Injuries from leg joint pain

Effective medications and folk recipes for joint pain

Joint pain is one of the complaints of any modern person. It is not always hidden behind her usual physical overwork. This can be a severe pathology of the musculoskeletal system, which dictates the need for mandatory clarification of the exact cause of the onset of pain. But, as practice shows, due to the constant shortage of time, mild symptoms remain for a long time without due attention. Therefore, information about which medication for joint pain can be used in a given situation is useful for those who, for various reasons, can not consult a specialist in a timely manner.

Types of

medications Among the anesthetics that are indicated for joint pain, drugs are given that are intended solely for symptomatic treatment and pathogenetic therapy. In the first case, the effect of the remedy is aimed only at arresting the pain syndrome, in the second, except for anesthesia, there is an effect on the mechanisms of the triggering and progression of the disease. Therefore, the fight against long-lasting painful pain in the joints should be differentiated and based on the cause of their occurrence.

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Depending on the mechanism of action on the pathological focus and the cause of articular pain, these drugs are distinguished:

  1. Analgesics are agents with predominantly or exclusively anesthetic effects: tempalgin, ketones, dexalgin, analgin, dynastat, larfix, ketoprofen, nalbuphine. Can be used in pain syndrome of any severity, regardless of the cause. Long-term use should be strictly controlled.
  2. Anti-inflammatory drugs of non-steroidal origin: nimesulide, diclofenac, indomethacin, meloxicam, rheumoxicam, movalis. They form the main group in the treatment of pain in the joints, because, in addition to the relief of pain, they partially or completely eliminate the cause of its appearance.
  3. Chondroprotectors: alflutope, dona, teraflex, arthron, structum, naltrex. Their analgesic effect is minimal both in strength and duration of action. They are designed to prevent repeated occurrence of pain in the joints, rather than to stop the pain syndrome.
  4. Anti-inflammatory preparations of glucocorticoid type: triamcinolone, hydrocortisone, methylprednisolone, dexamethasone, diprospan. Do not have direct analgesic effect. The analgesic effect is due to the suppression of inflammation in the joints, one of the main manifestations of which is pain. Assigned according to strict indications. Uncontrolled reception is absolutely unacceptable.
  5. Homeopathic remedies. This is a relatively new direction of therapy in orthopedics. In the arsenal so far there is only one effective drug - traumeel. Well tolerated, has a direct analgesic and anti-inflammatory effect.

It's important to remember! Self-administration of medications is permissible only in the case of the first time arisen or uncontrolled syndrome of joint pain. In all other cases, the drugs should be prescribed by a qualified specialist taking into account the pathological condition that caused the pain.

Methods of administration of funds for the treatment of joint pain

Proper anesthesia involves not only a competent approach to the choice of analgesic drugs, but also the selection of optimal methods for their administration into the body. Such an approach will not only ensure the fastest and longest possible disposal of a person from joint pain, but also minimizes the dose of necessary drugs. Among the methods of introducing the active active components of any drug with an analgesic type of action, one can distinguish such.

Oral or enteral administration of

Assumes internal ingestion of tablets and capsules. This method of administering drugs is suitable for arresting acute and chronic moderate pain syndrome. Can be used alone and in combination with other methods( injections, ointments, gels).In the form of oral dosage forms, absolutely all types of pain relievers are available for the treatment of joint pain.

Parenteral administration of

Assumes intramuscular or intravenous injection. This method of anesthesia is optimal for severe articular pains, since it provides a rapid and prolonged onset of the analgesic effect. Perfectly combined parenteral administration with the transition to the tablet administration of the same drugs or another drug with the same active substance. The need for this arises as the pain is relieved.

Rectal administration of

To date, there are drugs with analgesic effect in the form of rectal suppositories: dicloberl, indomethacin, efflergan. Anesthetic and anti-inflammatory effect with this form of administration is insignificant. By combining tableted and injectable forms with rectal suppositories, a longer analgesic effect can be achieved by slow release and maintenance of the required concentration of the active substance.

Percutaneous introduction of

It presupposes the application to the skin of special medicinal patches impregnated with analgesic and anti-inflammatory drugs( dicloberl, nanoplast, olfen), as well as papillary patch and various patches of non-traditional oriental medicine. Provide a sufficiently effective and prolonged anesthesia with moderate pain in the joints, since the active substance is evenly released into the bloodstream through the surface of the skin during the day. In addition to patches, an anesthetic cream, ointment or gel can be used: diprifilif, indomethacin, diclac, remisid, voltaren.

Intra-articular administration of

Allows the active therapeutic components of specific drugs to be administered for this route of administration( diprospan, hydrocortisone, alflutope, naltrex, syngial) to diseased joints. Such treatment provides not only a good analgesic, but also a therapeutic effect with local soreness in one or two large joints. The disadvantage of the method is that it can not be used by the patient independently, since it is associated with the need for appropriate skills and is conducted exclusively by a specialist.


When injecting drugs into the joint cavity, the highest analgesic and curative effect is achieved.

Secrets of Traditional Medicine

Traditional medicine is widely used for pain in joints of any origin. The most important secret of this method of treatment is that every sick person should choose his own recipe that suits him in a particular case of pain syndrome. This is not so simple, but among the effective means there are a wide variety of dosage forms: tinctures, decoctions, lotions, baths, etc. Some folk remedies are given below.

Lemon and garlic extract

For its preparation, medium-sized lemons( 3 pieces) and garlic( one large head) are needed. Ingredients are finely ground, poured a glass of boiled luke warm water and infused for a day. Take chronic pain in joints every morning on an empty stomach on a teaspoon.

Pepper kerosene ointment

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Ingredients: an equal amount of green peppers and pure kerosene. After grinding the pepper to a powdery state and thoroughly mixing with kerosene, the mixture is infused for a week. At the end of this time, 100 ml of sunflower oil is added to the resulting mass. Use in the form of rubbing on a painful joint, followed by wrapping gauze or a warm scarf by the type of compress. If a burning sensation occurs, the amount of sunflower oil increases in the composition of the ointment.

Wrinkles against horseradish-based pain

After grinding the horseradish root, juice is squeezed out of it, which moistens the gauze dressing from several layers and is laid on the joint area. From above evenly wiped dry mass, formed after wringing horseradish and wrapped up with its fresh leaves, is evenly distributed. It is fixed by an elastic bandage or a bandage. Duration of the compress - until the appearance of severe burning.

Aloe vera

Ideally, leaves of a five-year-old plant are required, which are ground through a meat grinder. To the resulting gruel, honey and rubbed garlic are added. Mix thoroughly until a homogeneous mass is obtained, which is filled with a glass of vodka and infused for 5 days. Apply by type of rubbing into the skin in the area of ​​the affected joints, which are then wrapped up warmly.

Seeds from fresh nettles

For their preparation, the leaves of a fresh plant are strongly crushed until juice is obtained. The resulting mass is spread on gauze and wrap the joint.

When choosing medicines to combat joint pain, there can not be a standardized approach and the same therapeutic tactics. Clarification of the exact cause of pain in combination with individual selection of drugs and methods of their administration can become the key to successful treatment.

MoyaSpina.ru

All about injections with arthrosis: advantages and disadvantages, the best medicines

With arthrosis, the process of self-healing of the cartilaginous tissue is disrupted, which invariably leads to abrasion, cracking, and ulceration of the intraarticular cartilage. Unfortunately, even the most up-to-date oral preparations that can restore the integrity of the cartilaginous tissue act slowly: it takes about six months for the first results to appear, and this is with an almost continuous reception. Preparations for insertion into the joint cavity have a number of advantages: they act much faster, do not affect the work of internal organs, and the active substance completely falls directly into the lesion.

Also in therapy, intravenous and intramuscular injections are used. Usually, their use is justified in the case of rare exacerbations of osteoarthritis, when it is necessary to help a person quickly. For routine therapy in most cases, such injections can be successfully replaced with the same preparations in the form of capsules, tablets or powders.

Let's talk about injections in more detail: their pros and cons, what are the drugs used for? Answers read further in the article. We focused on intraarticular injections.

Injection of the knee

Intraarticular injections

Advantages and disadvantages of intra-articular administration of

preparations The advantages of this method of drug administration can not be overestimated: preparations injected into the joint cavity very slowly resolve( up to a year), have a local effect on all joint tissues, whilepractically do not penetrate into the blood and do not affect the work of internal organs. From this point of view, they are much safer and can be used even in patients with severe co-morbid diseases, because of which treatment by other methods becomes simply dangerous.

The main disadvantage is the inability to apply the technique for the treatment of small or deep joints: requires that the articular cavity is large enough to insert the needle, and the joint - accessible for injection. It is most convenient to put shots in the knee joints. Even with this introduction of drugs there is always the danger of infectious complications.

Drugs in the form of intraarticular injections for the treatment of arthrosis

Glucocorticoid hormones

Glucocorticoid hormones have a very powerful anti-inflammatory effect. Introduced into the joint cavity, they are already on the first and second days lead to a significant reduction in pain, redness, swelling in the affected area. The effect of injections for arthrosis persists for 1-4 weeks, after which it comes to naught. Of the drugs in this group, injections of methylprednisolone, triamcinolone, betamethasone are used.

Despite their high effectiveness in the presence of severe pain and inflammation, these medicines have one significant drawback: with constant use, they accelerate the destruction of cartilage. For this reason, the treatment of arthrosis with hormones is carried out no more than 2 or 3 times a year.

Hyaluronic acid preparations( ostenil, synviscus, syncope)

Hyaluronic acid plays an important role in the formation of a new cartilage. It is an integral part of the cell membranes that produce connective cartilaginous tissue, it also gives cartilage elasticity, and intra-articular fluid - viscosity, sliding and lubricating properties.

Hyaluronic acid preparations injected into the joint in the form of injections create favorable conditions for the speedy restoration of the cartilaginous tissue. They improve the cushioning and facilitate the sliding of articular surfaces during movement, the pain in the joint decreases, the volume of movements increases. The drug is in the joint cavity for many months( from 3 to 12), and all this time has an effect.

It's no secret that the peak incidence of arthrosis falls to the elderly. But it is in patients over 60 years of age that there arterial hypertension, cardiovascular diseases( strokes, heart attacks, angina).Concomitant diseases often make it impossible to use effective drugs for pain and inflammation - NSAIDs. In this situation, intra-articular injections with hyaluronic acid become literally salvage: they reduce pain in the joints and significantly improve the quality of life of patients and do not have the side effects of NSAIDs. Intra-articular administration of hyaluronic acid is the preferred method of treatment when a patient suffers from a peptic ulcer, an erosive lesion of the intestine, or takes glucocorticoid hormones inwards or as injections( prednisolone, metipred, etc.).

Hyaluronic acid may cause an allergic reaction in patients with intolerance to chicken protein. Do not inject if the skin is damaged in the joint area. All these points must be taken into account when planning treatment with intra-articular injections.

Alflutop

Another drug in injections that can be used for intra-articular injection is Aflutop. The drug includes a concentrate of 4 fish species, diluted in water for injection( this is the base), and additional substances.

Alflutop promotes the regeneration of cartilaginous tissue, as it stimulates the synthesis of hyaluronic acid. In addition, it helps in a short time to eliminate inflammation in the joint and promotes the healing of erosions and ulcers that form on the cartilaginous tissue. The drug has a positive effect on the properties of the intra-articular fluid: it increases its shock absorbing and damping properties. The intra-articular administration of Aflutop leads to a reduction in pain in the joints, an improvement in their function, and in the long run the progression of the disease slows or stops.

Intramuscular and intravenous injections

For the treatment of arthrosis, intravenous and intramuscular injections are also used, which are used:

  1. for exacerbation of the disease, accompanied by intolerable pain;

  2. with low effectiveness of medicines in tablets;

  3. for lesions of small joints, when it is impossible to use intraarticular injections.

For severe pain, narcotic analgesic tramadol is used, with severe inflammation - injections with glucocorticoid hormones, which have a very powerful anti-inflammatory effect. The drug for the restoration of cartilage - chondroitin sulfate - can also be used in the form of intramuscular injections.

Conclusion

In most cases, injections for osteoarthritis are part of a comprehensive treatment program. However, the doctor who has a specialization in rheumatology or orthopedics should select the therapy for arthrosis. Only in this case it is possible to observe the main medical rule: do no harm. And if you, after reading the article, want to undergo treatment, for example, with intra-articular drugs - be sure to visit a specialized specialist. The objective view of a professional, when the question is about health, has never been superfluous.

SustavZdorov.ru

Age, weight, long walking on heels, playing sports, deficiency of vitamins В1 and В6 - possible causes of wear of joints and, as a result - destruction of cushioning cartilage, painful and persistent pain. This disease in medicine was called arthrosis of the joints.

Aching joint pains disturb sleep, are able to loosen the nervous system and lead to an imbalance in blood pressure. Osteoarthritis more often affects the following joints:

  1. Shoulder;
  2. Knee;
  3. Hip.

When the first symptoms of arthrosis appear, it is necessary to begin treatment, using painkillers that can stop the pain of the shoulder and knee joints for a while. It should be noted that analgesic drugs in injections( both intramuscular and subcutaneous) against tableted drugs help much faster. But the inflamed joint does not a little anesthetize, it is necessary to remove the inflammatory reaction. So:

Drugs for intramuscular injection

  1. Analgesics .Such as actually Analgin and Baralgin. Dull pain of the knee joint, shoulder joint, do not have arthrosis.
  2. Spasmolytics .For injection by injection subcutaneously with joint arthrosis, one antispasmodic - Midokalm - is very helpful. Quickly removes spasms from the musculature of the skeleton, while reducing the pain in the joints.
  3. Non-steroidal anti-inflammatory drugs .The most popular are Ibuprofen, Diclofenac, Ketonal, etc. These medicines can not only relieve the pain, but also remove puffiness and stop the inflammation of the hip, knee, shoulder and other joints. At course treatment it is possible to forget about pain for ever. But to use these drugs should be cautious: the fact is that anti-inflammatory drugs are very irritating to the mucous membrane of the stomach and contribute to the formation of ulcers in it. Therefore, these medications are usually prescribed by short courses and strictly under the supervision of a doctor. After the course of such drugs, it is worthwhile to take a course of support with vitamins B1 and B6.
  4. Steroid preparations .Ambene is the first in terms of efficiency. This is a complex preparation consisting of six special syringes: in the amount of three pieces with solution A( lidocaine hydrochloride and dexamethasone) and three with solution B( vitamin B1, B6, cyanocobalamin, lidocaine).These drugs have pronounced both analgesic and anti-inflammatory effects, regenerating the processes of the knee joint. The content of lidocaine makes the injections completely painless. Solutions A and B are mixed, injected into the gluteus muscle deeply, before administration, the solution is heated to body temperature.

In modern medical practice, it is possible to treat arthrosis with the help of an effective technique, the essence of which is the introduction of drugs not subcutaneously, but directly into the joint. Preparations are made on the basis of hyaluronic acid, corticosteroid hormones, vitamins for the restoration of cartilage tissue B1 and B6, as well as other components.

Intra-articular injections are prescribed in cases where the usual pain relievers described above are no longer effective. The most popular and common drugs for these types of injections are the drugs listed below.

Drugs for intraarticular injections

Corticosteroid hormones

Intraarticular injections are administered for the treatment: corticosteroid hormones Celeston, Kenalog, Flosteron, Diprospan, Hydrocortisone. Corticosteroids are valued for the rapid and effective suppression of pain of the knee, shoulder and other joints. But the downside is that these substances are not able to cure arthrosis. There is no influence on the joint: they do not improve the condition of the cartilaginous tissue, do not restore blood circulation( especially the knee).In this regard, use of such intraarticular prick is necessary in conjunction with vitamins B1 and B6.

Hyaluronic acid

Hyaluronic acid - an innovation in the physician's arsenal - is a lubricant fluid that helps slip almost destroyed cartilage and is an absolute substitute for synovial fluid of the knee joints. Often, intra-articular injections are performed with lesions of the knee and shoulder joints as the most vulnerable. It should be noted that treatment with this drug is effective, but expensive. For the injection of enough 3 to 5 injections, which contains acid.

Chondroprotectors

These are medical intraarticular preparations, which heal joints. They are more often used for malnourishment of the joint( often with a deficiency of vitamins B1 and B6) or when injuring the shoulder joint or knee.

It is advisable to start treatment and use intraarticular nuzzles for knee, hip and shoulder arthrosis only after removal of inflammation.

Intra-articular prick with chondroprotectors have their effect faster, against oral medication. Having already received the first injection the result will not be long in coming. The knee or shoulder will get sick less.

All described preparations for intraarticular injections do not pass without a trace - after their treatment it is necessary to restore the balance of some vitamins( B1, B6, B12, A, C, etc.) using Neurobex( B1, B6, B12), Triovit, C, E) or directly administering these vitamins subcutaneously or intravenously.

NovaQainic blockade

Often used for arthrosis of the shoulder and knee joints. This is a special treatment, during which an injection of novocaine with a certain frequency and frequency as an intramuscular injection is injected into the inflamed area of ​​the shoulder joint affected by arthrosis, as well as adjacent tendons and muscles. The use of the so-called Novocain blockade in medicine makes it possible to remove painful contracture. The procedure is repeated 1 to 3 times a month. It is also combined with mandatory vitamin therapy( B vitamins, especially B1 and B6).

All these injections are good, but self-medication is not worth it. Therefore, it is important to see a doctor and get expert help in diagnosing and in the appointment of correct and effective treatment if pain symptoms of knee, hip and shoulder joint arthrosis appear.

osustave.ru

Painkillers: injections for pain in the back, joints, injections for back pain |ABC of health

When there is severe pain in the back, in the lower back, joints, of course, first of all it is necessary to determine the cause of its occurrence. If this is a chamber from hypothermia, lumbago, or a pinch of the sciatic nerve, an intervertebral hernia, etc., it is necessary to undergo a examination with a neurologist, an osteopath, possibly a gynecologist, urologist, gastroenterologist, because back pain can be not only from spasm of muscles and ligaments, but also with certain diseases of internal organs. After careful diagnosis, the doctor can prescribe as part of a complex therapy - NSAIDs, B group vitamins in pricks from back pain.

What are the tools that relieve back pain in injections?

Today in the treatment of acute pain in the lumbar region, back, medicine finds new principles and algorithms, rather than 50 years ago. The main emphasis in the fight against pain is done to eliminate pain with NSAIDs - non-steroidal anti-inflammatory drugs that suppress inflammation, and reduce pain, as well as carrying out muscle blockages.

And after the withdrawal of severe spasms, it is recommended to refrain from immobilizing the patient, that is, carrying out exercises of physiotherapy exercises, performing a massage. Most doctors insist that a person during pain syndromes in the back area does not limit his activity as much as possible.

The use of combined vitamin complexes that can have a moderate analgesic effect, vitamins B12, B6, and B1 has also become popular and effective. It is believed that vitamin B12 has a more significant analgesic property. Why these vitamins?

Recently, these drugs have been treated in medicine as moderate analgesics, since they are neurotropic - they normalize the innervation of the muscles, participate in the transmission of excitation, in the metabolism of mediators, influence metabolism, processes in the nervous system, and contribute to the repair of damaged nerves.

More than 90 different studies have shown that the use of B vitamins in clinical practice led to a significant reduction in the pain syndrome in acute phases of inflammation in complex treatment. Therefore, they can be used both individually and in the form of complex preparations of B vitamins.

Most of the complex preparations of this group contain an anesthetic lidocaine, which strengthens the local analgesic effect. However, it should be remembered that the use of this group of vitamins makes sense only with acute pain in the back, joints, alcoholic polyneuropathy, myasthenia B12 for 10-14 days, and with chronic relapsing diseases they are already becoming ineffective.

In cases where anesthetics do not help, specialists can offer the patient a method of injection and stretching. It consists in the following: after the patient lies on the stomach, the muscles find the most painful seals or points where the pain is the most intense, and they do exactly perpendicular injection with a solution of novocaine.

Immediately after the injection, passive stretching of the muscle is made, after which a hot compress is placed on this place. Then, when the compress is removed, the patient must make active movements, maximizing the painful muscle movements.

The goal of the Novocain blockade is to "disconnect" the nerve. Therefore, the points of the injection should be as close as possible to the exit points of the nerves, for example, the sciatic - at the large trochanter of the thigh, with intercostal neuralgia - in the corresponding intercostal space, with osteochondrosis - at the outer edge of the extensor of the back, etc. It is also advisable to carry out epidural blockades in chronic pain syndrome, for example.with hernias of intervertebral discs.

Below is a list of drugs that are prescribed by the attending physician according to the indications. Only the doctor determines the advisability of using B vitamins, NSAIDs, muscle relaxants, and hondoprotectors. The information below is only for reference, the treatment and dosage are determined by a specialist.

When hurting back or joints, injections of Group B vitamins should help

Group B vitamins can also be taken in tablet form, but naturally, intramuscular injection is considered more effective. Consider what medicines exist for this group in the modern pharmaceutical market, their general indications, contraindications, side effects, methods of application and comparative prices in pharmacies:

Milgamma

Milgamma 5 amp.the price in pharmacies is 220 rubles, 10 amp.400 rubles.25 amp.900 rubles.

The composition of all the listed drugs is the same: Lidocaine, Thiamine, Pyridoxine Cyanocobalamin

Indications: Used for neurological diseases and syndromes of nervous system disorders in complex therapy:

  • Neuritis, facial nerve paralysis,
  • spinal neuralgia Back pain caused by spine diseases, neurological manifestations(radiculopathy, lumboschialgia, muscular-tonic lumbar, cervical, cervico-brachial syndromes, intercostal neuralgia, radicular syndrome due to degenerative changesspine)
  • nocturnal muscle spasms, alcoholic, diabetic polyneuropathy, shingles.
Komplipen

5 amp.100 -120 rubles, 10 amp.170-210 rub.

Contraindications: Can not be treated with:

  • Pregnancy, lactation
  • acute, severe types of heart failure
  • hypersensitivity to components of combined vitamins of group B
  • due to lack of research - child age
Neurobion

3 amp.220 rub. - Neurobion does not contain Lidocaine

Side effects: Tachycardia, increased sweating, rarely - allergic reactions - rash, itching, urticaria, skin reactions, shortness of breath, anaphylactic shock. When an overdose - nausea, vomiting, dizziness, tachycardia.

Trigamma

5 amp.about 100 rubles.

Usage: All listed injections of back pain are injected deep intramuscularly 2 ml of 1p / day for 5-10 days, then it should be switched to 2-3 r / week for 14-21 days.or to take vitamins inside.

Efficacy, contraindications and side effects of NSAIDs

Painkillers, of course, are used only as symptomatic therapy, they help to eliminate pain in the joints, back, but do not eliminate the cause of its appearance, in addition, 50% of patients may experience various side effects.

When carrying out more than 50 studies aimed at identifying the best painkiller, the researchers found that none of the NSAID products showed higher efficacy than other painkillers, and some of them are very expensive drugs. The only thing to pay attention to when choosing - some generics( Russian diclofenac, for example) are much inferior in effectiveness to the original drugs( European Diclofenac).

These studies were also aimed at determining the drug with the least side effects. As a result, it was found that Ibuprofen is the least toxic of all NSAIDs.

Manufacturers of the new Cox-2 inhibitor-Celebrex stated that it had the least side effects, but no convincing evidence of this fact was found during the studies.

Мелоксикам

Мовалис ( 3 amp 530 rub.) Amelotex ( 3 amp.-280 rub.) Arthrosan

Indications for NSAIDs: Symptomatic treatment of ankylosing spondylitis, osteoarthritis, rheumatoid arthritis, elimination of pain - musculoskeletal, back pain of any etiology, postoperative and other painful sensations.

Ketoprofen

Arthrosylen ( 6 amp 170 USD) Ketonal ( 10 amp 200 rubles) Flamax ( 5 amp. 110 rubles). Flexan

Contraindications: Hypersensitivity to any component of the drug, heart failure, pregnancy and lactation, severe hepatic or renal failure, bronchial asthma, aspirin, children under 16-18 years of age, inflammatory bowel disease,exacerbation of gastric ulcer, gastrointestinal bleeding. Cerebrovascular diseases, ischemic heart disease, any severe diseases of the cardiovascular system, joint administration of antiplatelet agents( clopidogrel, acetylsalicylic acid) prednisolone, a violation of liver function, severe somatic diseases.

Precautions: GI disease, presence of Helicobacter pylori infection, edema, fluid retention, diabetes mellitus, prolonged use of NSAIDs.

Ketorolac Ketorol ( 10 amp 70-90 rub.)

Kestorol ( 10 amp 130-150 rubles), Ketanov ( 10 amp 100 rub.) ( 10 amp 70-90 rub.)

The solution for injections from back pain followsenter intramuscularly intramuscularly in a dosage matched by the doctor depending on the patient's age, intensity of pain. Up to 65 years, appoint a single dose of 10-30 mg.in / m every 4-6 hours. Persons with renal dysfunction or older than 65 years in a dose of 10-15 mg IM once, or every 4-6 hours. The maximum daily dose should not be more than 60-90 mg.and the duration of therapy is not more than 5 days.

Diclofenac

Diclofenac Voltaren Naslofen ( 5 amp 50 rubles), Ortophen ( 10 amps 40 rub.)

Side effects:Digestive system: often - diarrhea, gastralgia, constipation, vomiting, nausea, heartburn, hepatitis, acute pancreatitis. Urinary system: frequent urination, nephritis, edema, acute renal failure. Respiratory system: dyspnea, laryngeal edema, allergic rhinitis, difficulty breathing. CNS: dizziness, headache, drowsiness, hyperactivity, psychosis, hearing loss, depression, impaired vision. CCC: syncope, increased blood pressure, pulmonary edema. Organs of hematopoiesis: eosinophilia, anemia, leukopenia. Blood coagulation: rectal, nasal, gastric bleeding, from a postoperative wound. Dermatological manifestations: urticaria, skin rash, skin peeling, Lyell syndrome, Stevens-Johnson syndrome. Allergic reactions: swelling of the eyelids, wheezing, shortness of breath, discoloration of the face, itching of the skin, rash, heaviness in the chest. Other: often - weight gain, swelling of the ankles, face, fingers, shins, excessive sweating.

Lornoxicam

Xephocam ( 5 amp 700-720 rub.)

Tenoxicam

Texman 1 flask.200 rubles.

Overdose: vomiting, nausea, abdominal pain, the occurrence of peptic ulcers of the stomach, metabolic acidosis, impaired renal function.

Interaction: Simultaneous use of NSAIDs with acetylsalicylic acid or other non-steroidal analgesics, as well as corticosteroids, calcium preparations, ethanol, can lead to gastrointestinal bleeding and the formation of gastrointestinal ulcers. Simultaneous administration of c with paracetamol increases the risk of nephrotoxicity.

Chondroitin sulfate

Mukosat ( 5 amp 250-500 rub), Chondroguard ( 10 amp 600 rubles), Chondrolone ( 10 amp 800-1100 rub), Artradol ( 10 amp 700 rub))

Chondroitin sulfate - this drug is an anti-inflammatory drug that is prescribed for the treatment of joint and spine diseases. It slows the resorption of bone tissue, improves calcium-phosphorus metabolism in the cartilaginous tissues, stops the destruction of connective and cartilaginous tissue, accelerates the recovery processes. Reduces painful sensations and increases the mobility of the spine and joints. It has a structural similarity with heparin, therefore it prevents the formation of thrombi in the subchondral and synovial channels.

Therefore, when choosing a non-steroidal anti-inflammatory drug, it should be remembered that they have almost the same anesthetic properties, the same side effects, but different frequency, intensity, severity of side effects, harmful effects, and that not unimportant - different prices. For example, Meloxicam has less effect on the stomach and intestines than aceclofenac( Aertal).Indomethacin gives a pronounced anesthetic effect, but it destroys the cartilage with prolonged use and is now used less and less.

And doubling the dose does not reduce the intensity of pain, and in the case where one non-steroid drug does not help( if it is not a fake), replacing it with another one does not make sense. Moreover, based on research, it can also be concluded that they are not much more effective than conventional paracetamol. Details of all ointments from back pain can be found in our article.

The choice of pain medication

In chronic pains before prescribing an anesthetic, the doctor determines the causes and nature of chronic pain - reflected, neuropathic or central, and prescribes appropriate treatment.

If the pain is acute, the doctor determines the risk of GI-related side effects, cardiovascular complications, if the risks are not great, and:

  • does not have dyspepsia - then any NSAID
  • dyspepsia is - better ibuprofen( or diclofenac, naproxen), nimesulide( or milixicam)

If the risk of cardiovascular complications is high, then NSAIDs should be avoided, and Paracetamol, opioids should be used. With a moderate risk, nimesulide can be administered, provided that there is adequate correction for BP( amlodipine, see drugs to reduce blood pressure).

If the risk of GI bleeding is high - NSAIDs + necessarily proton pump inhibitors( omeprazole).It is understood that the administration of NSAIDs is in itself a sufficient risk even for a single dose, therefore, according to the standard, all NSAIDs are taken in combination with proton pump blockers, regardless of the risks of gastroduodenal bleeding.

When combined with the risks of gastrointestinal side effects and complications of CCC - Nimesulide + acetylsalicylic acid + omeprazole.

If within 5-7 days the pain ceases, then continue the treatment until it is completely stopped. If the acute pain does not subside within a week, then muscle relaxants, local anesthetics are prescribed. Local administration of corticosteroids is possible with the exclusion of the diagnosis - tuberculosis of the joints or spine. With very severe pain and no effect on painkillers, the infectious nature of pain should be excluded( tuberculosis pathology - consultation and examination in an anti-TB dispensary), joint pain in gonorrhea, syphilis or other infection.

Overview of pain medication in injections

All known NSAIDs in injections, with their general contraindications and side effects, average prices in pharmacies are presented in the table:

Painkillers in tablets

When the back is badly hurt, the doctor can prescribe anti-inflammatory, analgesics in tablets, previouslyit was believed that oral administration slows down the onset of action, reduces effectiveness and leads to stronger side effects on the part of the gastrointestinal tract. To date, it is believed that intramuscular injection and oral administration give the same bioavailability of the drug. Side effects from the gastrointestinal tract are realized through suppression of the arachidonic acid system, that is, not with direct contact with the mucosa, but after absorption into the blood. Therefore, the side effects are almost identical when administered orally and when injected.

Essential NSAIDs in tablets

  • Celebrex( active ingredient celecoxib 10 pieces 400-420 rub)
  • Arcoxia( active ingredient etorikoksib 7 pieces 520-600 rub)
  • Texamen( active ingredient tenoxicam 10 pieces 200-250 rub)
  • Nyz, Nimulid, Nimikasubstance nimesulide price 20 pieces 80-140 rub)
  • Nalgezin( active substance naprksen 10 items 110-130 rub)
  • Movalis, Arthrosan, Meloxicam( substance Meloxicam price 20 tab. 40 rubles, Movalis 20 tablets 250 rubles)
  • Ketanov, Ketarol, Ketorolac( Ketorolac substance price 20 tab. 40-60 rub.)
  • Arthrosilen, Bystrumcaps, Ketonal, Flecksen( substance ketoprofen 20 pcs 150 rub, Bysrumkaps 10 pcs 250-270 rub., Fleksen 30 pcs 170 rubles)
  • Burana, Nurofen, Faspik, Ibuprofen( substance Ibuprofen price 20 pcs 15 rubles, Nurofen 12 pcs.110 rubles, Faspik 6 pieces 100 rubles, Buran 10 80 rubles)
  • Voltaren, Diklak, Naklofen, Orthofen,( substance Diclofenac price 20 pcs 40 rubles, Voltaren 20 pcs 200 rubles, Orthofen 30 pcs.20 rubles., Diklak 10 pcs.70-100 rubles.)
  • Aertal 20 tab.400 rubles.- active ingredient Aceclofenac.
  • Xsefokam 10 pcs.130-200 rub.- Lornoxicam.

Combined painkillers

  • Dolaren, Panoxen( 20 pcs 120 rubles) - diclofenac + paracetamol.
  • Neurodiclavitis( 30 pieces 300 rubles) - diclofenac + vitamins of group B.
  • Some( 120-170 rub.) - paracetamol and ibuprofen.

Muscle relaxants

Most of the pains are based on muscle spasm, which itself pulls the nerve root and causes a secondary radicular syndrome, so in many cases, muscle relaxants are prescribed as an anesthetic:

  • Tolperizone - peripheral action, Midokalm( instructions for use, tablets,injections of 30 tablets to 50 and 150 mg 300-400 rubles.), Tolperizon 30 pcs.150-200 rub.
  • Hydroxine - central with inhibition of the central nervous system, suitable for severe pain, Atarax 25 pcs.300 rubles, Hydroxysin 25 pcs.200 rubles.
  • Baclofen is also a central action, Baclosan.
  • Tizanidine - central action, Sirdalud( 2 mg 30 pcs.230 rub, 4 mg 30 pcs 330 rubles), Tizanil( 2 mg 30 pcs 170 rub, 4 mg 30 pcs 250 rubles), Tizalud( 2 mg 30pcs 140 rubles), Tizanidine 4 mg.30 pcs.150-200 rub.

Hondoprotectors

Alflutop

Alflutop( 10 am 1400-1500 rub.)

This is a modern preparation that is a concentrate of small sea fish that regulates the metabolism of cartilaginous tissue. The bioactive concentrate contains amino acids, ions of potassium, sodium, copper, iron, calcium and zinc, as well as mucopolysaccharides, peptides. This agent stimulates the processes of restoration of cartilaginous tissue, inhibits the destruction of bone-cartilage tissue structures, thus providing a moderate analgesic effect.

The drug is prescribed only for adults with osteochondrosis or polyosteoarthrosis, it should be administered intravenously deep 1 ml / day by a course of 20 days. If large joints are affected, then it is possible to inject the drug into the joint 1 time in 3-4 days for 1-2 ml, a course of 5-6 injections.

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