Comprehensive conservative treatment of patients with osteochondrosis of the lumbar spine

Treatment of patients with spinal osteochondrosis should be based on knowledge of the pathogenesis of the disease and take into account not only the stage of development of the pathological process, but also individual clinical manifestations, as well as the compensatory capabilities of the body. Principles of complex treatment of osteochondrosis: – early onset; – gentle targeted nature of therapeutic effects; – complexity; – continuity; – timeliness. At the stages of rehabilitation and therapeutic measures in this category of patients, an important point is the elimination of pain. Therapeutic regimen. Immediately patients with osteochondrosis need to provide rest to reduce the load on the spine and relax the paravertebral muscles. To this end, 3 – 5 day bed rest. Then use physical and postural exercises, massage. It is advisable to teach patients methods of post-isometric auto-relaxation, wearing orthoses (belts, corsets). Certain types of activity that increase mechanical pressure on the spine are temporarily excluded: prolonged stay in a sitting position without support, weight lifting in the pose of a “crane”. Patients are taught to go to bed and get out of bed correctly. Manual therapy. After acute pains, it is possible to use gentle manual therapy techniques aimed at mobilizing and relaxing muscles, eliminating functional blocks if necessary, which helps reduce analgesic scoliosis and increase the range of motion in the lumbosacral spine. Postisometric muscle relaxation (PIR) is also widely used as an integral part of manual therapy. But if there is no effect after 2 – 3 sessions, manual therapy should be abandoned. Physiotherapy. In the complex treatment of patients with osteochondrosis of the lumbar spine, along with these methods, physiotherapeutic methods are widely used. Physiotherapeutic methods have a certain universality of influence on the main manifestations of the disease and are characterized by specificity, which allows to target not only certain links of pathogenesis, but also the sanogenetic reactions of the body. To achieve a trophic-generative, anti-edematous, anti-inflammatory, analgesic, antispasmodic effect, a low-frequency alternating magnetic field is applied for a duration of 30 to 40 minutes, an intensity of 20 to 35 mT, and a frequency of 50 Hz. In order to improve blood circulation in the tissues of the affected segment, darsonvalization or ultratonotherapy is prescribed. Widely used drug electrophoresis. Galvanic current, changing the skin temperature, provokes a quantitative and qualitative distribution of the ratio of ions, with the predominance of monovalent cations near the cathode, and divalent anions near the anode . In addition, under the influence of galvanization, the activity of basic inorganic ions improves due to an increase in the number of free ions, and the acid-base balance changes, which contributes to an increase in the metabolic activity of tissues. This mechanism can also be considered from the perspective of the stimulating effect of galvanization. When using a galvanic current, metabolism is accelerated, regeneration is optimized, and impulses are carried out along nerve cells. A change in the excitability of nerve fibers helps to reduce the pain sensitivity of human tissue receptors. For electrophoresis in this category are used: – anesthetizing and analgesic substances (2 – 5% analgin solution, 2 – 3% novocaine solution, 2 – 5% lidocaine solution); – drugs that improve the state of microcirculation (5% solution of compliance, 1 – 2% solution of nicotinic acid, 2% solution of pentoxifylline); – sulfur-containing preparations (2 – 5% solution of unitiol, 3 – 5% solution of ichthyol); – vitamins (0.5 – 1% solution of ascorbic acid, B1, B12); Biostimulants (FIBS, aloe, mud extraction, mud, pelodex, peloidin, humisol) Thus, experience has shown that a comprehensive conservative treatment of patients with osteochondrosis of the lumbar spine using the above methods of therapy allows to obtain positive results and achieve stable remission of the disease.

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