The use of injection solutions, tablets, ointments is one of the main methods of treatment of osteochondrosis of the cervical spine. The drugs are used to eliminate neck pain, swelling, muscle cramps, stiffness. With the help of drug treatment, it is possible to improve blood circulation, which always worsens with cervical osteochondrosis, stimulate the restoration of damaged soft and cartilage tissues.
- The goals and principles of drug treatment of cervical osteochondrosis
- Blood supply improvement
- Slowing tissue destruction
- Types of drugs
- Drugs to improve blood microcirculation
- Application forms
- Local preparations
- Are there any contraindications
The goals and principles of drug treatment of cervical osteochondrosis
Cervical osteochondrosis has not yet been completely cured. No pharmacological preparations have been synthesized, the use of which would help restore damaged intervertebral discs and deformed vertebrae. Therefore, the main objectives of the treatment of this degenerative-dystrophic pathology are to improve the patient’s well-being and prevent further damage to all vertebral structures. Such an integrated approach allows you to quickly achieve a stable remission. At this stage, there is no pronounced symptomatology, and the patient can lead an active lifestyle.
The use of solutions for parenteral administration helps to relieve severe pain within a few minutes. Drugs from the group of non-steroidal anti-inflammatory drugs (NSAIDs), glucocorticosteroids, muscle relaxants, narcotic analgesics are used. And to eliminate pain of moderate severity, patients are shown taking tablets for 7-14 days. The course of treatment can be extended only with the permission of a neurologist or vertebrologist.
Applying ointments, gels, creams to the area of pain allows you to get rid of weak discomfort. These are drugs with NSAIDs, components with local irritating and distracting effects, local chondroprotectors.
Blood supply improvement
Only by normalizing blood circulation, you can eliminate the deficiency of nutrients that has arisen in the discs and vertebrae. Taking medications to improve microcirculation helps to restore, replenish the reserves of fat-and water-soluble vitamins, trace elements (phosphorus, calcium, magnesium, molybdenum, potassium).
With cervical osteochondrosis of degree 2, 3, severity often occurs by compression of the disc or bone growth (osteophyte) of the vertebral artery. This blood vessel supplies all parts of the brain with nutrients and oxygen. With its infringement, the patient suffers from headaches, jumps in blood pressure, dizziness, decreased visual acuity and hearing. To eliminate neurological symptoms, doctors include drugs to improve blood circulation in treatment regimens.
Slowing tissue destruction
The course of cervical osteochondrosis is accompanied by a slow but persistent thinning of the discs and deformation of the vertebral bodies. There are two ways to stop the destructive process – daily physical therapy classes and course medications. To slow the destruction of tissues, drugs that improve blood circulation and lymph drainage are used.
But the most effective drugs from the group of systemic chondroprotectors. If you use them with cervical osteochondrosis of the 1st degree of severity, you can not only stop the damage to the cartilage tissue, but also partially regenerate them. And with advanced pathology, chondroprotectors are prescribed both for the prevention of tissue damage and for reducing doses of systemic analgesics.
To restore damaged tissues, improve overall health, strengthen protective forces, it is necessary to provide vitamins and minerals to the body. These bioactive substances are involved in all biochemical processes, including those occurring in the cervical spine. With their deficiency, the rate of tissue destruction begins to prevail over the rate of recovery.
With food, an insufficient amount of vitamins may enter the body. Doctors recommend an additional medication. They include all the vital vitamins and minerals. It is enough for a few months to take 1 tablet at breakfast to replenish the reserves of bioactive substances.
Types of drugs
There are standard treatment regimens for cervical osteochondrosis with pharmacological preparations, which include analgesics, chondroprotectors, muscle relaxants, and blood circulation improvers. But they can be supplemented if necessary. For example, with memory impairment, decreased concentration and attention, therapeutic regimens are replenished with nootropics. And if the course of osteochondrosis is not complicated by muscle spasms, then there is no need to use muscle relaxants.
NSAIDs are the first choice in the treatment of cervical osteochondrosis. They are used to eliminate pain, stop the inflammation of the soft tissues, accelerate the resorption of edema. NSAIDs can be prescribed in the form of injections, tablets, capsules, gels, ointments, powders for the preparation of solutions, plasters, rectal suppositories. The most popular drugs with these active ingredients are:
NSAIDs are non-selective and selective. The latter selectively suppress the activity of cyclooxygenase produced in inflammatory foci. Selective NSAIDs (meloxicam, celecoxib, etoricoxib) do not damage the gastric mucosa. Non-selective drugs (Diclofenac, Ketoprofen) inhibit cyclooxygenase in the internal organs, which can cause their damage.
When the spinal roots are compressed by osteophytes or hernial protrusion, there is such a sharp pain that a person is afraid to tilt or even turn his head slightly. In this state, even NSAID injections are powerless. Therefore, with an exacerbation of the disease, for the relief of pain, drug blockades with glucocorticosteroids are carried out. So-called drugs are analogues of hormones produced by the adrenal glands. They have a pronounced anti-inflammatory, analgesic, antiexudative effect. Most often for drug blockades, the following glucocorticosteroids are used:
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Hormonal drugs exhibit immunosuppressive activity, that is, inhibit immunity. They are toxic to internal organs, bone, cartilage, soft tissues. Therefore, despite the effectiveness of glucocorticosteroids, they are used only with the failure of NSAIDs.
Drugs of this group (Lidocaine, Novocaine) are used for drug blockades, usually in combination with hormonal drugs. They enhance and prolong (prolong) the action of glucocorticosteroids. But the analgesic effect of the anesthetics themselves is not long – the pain is felt already 1-2 hours after the use of drugs.
These agents are also used in physiotherapy of cervical osteochondrosis for electrophoresis or ultraphonophoresis. Lidocaine is one of the active ingredients of the Mydocalm muscle relaxant and preparations with B vitamins in injections.
After the relief of acute pain and inflammation, vertebrologists include ointments, gels with distracting, analgesic, decongestant effects in treatment regimens. After application to the back of the neck, their components irritate subcutaneous receptors. This stimulates the flow of blood to damaged tissues, accelerating their recovery.
The composition of locally irritating agents includes ingredients that can provoke a pronounced local allergic reaction. And for people with sensitive skin after their application, an unbearable burning sensation, and sometimes a chemical burn, can occur. Therefore, before using the ointment, you need to rub a small amount (with a pea) in the wrist. If after an hour the skin does not swell, rashes do not appear, then you can proceed to treatment.
|Name of local irritant for the treatment of cervical osteochondrosis||The composition of the active ingredients of the drug|
|Capsicum||Benzyl nicotinate, racemic camphor, dimethyl sulfoxide, nonivamide, turpentine oil|
|Viprosal||Camphor, salicylic acid, turpentine turpentine, viper venom|
|Efcamon||Camphor, methyl salicylate, eucalyptus, clove, mustard oil, menthol, tincture of capsicum|
|Apizartron||Bee venom, methyl salicylate, allyl isothiocyanate|
|Nayatoks||Methyl salicylate, camphor, eucalyptus oil, dry cobra venom|
Drugs to improve blood microcirculation
Medicines from this group are prescribed for patients with 2, 3 degrees of severity of cervical osteochondrosis. Pathology is clinically manifested by disorders provoked by a state of hypoxia (oxygen starvation of the brain). The drugs are used in combination with muscle relaxants or NSAIDs that eliminate the causes of compression of the vertebral artery – muscle cramps, inflammatory edema. What funds can appoint a vertebrologist:
- Eufillin – reduces the tension of the vascular walls, promotes the expansion of peripheral vessels and oxygen saturation of the blood;
- Pentoxifylline – reduces blood viscosity, causes platelet disaggregation, increases the elasticity of red blood cells;
- Niacin – has a vasodilating effect at the level of small vessels (including the brain), has anticoagulant properties, improves microcirculation;
- Cinnarizine – has a vasodilating effect (especially in relation to the vessels of the brain), does not affect blood pressure;
- Piracetam – improves microcirculation due to the impact on rheological blood characteristics.
Often, Vinpocetine, a drug that improves cerebral circulation and brain metabolism, is included in treatment regimens.
To replenish the supply of nutrients for patients with cervical osteochondrosis, balanced complexes of vitamins and minerals are prescribed. These are Centrum, Vitrum, Selmevit, Complivit, Multitabs, Supradin, Alphabet. But drugs with vitamins of group B are especially in demand:
Due to the compression of the displaced spinal roots, not only acute pain occurs, but the transmission of nerve impulses to the central and peripheral nervous systems is often frustrated. The use of B vitamins, such as pyridoxine, thiamine, cyanocobalamin, riboflavin, and folic acid, makes it possible to restore innervation and accelerate the processes of metabolism and regeneration.
Treatment of cervical osteochondrosis begins with intramuscular or intraarticular administration of chondroprotectors. Mucosat, Chondrogard, Chondroitin, Don, Alflutop, Rumalon are available in the form of solutions. A therapeutic course usually consists of 20 injections. Then, to restore cartilage and soft tissues, chondroprotectors in tablets are used:
The duration of treatment with chondroprotectors is from 3 months to several years. The active ingredients of the drugs accumulate in the area of damaged discs and vertebrae, therefore, after about 2 weeks, their pronounced analgesic and anti-inflammatory effect is manifested.
The main criteria for choosing a dosage form are the severity of symptoms, the presence of a history of chronic pathologies of the liver, kidneys, gastrointestinal tract, the patient’s age and general health. In the treatment of cervical osteochondrosis, powdered preparations are used to prepare solutions, tablets, injections, ointments, rectal suppositories.
This is the most convenient dosage form of drugs for use. The tablets are easy to dose. For this, manufacturers produce drugs with different amounts of active substances, and also supply them with risks (recesses on the surface) for quick division. For severe pain, patients are prescribed tablets with a modified release of the active ingredients. This form of drugs provides a long-lasting analgesic and anti-inflammatory effect.
Despite the fact that many tablets are coated with enteric coatings, there is a possibility of damage to the gastric mucosa. This is especially true for NSAIDs, which provoke increased production of caustic gastric juice.
To eliminate acute pain, inflammation, muscle spasms, drugs for intramuscular administration are used. Their therapeutic effect appears after a few minutes and lasts for 5-8 hours. Intravenous drugs, including drip, can be administered to improve blood supply to the brain, B vitamins. Injectable solutions of glucocorticosteroids and anesthetics are used for drug blockages.
Preparations in this form act indiscriminately, unless they are directly injected into the region of intervertebral discs affected by osteochondrosis. This leads to a high probability of developing systemic adverse reactions.
Eliminate uncomfortable sensations of moderate or weak severity that occur after excessive physical exertion or hypothermia, you can local application of ointments or gels. In the treatment of cervical osteochondrosis, external agents with NSAIDs, chondroprotectors, and ingredients with a warming effect are used.
Ointments and gels are also prescribed in the subacute period in combination with systemic drugs. This allows you to reduce the dose of tablets and injection solutions, thereby reducing the pharmacological burden on the body.
Are there any contraindications
Almost all drugs for the treatment of cervical osteochondrosis have wide lists of contraindications. These are severe pathologies of the liver and kidneys, the gastrointestinal tract, endocrine diseases, and hematopoiesis. Most medicines are forbidden to use in childhood, during pregnancy and breastfeeding.
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