Pain reliever for osteochondrosis
The content of the article:
- The mechanism of action of pain medications
-
Non-steroidal anti-inflammatory drugs (NSAIDs)
- Mechanism of action
- Pills
- Injections
- Ointments and gels
- Plasters
- Narcotic analgesics
- Local anesthetics
- Combined medicines
- Painkillers for cervical osteochondrosis: how to choose
- Video
Pain reliever for osteochondrosis is one of the main components of the treatment of the disease, aimed at relieving pain. For pain relief, medications from different groups can be used, but most often - non-narcotic and narcotic analgesics. Medicines are prescribed in the form of tablets, injections, ointments and patches. This treatment is indicated for any type of spinal osteochondrosis (cervical, thoracic, lumbar, sacral).
The mechanism of action of pain medications
Painful sensations are one of the main signs of osteochondrosis at any stage. To combat pain, drugs from different groups can be used:
- non-narcotic analgesics;
- narcotic analgesics;
- antiepileptic drugs (to relieve neuropathic pain);
- local anesthetics;
- combined medications (for example, chondroprotector + analgesic).
The use of analgesics refers to symptomatic treatment, that is, such drugs only eliminate the symptom of the disease. It is impossible to change the state of the cartilage tissue and, accordingly, to influence the mechanism of development of osteochondrosis with the help of painkillers.
Non-steroidal anti-inflammatory drugs (NSAIDs)
NSAIDs are the main group of drugs that are used to relieve pain in osteochondrosis. The advantage of this group is that they relieve not only pain, but also inflammation.
Diclofenac is one of the most popular NSAIDs used for osteochondrosis in various forms
Mechanism of action
NSAIDs can be taken at any stage of the disease. Their mechanism of action is associated with the blockade of cyclooxygenase, an enzyme that is involved in the formation of prostaglandins. Prostaglandins are pro-inflammatory mediators that are involved in the development of pain and inflammation.
There are 2 types of COX in the human body:
- COX-1 - is constantly in the human body, is responsible for the production of protective mucus in the stomach.
- COX-2 - begins to function only with inflammation.
Depending on which type of cyclooxygenase suppresses the drug, 2 groups of NSAIDs are distinguished - selective and non-selective.
| NSAID type | What type of COX blocks | Explanation |
| Non-selective | COG-1 and COG-2 |
They block not only the "pathological" COX-2, but also the "physiological" COX-1, which is fraught with the development of side effects from the gastrointestinal tract. |
| Selective | COG-2 only | Selective NSAIDs are a new generation of drugs. They act only on the "pathological" COX-2, therefore, when using them, the mucous membrane of the stomach and intestines is not affected. |
The doctor may prescribe systemic NSAIDs (tablets and injections) and local (ointments, gels and patches).
Pills
In most cases, systemic drugs are prescribed for the treatment of osteochondrosis - that is, those medicines that enter the bloodstream and affect all systems of the body.
The tablets are convenient and easy to use and can be used at home. An overview of the most popular pills (from strongest to weaker):
- Ketalgin, Ketanov (active ingredient ketorolac);
- Dicloberl (diclofenac);
- Celebrex (celecoxib);
- Movalis (meloxicam);
- Metindol (indomethacin);
- Nurofen (ibuprofen).
Movalis tablets have NSAIDs as the active ingredient
Injections
To quickly relieve pain, NSAIDs are used in the form of injections. More often intramuscular injections are made, less often intravenous ones. With intravenous administration, the drug relieves pain after 3-4 minutes, with intramuscular administration - after 10 minutes.
Fast and powerful action is the main advantage of the injections. This method of administration also has its disadvantages:
- invasiveness;
- the likelihood of infection;
- it is impossible to carry out treatment at home;
- soreness.
NSAIDs in the form of drugs for injection, like other systemic drugs, are of 2 groups:
- Non-selective: ketorolac, diclofenac (Dicloberl, Voltaren),
- Selective: meloxicam, etoricoxib (Arcoxia).
Voltaren's active ingredient is diclofenac, which belongs to NSAIDs
Ointments and gels
Local pain relief agents are less frequently prescribed. Ointments and gels act locally, are not absorbed into the general bloodstream. This has its advantages - side reactions develop less often.
The disadvantage of using ointments is their weaker effect compared to systemic drugs. In addition, if ointments are used incorrectly, the effect may be completely absent. For example, if you apply the ointment to the site of pain irradiation, and not to the source of the lesion.
What non-steroidal anti-inflammatory ointments can be used for osteochondrosis:
- Voltaren emulgel, Diclac, Doloxen, Clodifen (active ingredient diclofenac);
- Arthrocol, Ketonal, Ketoprom, Ketum-gel (active ingredient ketoprofen);
- Dolgit, Nortafen, Nurofen (active ingredient ibuprofen);
- Indomethacin, Indovazin (active ingredient indomethacin).
The ointment must be applied to the lesion, that is, to the area of the spine (neck, thoracic region, lower back).
Dolgit is a gel containing NSAIDs
Plasters
Patches with NSAIDs can be used for additional treatment of osteochondrosis. They act locally, rarely cause side reactions, and are easy to use. At the same time, plasters are not a substitute for full treatment.
The most popular remedies include:
- transdermal patch Voltaren;
- plaster Diclobene;
- plaster Ketotop.
Ketotope - an anesthetic patch containing NSAIDs
Narcotic analgesics
Narcotic analgesics for osteochondrosis are used much less frequently than non-narcotic ones. This is the most powerful group of pain relievers and can be used for any type of pain. The mechanism of action of narcotic drugs is associated with the stimulation of opioid receptors.
What are the indications for the use of opioid analgesics:
- pain syndrome is not relieved by NSAIDs and muscle relaxants;
- complications associated with pain syndrome developed.
Local anesthetics
In the acute period of the disease, drugs with a local anesthetic effect can be used. They are usually prescribed as patches or blockages. For example, the plaster Versatis, the main active ingredient of which is lidocaine.
Well relieve the pain of blockade with local anesthetics. For the treatment of osteochondrosis, paravertebral blockade is most often used - a 1-2% solution of novocaine or lidocaine is injected into the paravertebral points at the level of the affected segment. In addition to novocaine or lidocaine, glucocorticoids or B vitamins can be administered.
The blockage effect usually occurs immediately after the administration of the local anesthetic. The analgesic effect persists for 4–7 days, then the procedure must be repeated.
With severe pain, novocaine blockade is used
Combined medicines
Combined drugs can be used to relieve pain in osteochondrosis. They include drugs from different groups, for example, NSAIDs and local anesthetic, NSAIDs and chondroprotector.
Combined drugs that are used for osteochondrosis:
- Gel Flamides (diclofenac, methyl salicylate, levomenthol).
- Olfen patch (diclofenac, lidocaine).
- Dolaren gel (diclofenac, menthol).
Flamidez is a gel that contains several active ingredients
Painkillers for cervical osteochondrosis: how to choose
The choice of pain medication depends on several factors. The main factor that is guided by when choosing an anesthetic drug is the severity of pain. Usually, the intensity of pain correlates with the stage of osteochondrosis and the presence of complications:
- for mild pain, local drugs are more often used in the form of a patch, or NSAIDs with a weak analgesic effect (ibuprofen);
- if the pain is of moderate intensity, NSAIDs with a pronounced analgesic effect (ketorolac, diclofenac, celecoxib) are prescribed;
- with a very pronounced pain syndrome, paravertebral blockade is performed or even narcotic analgesics are prescribed.
When choosing a medication, the presence of concomitant pathology is important - diseases of the digestive tract, cardiovascular system, dermatological problems. A history of allergic reactions to medications is also taken into account:
- in case of erosive gastritis, gastric ulcer and duodenal ulcer, it is contraindicated to use systemic non-selective NSAIDs (diclofenac, indomethacin), as they damage the mucous membrane of the gastrointestinal tract;
- in case of cardiovascular pathology, the use of selective NSAIDs is limited (Movalis, Arkoksia);
- with pustular skin lesions, systemic agents are preferred, rather than local ones (ointments, gels, patches).
The localization of osteochondrosis usually does not affect the choice of anesthetic.
Treatment of osteochondrosis is never limited to the use of only one anesthetic drug. A prerequisite for getting rid of the disease is the complexity of the treatment.
Video
We offer for viewing a video on the topic of the article.
Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
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