Sciatica and its treatment
If a person develops lumbosacral radiculitis, treatment of the disease should begin as early as possible - adherence to this rule helps prevent the development of severe pain syndrome, spasm of the muscles of the back and waist of the lower limb, impairment of the function of the pelvic organs.
Timeliness of treatment is important because the spinal column is closely connected with the work of almost all organs and systems of the human body, because the segments of the spinal cord yield pairs of spinal nerves that provide innervation of organs located in the abdominal cavity and small pelvis.
In the case where the doctor, based on the patient's complaints and the results of the examination, puts this diagnosis, it is important not only the appointment of symptomatic treatment, which is aimed at eliminating the symptoms of the disease, but also the choice of the examination program conducted simultaneously. If the disease that caused the symptoms of lumbosacral radiculitis is not detected, and its treatment is prescribed, there is a high probability of relapse of the radicular syndrome in the patient.
Causes of the syndrome
It is very important not only to prescribe the treatment of sciatica, but also to identify the cause of its appearance
The cause of development of the radicular syndrome is the pathological processes occurring in the spinal column. Most often, the symptoms of lumbosacral radiculitis occur in patients suffering from diseases of the spine - they include:
- traumatic injuries of vertebral bodies, intervertebral discs, ligaments and muscles surrounding the spine;
- degenerative-dystrophic processes in the discs connecting vertebrae - osteochondrosis, herniated intervertebral discs in the lumbar region;
- malformations of the musculoskeletal system, which are accompanied by a change in muscle tone;
- disorders of posture - scoliosis, and the treatment of lumbosacral radiculitis in this case may be required for patients of relatively young age, and persistent pain syndrome becomes one of the indications for the surgical treatment of scoliosis.
Immediately the cause of an attack of radiculitis can be an unsuccessful movement, a prolonged stay of the body in a motionless, physiologically unfavorable position, a sharp rise in gravity - almost any condition in which there is a sharp stretching of the muscles in the lumbar spine or local impairment of blood circulation in the structures of the spinal column or surrounding tissues.
Many patients who for a long time suffer from sciatica often do not pay attention to the advice of a neurologist who recommends abandoning addictions. Nevertheless, conducted studies have proved that smoking, alcohol abuse, consumption of large amounts of foods rich in caffeine, the abuse of diets worsens the condition of the blood supply to the spine and burdens the course of sciatica.
How to treat this disease correctly?
Often patients ask their doctor how to treat lumbosacral sciatica correctly and whether it is necessary to prescribe a complex therapy for this disease, or it can be limited to medicamental treatment or sets of physical exercises, manual therapy, massage or physiotherapy. A long-term study of this disease has proved that only complex treatment of this disease will be effective, in which all these methods will be used.
Belt for prophylaxis and treatment of sciatica
If there is an exacerbation of lumbar radiculitis, it is impossible to cure the patient without the prescription of drug therapy, and the combined use of systemic and local treatment, which should be examined in order to clarify the root cause of radicular syndrome development, is almost never possible.
The heavier the exacerbation and the greater the changes in the structures of the spinal column, the more medications and larger doses may be required by .That is why it is important to start treatment with the first symptoms of lumbosacral radiculitis - the appearance of pain in the lumbar spine, difficulty in movement or the emergence of a forced position of the trunk, development of paresthesia or muscle weakness, impaired function of pelvic organs.
Drug therapy involves the use of drugs for systemic therapy and topical treatment - in this case it is possible to reduce the total dose of the drug substance and prevent the development of numerous side effects. Drugs for systemic therapy are prescribed orally or parenterally( in the form of subcutaneous, intramuscular injections or adhesion).With local treatment of radiculitis drugs are applied directly to the innervation zone of the inflamed nerve root - in this capacity, substances of irritant effect can be used.
Systemic treatment of
These drugs allow you to quickly stop pain and muscle spasm, but remember that such treatment is only the elimination of symptoms, and it can not be a solution to the problem. After improving the patient's condition, it is important to prescribe active treatment of the underlying disease, which triggered the development of radicular syndrome. If this rule is fulfilled, the patient will be able to forget about the existence of problems with the spine for many years. The complex of medicines for systemic treatment of radiculitis usually includes:
- muscle relaxants, which contribute to the rapid arrest of spasm of skeletal muscles - their appointment helps to eliminate the compression of nerve fibers, but these substances have quite a lot of side effects when applied;
- non-steroidal anti-inflammatory drugs that provide analgesic, anti-inflammatory and anti-edematous action - they help to quickly eliminate pain( the main symptom of radiculitis).Despite the fact that most of these medicines can be purchased in the pharmacy network even without the appointment of a doctor, it is worth remembering the possibility of side effects from the digestive tract, hemopoiesis, urinary system, hemostasis system;
- narcotic analgesics are currently not used for the treatment of lumbosacral radiculitis - despite the rapid pain relief, these addictive drugs quickly become addictive;
- antidepressants, hypnotics and sedatives can be prescribed only as part of a comprehensive treatment - their use improves the general condition and well-being of the patient.
Injections prescribed for the treatment of radiculitis
- non-steroidal anti-inflammatory drugs can be prescribed for rapid relief of an exacerbation of sciatica in the form of injections;
- vitamin complexes, normalizing the metabolism in the inflamed nerve fiber;
- biologically active substances, restoring the processes of blood circulation and tissue metabolism in the inflammation zone;
- adhesion - the introduction of a complex solution, which includes corticosteroid hormones, preparations for local anesthesia, several B vitamins in the epidural space of the spine.
More similar about nyxes with radiculitis read in this article.
To eliminate the symptoms of inflammation, the appointment of bed rest is indicated, and the patient's bed should be as rigid as possible - in this case, optimal conditions are created for unloading the lumbar spine. At the same time, the use of physiotherapeutic treatment is shown:
- Khivamat( relieves pain in 2 sessions)
- Laser therapy MLS
- Ozokerite application
- Electrophoresis( but only by Ionoson device)
The prescribed procedures help to reduce pain, eliminate muscular spasms, and reduce hernia size.
Often patients ask a question - when can exercises be prescribed for lumbosacral radiculitis and whether it is possible to stop manifestations of the disease with the help of additional physical activity. In the presence of signs of lumbar radiculitis, excessive physical stress can lead to deterioration of the patient's condition - the patient has a spasm of overstretched muscle fibers, and the intensity of pain and muscle spasm will only aggravate the symptoms of the disease.
Complexes LFK should be selected for each patient individually, and appointed only when the condition improves - this treatment helps to restore the state of the muscular skeleton of the spine and normalize muscle tone.
Medicamentous treatment of lumbar radiculitis effectively!
Radiculitis is a combination of symptoms that characterize the damage to intervertebral discs in the lumbosacral spine. The manifestation of this disease is severe back pain, which almost immobilizes the patient suffering from radiculitis. If the diagnosis is lumbositis, treatment with medicines is the most effective method. In this disease, medicines of three types can be prescribed: ointments, tablets and injections. Consider treatment with ointments and tablets in more detail. A separate article is devoted to treatment with injections.
The most effective tablets with radiculitisWith lumbar radiculitis, medication treatment consists mainly in the administration of special, prescribed by the attending physician, tablets. Consider the medication in more detail.
As for this disease very strong pains are characteristic, first of all medicines are called to block a painful syndrome. To anesthetics, which are used for radiculitis, include, for example, tablets "Nyz".However, it should be remembered that the drugs taken orally begin to work after a while after they are taken.
With a problem such as lumbosacral sciatica, medication may include muscle relaxants( also called narcotic analgesics).This group of drugs relaxes skeletal muscles, improves blood circulation and reduces pressure on nerve endings due to substances of central action. However, the drugs in this group have many side effects, so they are appointed with caution. With such therapy, it is necessary to follow all prescriptions of the doctor and constant monitoring of the patient's condition.
What are the features of treatment of radiculitis NSAIDs?Treatment of radiculitis with medicines is impossible without nonsteroidal anti-inflammatory drugs. This is one of the most extensive groups of drugs used in anti-radiculite therapy, so most of these drugs in addition to anti-inflammatory, has analgesic and anti-edema. Most non-steroidal anti-inflammatory drugs are sold in a pharmacy without a prescription, but it's worth remembering that they should not be used uncontrolled, as they can cause pathologies of organs related to the digestive tract, hematopoietic system, and also disrupt blood coagulability. Therefore, long-term courses of treatment with such drugs can do more harm than to bring benefits. However, a short-term treatment( less than two months) will help relieve pain, since the active substances of these drugs directly in the inflammatory focus suppress the formation of mediators and block painful impulses.
How to treat sciatica medically if long-term therapy is necessary? In such cases, the doctor prescribes softer acting selective anti-inflammatory drugs, as they are much less likely to cause side effects. In combination with vitamins of group B( they have a relaxing effect, reduce the swelling of nerve roots, help restore nervous tissue and conduct nerve impulses), the effect of such drugs is most effective.
Anti-inflammatory drugs used in radiculitis in the lumbar region include Ketoprofen, Diclofenac, Movalis and Nimesulide. The last two drugs can be used for ulcers. They are taken after a meal( in an hour) 2 or 3 times daily for one tablet.
When are hormones prescribed for radiculitis?If lumbar sciatica is aggravated, then medication may include the use of steroids, which are substitutes for cortisol. The action of steroid drugs helps relieve pain, inflammation, as well as internal swelling. This group includes such drugs as Hydrocortisone, Dexamethasone, Diprospan, Kenalog, Methylpred, Prednisolone and many others. These drugs are used solely for the purpose of the attending physician, since they can cause side effects, including: osteoporosis, weight gain, gastric diseases and facial edema.
Medication for lumbar sciatica may include the use of antidepressants. These medications are prescribed so that the patient relaxes more easily, calms down and quietly falls asleep.
The most effective ointments with radiculitisTreatment of radiculitis should be complex. Many of the external agents prescribed for this disease are aimed at reducing pain, because it can be so strong that it even hurts to touch the affected area. In anti-radiculitis ointments and triturals add snake or bee venom, capsicum, camphoric or formic alcohol and other warming components. When diagnosed, lumbar radiculitis treatment with ointments may include the following drugs:
1) Ketonal cream, which contains ketoprofen, which reduces the activity of pain receptors and has an anti-inflammatory effect. It is available in the form of a gel, so it is quickly absorbed and does not spoil clothes.
3) "Alor"( it can not be applied if there is skin damage).
Than to treat lumbar radiculitis?
Spinal cord injuries are called radiculitis. The disease is very common: they suffer every 8 inhabitants of the globe. Today, with complaints of back pain, not only old people turn to doctors, but also young people, many of whom are athletes and those who spend most of their time working on the computer.
The most common lumbar and lumbosacral radiculitis, caused by degenerative-dystrophic changes in the spine, its joints, ligaments, discs, nerves and muscles.
Acute lower back pain occurs suddenly after some kind of physical exertion or abrupt movement. If you take a painkiller pill, then soreness will subside for a while. Since radiculitis is characterized by a wave-like course with periods of exacerbations and remissions, rest assured that the next time it will be more difficult to cope with the pain. And remember, with each attack, both inflammation and swelling in the lumbar tissues increase, which means that pressure on the root of the spinal nerve increases.
Treatment of lumbar sciatica should be comprehensive. To tighten with the reference to the doctor for the help it is impossible - the disease in itself will not pass or take place, and only will worsen in due course.
The medicamentous treatment of lumbar radiculitis includes the use of painkillers, anti-inflammatory, anti-edema, resorption drugs, muscle relaxants, vitamins, etc. The palette of the used products, as you can see, is wide, so it is quite difficult to choose the drugs necessary in your case. Leave the decision of this question to the specialist, and from you only strict fulfillment of his appointments and recommendations will be required.
In case of exacerbation of sciatica in the lumbar region, the pain is so strong that not every tablet will take it off once. This requires strong analgesics, sometimes in the form of injections. Of the pharmaceuticals are usually recommended to take Analgin, Baralgin, Ketorol, Butadion, Pyraminal, Tramal, Pyramein. Limit one painkillers can not, because these drugs for symptomatic therapy, i.e., in order to only eliminate pain.
Injections with lumbar radiculitis into the lumbar region or directly into the vertebral joint are called blockades. This procedure( performed by a doctor!) Is the manipulation of "rapid response" in case of an acute attack of the disease. As an active ingredient, Novocain, Lidocaine, Trimecaine are used. The pain is removed almost instantly, but not for a long time. Therefore, blockades are carried out repeatedly. The frequency and frequency of the procedure is determined by the attending physician and the patient's condition.
Performing blockade with lumbar radiculitis
Universal medications for getting rid of inflammation, swelling and pain are non-steroidal anti-inflammatory drugs( NSAIDs).They are used in the form of tablets, injections and ointments. Diclofenac, Orthofen, Ibuprofen, Naproxen, Voltaren, Nimesulide, etc. - used these drugs and knows what they are capable of, probably each of us.
The high effectiveness of NSAIDs allows them to be used during an attack of radiculitis and during the period of remission of the disease. Dosage and duration of the course are selected by the doctor. He also determines the method of administration of the drug depending on the patient's condition and severity of the disease: in injections( intramuscularly), orally( through the mouth) or externally.
But it must be remembered that NSAIDs have undesirable side effects on the organs of the gastrointestinal tract: these drugs are recommended to use short courses and on a "full stomach".
Decongestants and absorbents
The most common forms of drugs in this category are ointments, creams and gels. In one tube can contain substances with analgesic, anti-inflammatory, anti-edematous and resorptive action simultaneously.
Ointments with a heating action
Capsicum, Apizarthron, Virapin, Viprosal, Vipratox, Finalgon, Mellivenon, etc. In most cases, the active ingredient of these ointments is snake venom.
The area treated with ointment increases blood and lymph circulation, which improves nutrition of inflamed tissues, accelerates metabolism, relaxes muscles and activates protective forces of the body. The result is a reduction in soreness and inflammation at the site of the pathology. External skin in the treatment site reacts with redness and burning sensation.
In case of first use, any ointment, cream or gel should be applied to a limited area of the skin in small amounts. If the body does not react with allergy, then you can use the remedy to treat the sciatica of the lumbar spine.
Anesthetic creams and gels
Fastum-gel, Bystrum-gel, Febrofid, Ketonal, Finalgel, Naiz-gel, Dolgit, Nurofen, etc.
The effect from their use is similar to the heating means. The essential difference is that there are no burning sensations and redness of the skin, or they are insignificant. All external means of this category operate at the expense of the analgesics contained in them. But in the composition of some ointments there is menthol, which gives a cooling effect, which brings the patient considerable relief.
Anesthetic external drugs eliminate the lack of circulation of tissues and muscle spasms, accelerate the recovery processes in the lower back.
One of the popular remedies for lumbar radiculitis
Voltaren, Diclofenac, Mikloks, Najz, Ibuprofen, Diklak, etc.
Manufactured on the basis of NSAIDs, used to anesthetize, eliminate edema and inflammation in diseased muscles, restore functional mobilityin the joints of the spine.
In the complex treatment of lumbar sciatica( together with internal and injections), anti-inflammatory gels have the most pronounced positive effect.
Medicines to reduce muscle tone. These include Midokalm, Sirdalud and Baksolan. Tablets are prescribed by the attending physician in accordance with the severity of the disease. After the course of treatment with muscle relaxants, the patient feels relief of his condition, reduction of pain intensity, improvement of mobility of the waist.
DiureticsWe also recommend reading: Medical treatment of radiculitis
To remove excess fluid from the patient's body and to reduce swelling in inflamed muscles, Furosemide or Lasix is used, both inward in tablets and in intramuscular injections.
For the treatment of radiculitis, the doctor may advise to take chondroxit or chondroitin. These drugs increase the metabolism in the intervertebral discs and prevent further progression of sciatica.
Our loins take on too much strain, so it needs support, especially in times of illness. For this purpose, drugs with a high content of B vitamins are successfully used in the therapy of lumbar sciatica.
Polyvitaminic complexes can be used by the doctor( Neuromultivitis, Neurovitan, Multitabs-B, B-complex, Bimix-C, etc.) and in injections(Milgamma, vitamins B1 and B6, B12).
Special means to improve the trophism( nutrition) of tissues - antihypoxants and biogenic stimulants - the doctor will appoint an additional, if necessary.
Principles of treatment at home
It will not be superfluous if the traditional means of treatment are applied parallel to the main course of treatment prescribed by a doctor.
Recipes of traditional medicine you need to apply proven
From the whole "assortment" of folk recipes you can choose yourself the most effective and tested( follow the reviews used) or follow the recommendations of the doctor in charge.
Advice: consult a doctor beforehand about using a prescription of traditional medicine to avoid possible side effects and the development of allergic reactions.
The action of almost all folk methods of warming up and local irritating - compresses, rubbers, lotions, ointments, applications, etc. improve blood circulation, increase the excretion of metabolic products from tissues and stimulate the work of local immunity. These funds perfectly relieve pain and swelling in the muscle tissues of the lumbar, provided that the patient has a low back in warmth and peace.
It is necessary to change your daily diet - to increase the amount of fresh fruits and vegetables consumed, to restrict reception or to refuse from fatty, acute, salty, sweet, floury.
Those wishing to have a healthy loin are advised to perform daily strengthening sets of physical exercises for the back.
The success of the treatment of lumbar radiculitis depends, first of all, on the patient himself, and only then on the qualification of the attending physician. Therefore, we wish you patience and perseverance in the fight against the disease. And a speedy recovery! What is myofascial pain in the neck?
MoyaSpina.ruThe answer is here.
Drugs for the treatment of radiculitis
To date, the following groups of agents are used:
Non-steroidal anti-inflammatory drugs
Such drugs are the drugs of prime choice in the treatment of radiculitis with medicines.
The mechanism of their action is to suppress the synthesis of the enzyme cyclooxygenase. It plays a major role in the occurrence of inflammation and pain reaction. Thanks to these drugs, there is a minimization of manifestations of all phases of inflammation.
The analgesic effect of these medicines is visible already in the first week of intake, and sometimes after the first application.
Not all NSAIDs are suitable for radiculitis.
Suitable preparations include the following:
- Aspirin( acetylsalicylic acid, ascaff, aspecard, anopyrine, upsarin) has a strong antipyretic effect, analgesic and anti-inflammatory effect. Apply aspirin should be strictly after eating from 200 mg to 1 g per day. The entire dose should be divided into 3-4 doses. This drug should be taken "under the cover" of anti- cides( magnesium hydroxide, etc.).
- Diclofenac( almiral, voltaren, diclac, diclobert, orthophene, rapten, rumakar, etifenac) .This drug is characterized by a strong anti-inflammatory and analgesic effect. Its antipyretic properties are moderate. In tableted form should take 50-100 mg per day. If the pain syndrome is expressed, the dose can reach 125 mg. With iv administration, the dose should be 75 mg with a multiplicity of up to 4 times per day. When administered intramuscularly, the dose is 75 mg once per day.
- Aceclofenac( aerated) is released in tablet form of 100 mg. Take them after meals 1-2 times in d. The frequency of reception depends on the severity of pain.
- Ibuprofen( advil, bonifen, burana, nurofen, profile, solpaflex) well anesthetizes and relieves inflammation. Take inside up to 2.4 grams per day.
- Thioprofenic acid( surgam) is produced in tablets of 300 mg and candles of 150-300 mg. Take up to 600 mg per day. Candles for the night up to 300 mg.
- Indomethacin( methindole, indomin) is a drug in tablets or capsules of 25, 50 and 75 mg. Take them after meals. Start with 25 mg. In the absence or small effect, the dose is increased.
- Tolmetin( tolektin) is produced in capsules of 200 and 400 mg. Take 400 mg daily multiplicity of 3 times.
- Sulindac( clinoril) is a drug with a minimum of side effects. It is released in tab.on 200 mg. Assign one table.twice a day.
- Niflumic acid( donalyl, nifluril) is released in capsules of 250 mg each. Do not take more than 1 g per day.
- Tenoxicam( oxytene, tilkoil) is released as tab.20 mg, powder for injection 20 mg, suppository 20 mg. Apply once a day. The anti-inflammatory effect will be noticeable after a week of intake.
- Nimesulide( aponyl, nise, nimesil, nimika, prolid, floid) with tableted form is consumed 100 mg after 2 times 2 times.
- Etorikoksib( arkoksia) is released in tablets with a dosage of 30, 60, 90 and 120 mg. You need to start with 30 mg once a day. The maximum course of admission is 8 days.
Used to reduce spasm of the musculature of the back.
Spasms occur in response to a pain stimulus and vice versa, with a vicious circle being formed.
In order to break it, you need to reduce the hypertonic muscle. Reducing muscle tone, there is an increase in mobility of the spinal column, thereby improving blood flow to the tissues.
Some muscle relaxants that help with radiculitis:
- Baclofen( liorasil) is released in tablets.10 and 25 mg, and as a solution for intrathecal injection( into the spinal space).It should be used, starting with 5 mg three times a day, with a gradual increase in the dose every 4 days for 5 mg to 75 mg per day. For intrathecal administration, a special pump is used that is implanted into the skin.
- Tizanidine( sirdalud) is released as tab.for 2, 4 and 6 mg. The mechanism of its action is due to the suppression of excitatory amino acids in the synapses. This drug should be taken 2-4 mg three times a day. If the pain does not subside, then you can drink 2-4 mg more at night.
This group includes compounds that have a predominantly anesthetic effect, but practically do not possess an anti-inflammatory effect.
These drugs are shown with pain of low intensity.
Most of them are applicable for the treatment of acute pain, and chronic do not lend themselves to their action.
- Paracetamol( panadol, farrow, paracet) is taken in such a way that the daily dose does not exceed 1 g. At the same time the frequency of reception can reach 4.
- Metamizole( analgin, baralgin) in tableted form is applied at 0.5-1 tab( 1 tab - 500 mg) 3 rd in. Injections are used intramuscularly or intravenously in a dosage of 2-5 ml of a 50% solution.
- Ketorolac( todarol, ketalgin, ketanov, dolac) should be used so that the daily dose is not more than 120 mg, and for patients with kidney dysfunction - 60 mg. In this case, the drug is produced as a tab.10 mg, 3% solution in 1 ml ampoules.
- Nefopam( oxadol) is released in the table.30 mg and in 1 ml ampoules containing a 2% solution. Tablets are taken 2 to 3 times a day for acute pain, and injections are given intramuscularly by 20 mg 3-4 times.
- Parecoxib( dinastat) is more suitable for the postoperative period.40 mg is given after the operation, then 20-40 mg every 12 hours.
Apply in the absence of the effect of the aforementioned agents.
They relieve the signs of an inflammatory reaction, thereby performing decompression.
Glucocorticoids are applicable:
- Prednisolone( honeycomb) in tablets form 5 mg and in solution for parenteral administration. It is advisable to use in a dosage of 10-20 mg per day. In the absence of the expected effect of therapy, you can gradually increase the dose. To cancel a preparation also it is necessary gradually.
- Methylprednisolone( medrol, solu-medrol, lemod) is released as tab.and injection suspensions. The effect against inflammation is predominant in that of prednisolone. A day is taken from 4 to 40 mg orally, intramuscularly 10 to 80 mg.
Vascular drugs and antihypoxants
Used to improve the trophism of inflamed tissues.
Inflow of blood will better cope with inflammation.
- Eufillin is used as a drug that improves blood circulation in the area of the damaged root. Apply injections or tablets.
- Nicotinic acid - contributes to the improvement of the oxidation-reduction process. Begin treatment with 1.5 grams per day for three doses.
- Trental( pentoxifylline) due to improved blood rheology, promotes tissue trophism in the area of inflammation.
- Dipyridamole( curantil) take 75 mg before meals 3-4 r a day.
When radiculitis is prescribed in case of infection of a necrotic disc, a long infectious process.
Assign antibiotics of wide use:
- Benzylpenicillin acts efficiently on both gram-positive and gram-negative bacteria, in addition to bacteroides. Issued in the form of powder for injections in doses of 250, 500, 1000, 5000 thousand units. In a day, the dose can reach up to 12 million units.
- Cefotaxime is the representative of the third generation of cephalosporins. Applicable for the treatment of lesions of the nerve root infection process. Released in 0.5 and 1 and 2 g. Bottles. Enter three times per day for 1-2 g.
- Ceftriaxone is also a third generation cephalosporin. In bottles with powder for injection in doses of 0.5 and 1 g is produced by many manufacturers. It is administered once a day for 1-2 g.
- Chloramphenicol is released in a tablet of 250 and 500 mg and in vials with powder for injections of 0.5 and 1 g. When consumed no more than 1 g per day.
Assigned if radiculitis is caused by compression of the rootlet by a degenerate disc.
They are prescribed courses for 4 months with an interval of 2 months.
Chondroprotectors contain substances that are found in the intervertebral disc tissue.
Best for radiculitis apply:
- Chondroxide contains chondroitin sulfate with a dose of 250 mg.
- Dona - includes glucosamine 1.5 g. In addition to chondroprotective action, dona has some anti-inflammatory and analgesic effect.
- Teraflex combines glucosamine 500 mg and chondroitin sulfate 400 mg.
- Chondroitide contains chondroitin sulfate in a dose of 250 mg.
- Structum consists of chondroitin sulfate in a dose of 250 and 500 mg.
Contribute to restoring the structure of the compressed root:
- Milgamma consists of pyridoxine( vit B6), thiamine( vit B1), cyanocobalamin( vit B12).Contains ultra-high doses of vitamins. The injections stimulate neuronal metabolism.
- ATP is administered to stimulate repair of the nervous tissue within 25-30 days of 1 ml of a 2% solution.
- Introduction of vitamin B12 for 200 mg, every other day it is necessary to inject vitamin B1 with 1 ml of a 6% solution.
- Neurovitan is a combination of B vitamins: thiamine, octothiamine, riboflavin, pyridoxine, cyanocobalamin.
Assign with acute radiculitis.
The mechanism of their therapeutic effect is to eliminate the swelling of inflamed tissues that adhere to the root and further squeeze it.
- Lasix( furosemide) should be used for the beginning in a dose of 20-40 mg. If necessary, increase the dose to 80 mg. It should always be remembered that the use of furosemide is associated with the loss of potassium and magnesium.
- Hydrochlorothiazide( dichlorothiazide, hypothiazide) is not as strong a diuretic as furosemide, but retains calcium ions in the blood. The reception begins with 12.5-25 mg.
- Spironolactone retains potassium ions in the blood. Begin to apply with 25 mg per day.
A blockade is used to temporarily remove pain from impulse from a foci of an inflamed root or nerve.
This procedure involves the administration of an anesthetic( novocaine, lidocaine) to the zone with an intense pain syndrome.
These blockades are also called epidural, since for the introduction of the substance it is necessary to enter the epidural space.
Anesthetic penetrates into nerve fibers and "turns off" this sensitive nerve for a while.
The annual number of blockages can be as high as 4.
- A 0.5-1% solution of novocaine( 50 ml) is mixed with hydrocortisone( 50-75 mg).
- Treatment of the puncture site with an antiseptic.
- With a small needle for injection, we anesthetize the injection site to form a "lemon crust".
- Needle for epidural administration and syringe with air bubble for indication of getting into the epidural space, moving between the spinous processes.
- Introduction of the drug.
Are there any side effects of voltaren injections? You will find the answer here.
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Not all drugs used are used for treatment.
The doctor is trying to choose the drugs that will be most effective in a particular situation and for a specific patient.
In most cases prescribe:
Radiculitis lumbar: medicamental treatment
- 2 Rules for treatment of radiculitis medically
Radiculitis is a disease that arises from the inflammation of the nerve roots of the spinal cord. Treatment of his medication is the surest way to stop pain. Just need to find out exactly what is the reason for its appearance. This disease occurs for a variety of reasons and often occurs chronically with recurrent relapses.A new look at treatmentAs the former "hard worker" was able to get rid of arthritis and osteochondrosis for a month. .. More. ..
Treatment of lumbar radiculitis should begin as early as possible, be comprehensive and individual. The treatment is directed, first of all on the elimination of the root cause, which caused the disease. In addition to massage, medical gymnastics, manual therapy, a special place in the treatment of lumbar radiculitis is medication. It includes: the use of anti-inflammatory drugs prescribed by a doctor, taking analgesics, vitamins, drugs that improve microcirculation and blood circulation, anti-inflammatory ointments.
If symptoms of lumbar sciatica are found, then a qualified doctor will determine, after a complete diagnostic examination( X-ray and MRI), how much the pathological changes in the spine are expressed and prescribe complex therapy, including medical treatment of radiculitis.
The basic methods of treatment of sciatica with drugs
Usually, in the first stage, medications are prescribed that help to relieve pain.
Anti-inflammatory medications are used both during the period of exacerbation and during the period of remission of the disease. Such treatment in a few days leads to a reduction in pain symptoms in the lower back.
Non-steroidal anti-inflammatory drugs
The most effective means. They are able to remove swelling and inflammation in the diseased segment of the spine. However, they negatively affect the work of the gastrointestinal tract, so take them for a limited time. Therefore, before prescribing medication, the doctor compares the benefits that medications and possible negative consequences from them will bring to the body. After that, decides what medicines to prescribe to a person depending on his general condition and the presence of concomitant diseases.
If radiculitis is sharply aggravated, the patient should urgently take a couple of tablets of anesthetic non-steroid agent. These can be tablets of orthophene, diclofenac or ibuprofen. In the future, the doctor can prescribe treatment with tinctures and ointments. Nonsteroid preparations eliminate edema and eliminate the pinching of the nerve roots in the intervertebral openings.
Ointments, gels, creams
NSAIDs are often used in the form of ointments and gels with lumbar radiculitis. They are manufactured with indomethacin, orthophene, ibuprofen. Effective ointments such as Finalgon and Apizarthron. Absorbed, they provide a rush of blood to the focus of inflammation, which helps improve blood circulation. Ointments with radiculitis are applied with the addition of an extract of hot red pepper, snake and bee venom. The complex application of ointments, oral medications and nyxes will have the greatest effect and will help to overcome such an ailment as radiculitis. Among the ointments, the Finalgon, Capsicum, Viprosal, Nyz, Diclofenac, Indomethacin have proved themselves very well.
If the pain is already intolerable, then injections are prescribed, which quickly remove pain and relieve muscle spasm. However, injections do not treat radiculitis, but only alleviate the condition of the patient. As soon as the pain subsides, it is necessary to begin treatment. With the same symptoms, each person has cardinally different treatment. Some patients are prescribed a course of chondroprotectors, while others are prescribed B vitamins. Local anesthetics, such as Novocain, Lidocaine and Trimecaine, injections into the cervical region are one of the most effective means for eliminating pain in lumbar radiculitis. The effect is good but short-lived. Therefore, the disease will re-assert itself after a while. However, only a specialist should administer the medicine and he must ensure that the drug does not get into the vascular channel, otherwise a sharp drop in blood pressure is possible.
The injections with radiculitis give a positive effect much faster than tablets. What medications you need to prick is determined by the doctor depending on the condition of the person. Basically, to relieve the pain syndrome, injections of the following drugs are used: Voltaren, which is injected directly into the muscle and has an anti-inflammatory and analgesic effect, Ketorol is an anesthetic for the removal of pronounced pain syndromes. It can not be used for bronchial asthma, for inflammatory processes in the intestines and for blood clotting disorders. Milgamma is a drug that combines lidocaine and vitamins. This drug anesthetizes and improves nutrition of affected areas. This contributes to the abatement of the pathological process. Also a good technique for eliminating pain is ozone injections with steroid agents. They are carried out once directly to the affected area of the back.
If the disease requires a rapid response, then Novocain blockades are applied with simultaneous administration of Relanium, Hydrocortisone, Euphyllinum and Dimedrol intravenously. Injections with lumbar radiculitis are introduced either into the epidural space, or into the bone tissue, or into the joint cavity, or into the periarticular tissues, to the sites of infringement of the nerve trunks and plexuses, to the muscle sites of local injuries. Novocaine is sometimes substituted for Trimecaine, Lidocaine, hydrocortisone for other glucocorticosteroids such as prednisolone, diprospan, Kenalog 40.
Also with radiculitis, effective agents such as muscle relaxants are effective. They relax spasmodic muscles, reduce pain and increase the amount of movement. To miorelaxants include tablets Midokalm, Sirdalud, Baksolan. They can let the muscles relax. They are purchased only with the prescription of a doctor, but they have quite a few side effects, so they are not often prescribed to patients. Although they are very effective at radiculitis, they are prescribed only once, so that a person can relax and calm down.
These are substances that do not directly affect the radiculitis, but help to eliminate at least some of its cause - osteochondrosis. They improve metabolic processes in intervertebral discs and prevent the further development of radiculitis. Only such chondroprotectors as Chondroxit and Chondroitin should be drunk in long courses.
Rules for treating radiculitis medically
To enhance the effect of drugs, physiotherapy is necessary. Only 15 minutes of electrophoresis will dramatically increase the effect of drugs. It is recommended to rub an ants or camphor alcohol into a sore spot, a tincture of hot red pepper, novocaine, ointment based on a venom of a viper, a gurgi or a cobra, with the poison of bees. Also, special therapeutic patches are good.
In the lumbar spine of the spine, medication is usually combined, and, of course, supplemented by gymnastics, physiotherapy, hirudotherapy. So along with non-steroidal anti-inflammatory drugs, a doctor can prescribe pain medications such as analgin, indomethacin, pyraminal, injections of steroids around the painful nerve, biological biostimulators such as plasmin, aloe extract.
Medical treatment of radiculitis should be carried out cautiously, since drugs have many side effects, although they significantly improve the patient's condition. Only the right combination of medications, their dosages and the duration of the courses contributes to the rapid cure of sciatica. If the drug treatment of sciatica does not have the desired effect, then there is a need for surgical treatment. If there is a symptom of the horse's tail, then the operation can not be postponed.
Means for relaxation of muscle spasm
Very important in the treatment of radiculitis is allocated to muscle relaxants. These include substances that promote muscle relaxation. Sometimes such drugs are called narcotic analgesics. They can be purchased only by prescription. The known muscle relaxants include metokarbamol and cyclobenzaprine .Meanwhile, experts around the world are trying to avoid prescribing these drugs because of serious side effects. Appointed and antidepressants, helping to relax, calm down, fall asleep.
What are the injections of
? The medicines for the treatment of lumbar radiculitis include injecting a steroid drug( cortisone) into the painful area surrounding the sciatic nerve. These injections speed up the treatment process.
First, the area where the pain is concentrated by tomography( computer or magnetic resonance) is established. A fluoroscope, the doctor accurately determines the area of injection and injects a steroid connected to an anesthetic local remedy or saline solution.
Some experts consider such injections unsafe. Therefore, a method with point injections is more often used. Such injections include:
Injections are placed in the muscles and ligaments located next to the spine. According to the research, this form of drug therapy promotes the growth of connective tissue and activates the circulatory process. As a result, recovery is much faster.
Local forms of medicamentous treatment of radiculitis
Anesthetic cream Ketonal
Lumbar radiculitis is accompanied by exacerbation of inflammatory processes. This means the isolation in the tissues of special substances - prostaglandins. Because of them, the pain receptors increase sensitivity, in which even a simple touch is very painful. Because of the swelling in the focus of inflammation, pain develops with small movements and even at rest.
Ketonal Cream reduces pain through the penetration of ketoprofen molecules( non-steroidal anti-inflammatory substances) through the skin and blocking prostaglandins. As a result, the activity of pain receptors and the inflammatory response as a whole decrease. Ketonal cream contains a high concentration of ketoprofen( 5%), which causes the maximum anti-inflammatory and analgesic effect in lumbar radiculitis.
Ketonal is also available as a gel. It absorbs very quickly and does not leave marks on clothes. In this form, this medication is convenient to use in the morning.
Anti-inflammatory ointments and topical products
High results with radiculitis give local application of such anti-inflammatory ointments as "Fastum-Gel", "Diclofen" and the like. They directly affect the affected areas, removing the edema and providing some analgesic effect. These ointments have no irritant effect. In this regard, they can be used by people prone to allergic reactions. To reduce inflammation and reduce pain, rubs into the pain zone:
Treatment of lumbar radiculitis at home with folk remedies and preparations
Pain syndrome( radiculitis) is conventionally divided into three groups:
- Lumbago ( in people - chamber).Characterized by acute pain in the lower part of the spine( lumbar).It usually occurs after physical exertion and hypothermia.
- Sciatica .His symptoms - the pain is localized in the buttock and runs across the entire leg.
- Lumbosciagia .It is a combination of the two previous options.
Since the lower parts of the spine bear the main burden( more than 140 kg in a sitting position for a person weighing 70 kg), diseases like osteochondrosis, spondyloarthrosis and other dystrophic processes reduce the mobility of the lumbar region. This leads to a disruption of metabolism and jamming of nerve endings.
Treatment of radiculitis
Lumbar and lumbosacral radiculitis should be treated in two stages - to remove pain symptoms( apply medications) and daily gymnastics.
Treatment of radiculitis and its further prevention is a long-term occupation, but necessary. Therefore, have patience. This will bear fruit in the future.
Radiculitis of the lumbosacral and luminal in the acute stage should be treated with medication. These can be:
- nyxes or stitches;
- tablets( Diclofenac, Nimesulide, Ketoprofen, Movalis);
- ointment( Viprosal, Finalgon);
All these drugs relieve inflammation and spasms and pursue the sole purpose - to eliminate pain symptomsTreatment with injections is carried out only according to the appointment of a neurologist. The procedures quickly eliminate pain, but have a side effect on the part of the gastrointestinal tract. Therefore, if you have similar problems, then be sure to tell the doctor about it.
Tablets Ketoprofen and Diclofenac are contraindicated in patients with peptic ulcer. They treat lumbar and lumbosacral radiculitis preferable to Nimesulid and Movalis( up to 3 times a day, one tablet at 1 hour after eating).Sometimes Pentalgin and Paracetamol are added. However, such treatment only leads to anesthesia and does not affect the causes.
You can treat acute sciatica at home using ointments( a sore spot then wrap it) and a plaster( put on for 12 hours).Carry out treatment is acceptable in the complex.All the above methods will after some time relieve the painful symptoms of sciatica, but cure it completely they are not able to. For this you need physical exercises( in moderate doses).
Therapeutic exercises help to restore mobility of the lumbar spine. And, when it becomes a familiar way of life for you, radiculitis( and lumbar and lumbosacral) will be only a painful memory. You can do both in groups of exercise therapy, and independently at home. However, exercise treatment begins only after the pain symptoms of sciatica significantly decrease( or completely pass).The complex is simple and accessible for everyone.
Back tension. You have to lie on your back and bend your legs. Then try to clasp your knees with your hands. Treatment of sciatica begin with 30 seconds - round back( as much as possible) and try to do ricks( see photo above).If you can not "swing" - do not despair, just lie back in this position.
To treat the lumbosacral and lumbar sciatica, we recommend the exercise "cat" .Get on all fours. Inhale - tilt the head and round the back, exhale - throw back the head and bend back( see photo).In this case, treatment occurs by increasing the mobility of the entire spine( including the lumbar spine).
Lie on the floor on your stomach. Try to raise your arms and legs at the same time, as shown in the photo. This exercise will allow you to heal the back - to strengthen the muscular corset.
Physical education should be done every day, at a slow pace. If any exercise causes pain - do not do it. Over time, everything will turn out. Treatment of sciatica takes a long time and the effect will be noticeable not immediately. The main thing for you is to be sure of a positive end result. And then radiculitis( lumbosacral and lumbar) will recede.
Sometimes with exacerbations of sciatica there is no way to consult a doctor. In this case, you can use folk remedies and treat seizures at home.
Infusion of wild garlic .The raw material is tightly filled with a three-liter can. Fill with alcohol( you can vodka).Month insist in a dark place, filter and store in the refrigerator. To treat sciatica( both lumbar and lumbosacral) follows by rubbing the tincture of the sore spot.
The effective remedy for sciatica - is the rosemary ointment .At home, it is prepared in this way: in a pan it is necessary to put 2 tablespoons of harvested raw materials and 5 tablespoons of vegetable oil. The prepared mixture is heated( do not boil!).And 10 hours insist. Then filter. The ointment is ready. After five days of use, the pain symptoms noticeably decrease.
You can also cure with sheep wool also with acute sciatica. Soak in a salty water piece of cloth, dry it. Fixing such a compress on a sick site, you are relieved.Using the above folk remedies, you will reduce the pain manifestations of sciatica. However, only gymnastics can complete the treatment completely.
Lumbosacral and lumbar radiculitis is treated successively. First, the pain syndrome is removed( medicamentally or folk remedies).Secondly, there is a restoration of mobility of the spinal column( therapeutic gymnastics).And no matter how you do not think that everything is hopeless - continue to engage in physical education. It will help you get rid of back pain.