulfate (400 mg), sodium chloride (102,5 mg), lidocaine (10 mg).
- Ampoules with solution B contain the solvent diethanolamine (24 mg).
- Chondrolone is a lyophilisate for the preparation of a solution for intramuscular administration. The active substance is chondroitin sodium sulfate. Manufacturer – IMMUNOPREPARATE, Russia.
- Elbona – a solution for intramuscular administration. The active substance is glucosamine. Manufacturer – MC ELLARA LLC, Russia.
The above drugs are administered intramuscularly. Inside the joint, only Alflutop can be administered.
These are drugs prescribed to reduce joint pain and relieve muscle tension. The effectiveness of muscle relaxants is manifested in the elimination of muscle pain, the normalization of joint mobility, as well as improved blood circulation in the affected joint.
This type of drug should be used only in combination with chondroprotectors or manual therapy. Treatment with muscle relaxants can be combined with the use of vitamins.
Muscle relaxants are administered only intramuscularly and intravenously. You can not enter drugs into the joint!
List of the best drugs from among muscle relaxants:
- Midokalm is a solution for intramuscular and intravenous administration. Active ingredients: tolperisone hydrochloride (100 mg), lidocaine hydrochloride (2,5 mg). Manufacturer – GEDEON RICHTER, Plc., Hungary.
- Kalmireks is a solution for intravenous and intramuscular administration. Composition: tolperisone and lidocaine (the same dosages). Manufacturer – PharmFirma SOTEKS, CJSC, Russia.
These funds are used in cases where other drugs are powerless in eliminating pain in the back and joints. Most often, steroids are prescribed in the form of injections that are injected directly into the joint, due to which they have an immediate effect.
Among the drugs in this group can be noted:
- Solu-Cortef (hydrocortisone) is a lyophilisate for the preparation of a solution for intramuscular and intravenous administration. Manufacturer – PFIZER MFG. BELGIUM, NV, Belgium.
- Diprospan (betamethasone) – suspension for injection. Manufacturer – SCHERING ‐ PLOUGH LABO, NV, Belgium.
- Celeston (betamethasone) – injection. Manufacturer – SCHERING ‐ PLOUGH LABO, NV, Belgium.
- Kenalog (triamcinolone aceton >These are painkillers that are used intramuscularly for injections in case of pain in the hip, knee, ankle joints of the legs, arms, as well as the back and muscles (for how to make injections to the knee and what types of drugs are used to treat joints, read here). Drugs are used in cases where tablets or ointments for pain do not help. Analgesics are not able to cure the patient, but only temporarily eliminate the pain syndrome.
Analgesics relieve pain, soothe. This is due to the effect of drugs on opioid receptors of the nervous system and the suppression of pain at the level of the brain.
Analgesics that relate to narcotic drugs should be prescribed by a doctor and used strictly according to a prescription (Tramadol, Promedol, Codeine, Morphine and others).
Analgesics of a non-narcotic nature include simple painkillers, which are also available in the form of a solution for injection:
- Paracetamol (paracetamol);
- Analgin (metamizole sodium).
Drugs are administered intramuscularly.
Vitamins – a group of auxiliary drugs in the treatment of joint pain. They stop pain in the joints and improve the conductivity of nerve endings. This group of drugs relieves pain in the spine and shoulder blades.
These drugs include:
- Kombilipen is a solution for intramuscular administration. Manufacturer – PHARMSTANDART-UfaVITA, Russia.
- Trigamma is a solution for intramuscular administration. Manufacturer – MOSHIMFARMPREPARATY them. ON THE. Semashko OJSC, Russia.
- Milgamma is a solution for intramuscular administration. Manufacturer – SOLUPHARM PHARMAZEUTISCHE ERZEUGNISSE, Germany.
- Various diseases, including arthritis, gout, or bursitis, can cause joint pain.
- Joint pains are eliminated by injection of various drugs, including hormonal, anti-inflammatory and even vitamin.
- NSAIDs will help to temporarily eliminate joint pain, inflammation.
- Chondroprotectors are very effective drugs that have a therapeutic effect due to the content of glucosamine and chondroitin sulfate.
- Muscle relaxants not only affect the joints, but also help relieve muscle tension, reduce inflammation. Used in combination with other types of drugs.
- Analgesics do not cure, but relieve pain.
- Vitamins act as excipients that help restore joints.
What injections, injections and droppers to do with osteochondrosis
Injections (injections and droppers) for osteochondrosis are prescribed for severe pain, which does not go away on its own. The treatment of degenerative-dystrophic diseases is based on the correction of complex changes in the intervertebral discs, the vascular, muscle and bone-joint systems.
The main links of the medical treatment of osteochondrosis and pain associated with it include the appointment of several groups of drugs:
- Muscle relaxants and antispasmodics.
- Vitamins of group B.
- Blockades with local administration of novocaine, trimecaine, bupivacaine (anesthetics), corticosteroids or NSAIDs.
- Less commonly, chondroprotectors (only in some cases) and vascular preparations in the form of infusions.
It should be remembered that at present, with the diagnosis of osteochondrosis, nonspecific back pain (for example, myofascial syndrome), arthropathy of the arches and other joints of the spine are most often hidden. This material does not describe how to treat compression radiculopathy with intervertebral hernias and spinal stenosis. What anti-inflammatory drugs are prescribed for back pain?
Anti-inflammatory drugs – one of the most important links in the treatment of pain (reflex and muscle-tonic with cervical, thoracic, lumbar osteochondrosis). NSAIDs and glucorticosteroids (GCS) can be used as medicines of this group. Typically, corticosteroids are prescribed for the ineffectiveness of NSAIDs or for the proven autoimmune nature of the disease (for example, ankylosing spondylitis), as well as for osteoarthritis of the joints of the spine in the form of paraarticular injections.
However, NSAIDs are usually used as anti-inflammatory drugs for exacerbation. Among a large number of drugs of this group, the most effective and studied are the following:
The basic ones are usually celecoxib (the trade name is Celebrex), meloxicam (Movalis), nimesulide (Nimesil, Nise, Nimika). All of these preparations are in tablet, capsule, or powder form for oral administration only. Their effect becomes most pronounced by about the third day from the start of administration. Therefore, in the first 5 days (peak pain), injections such as diclofenac, ketorolac, ketoprofen can be prescribed. Subsequently, the patient is transferred to basic funds.
How are NSAIDs injectable (injections) used? To do this, see the table below.
All NSAIDs shown in the table have a non-selective effect, which means that they have a significant effect on the gastrointestinal tract (GIT) and can cause bleeding.
Therefore, if patients with back pain have contraindications (chronic diseases of the stomach or duodenum, coagulation disorder), it is better not to use these drugs, but immediately switch to selective ones (meloxicam, celecoxib).
The effectiveness of various NSAIDs in the treatment of pain was studied in the IMPROVE study (1), its results are presented in the table below. Nimesulide was not included in this study. However, in another clinical study, nimesulide was not inferior in its effectiveness (analgesic effect and frequency of side effects) to celecoxib.
Thus, the NSAID line of efficacy and safety can be as follows: meloxicam-nimesulide (celecoxib) -aceclofenac-diclofenac. It should be understood that the analgesic effect in the acute period is usually more pronounced in injection forms of ketorolac and diclofenac.
Muscle relaxants and antispasmodics
Muscle relaxants are almost always added to the treatment regimen for pain in osteochondrosis, especially when their duration is more than 6 weeks.
Since osteochondrosis of the spine in everyday life is usually considered to be the presence of myofascial pain syndrome or other non-specific pains, it is muscle relaxants that have their immediate therapeutic effect, namely they stop pain and relax the muscles of the back and spine. What muscle relaxants are usually prescribed for back pain?
The main muscle relaxants used for treatment are listed below:
- Midokalm (“Tolperizon”) – has an injection and tablet form.
- Sirdalud (Tizanil, Tizanidin, Tizalud) is an oral preparation in the form of tablets, capsules and powders.
- Baclofen – in the territory of the Russian Federation only in the form of tablets, abroad it is produced in the form of an injection form (“Gablofen”).
Muscle relaxants in the Russian Federation have mainly the appearance of tablets, only midocalm (“Tolperisone”) has an injection form in this group. Midokalm has the following features as advantages over other drugs of this group (3):
- It does not give a pronounced sedative effect.
- Does not cause muscle weakness.
In the presence of contraindications to the intake of muscle relaxants, pregnant women and lactating women may be prescribed antispasmodics, although their effect is more associated with the relaxation of smooth muscles. The most commonly prescribed are:
Antispasmodics can also be prescribed as injections for cervical osteochondrosis, with severe headaches and dizziness.
The main patterns of use of these drugs are shown in the table below.
Vitamins of group B and PP
Quite often, vitamins of group B, usually complex, and nicotinic acid (PP) are prescribed as adjunctive therapy for pain. Some authors recognize the fact that injections of vitamins B with osteochondrosis of the lumbar spine contribute to a significant reduction in the duration of the pain period (2), especially with a combination of tablet or injection NSAIDs.
At the same time, the combined effect of vitamins B1, B6, B12 has the optimal effect in the treatment, therefore, the combined formulations, for example, Milgamma, are the most successful form.
The main drugs and their administration are shown in the table below.
Chondroprotectors are a fairly controversial group of drugs prescribed for osteochondrosis. Currently, their effectiveness has been studied only in relation to osteoarthritis, therefore, chondroprotectors are present in the treatment regimens of this disease. The possibility of using chondroprotectors for osteochondrosis exists only when degenerative changes include osteoarthrosis of the facet joints of the spine (OFS).
In this case, at the initial stage of the OFS, chondroprotectors can be prescribed. For other cases, the effectiveness of the use of chondroprotectors has not been proven and is under study and testing. The most commonly used chondroprotectors are:
- “Teraflex” is an oral preparation containing glucosamine hydrochloride and chondroitin sulfate.
- “Dona” – in the composition glucosamine sulfate as the main active ingredient.
- Structum is the main active ingredient – chondroitin sulfate.
- “Alflutop” – as a part of a concentrate from different types of fish (chondroitin sulfate), amino acids, etc.
As studies in this group of drugs show, the best way to use them for osteoarthritis of the joints of the spine is paravertebral and periarticular (i.e., around the spine and the joints themselves). Oral administration and intramuscular injections (injections for lumbar and thoracic osteochondrosis) are less effective.
Possible application patterns according to the authors are given in the table below.
Intravenous vascular drug infusion
Despite the fact that droppers for osteochondrosis are not a mandatory component of treatment and are usually not present in the standards of therapy, they are often prescribed in medical practice.
Most often performed if there are problems in the cervical spine, accompanied by dizziness and headaches. In addition, vasoactive drugs are indicated for compression radiculopathy, but its treatment is not considered here.
Among the main vascular preparations, which are prescribed in the form of infusions and injections from osteochondrosis of the cervical spine, we can distinguish:
- Pentoxifylline (Trental).
- Xanthinol nicotinate or sodium nicotinate (nicotinic acid).
It is worth noting that these drugs for the most part relate to medicines with unproven effectiveness. Trental (or cheaper pentoxifylline), as well as nicotinic acid and its salts, have a vasodilating effect, mainly of peripheral vessels (limbs, brain), and therefore they are prescribed for symptoms of vascular pathology, sometimes accompanying degenerative processes in the cervical spine.
Actovegin and berlition are mostly related to angioprotectors and are aimed at improving metabolic processes in tissues. However, in fact, berlition was originally studied and was intended for the treatment of diabetic angiopathy and neuropathy. Actovegin was used in obstetrics.
In conclusion, it should be noted that any therapy, especially drug therapy, should be agreed with the attending physician. All injections are best performed in a treatment room in which a special environment is created, which is necessary for the safety and prevention of post-injection complications.