Ointments for osteochondrosis.

When, due to deterioration of the blood supply to the joints, the fibrous cartilaginous tissue surrounding and connecting them begins to change pathologically, the use of an ointment for osteochondrosis is recommended in local therapy of these disorders.

Reduced synthesis of chondrocytes (cartilage tissue cells) and fibrillar proteins (collagen) reduces the biomechanical properties of cartilage, and this can lead to necrosis of the subchondral bone tissue and joint destruction. In all cases, indications for the use of ointments for osteochondrosis are the presence of such clinical symptoms as arthralgia (joint pain, often radiating to other anatomical structures); hypoesthesia (loss of sensitivity of mechanoreceptors in the area of the affected joints); swelling of the tissues surrounding the joint (especially during an exacerbation); inflammation; dynamic limitations of joint connections.

For everyone, the best ointment for osteochondrosis will be the one that will cope with these symptoms and will not cause side effects.

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Release form

Regardless of the location of the disease, ointments for cervical, thoracic and lumbar osteochondrosis are the same.

Names of ointments for osteochondrosis recommended by doctors:

• Anti-inflammatory ointments for osteochondrosis based on non-steroidal anti-inflammatory drugs (NSAIDs): Diclofenac ointment (Dikloran, Voltaren emulgel, Diclac gel, etc.), Ketonal ointment (Valusan, Fastum gel, Bystrumgel, etc.), Ibuprofen (Ibutop gels, Deep Relief, etc.). Since these drugs relieve pain, any of them can be used as an ointment for exacerbation of osteochondrosis.
• In addition to the above-listed NSAID drugs, pain-relieving ointments for osteochondrosis include ointments with menthol (Menovazin, Bom-Benge, Efkamon) and ointment with bee venom Apizartron (Apifor, Ungapiven).
• Warming ointments for osteochondrosis (more precisely, warming or locally irritating): Kapsikam (Betalgon, Espole), turpentine ointment, as well as most products containing methol, camphor or bee venom.
• Chondroprotective ointments for osteochondrosis: Chondroitin ointment (Chondroitin, Chondrasil, Chondroxide), homeopathic ointment Ziel T.

Homeopathic ointment for osteochondrosis is represented by complex products Ziel T and Traumeel ointment (and gel) manufactured by Biologische Heilmittel Heel GmbH (Germany). It should be noted that the anti-inflammatory and analgesic homeopathic gel Traumeel is more applicable for bruises, hemorrhages, burns, frostbite and soft tissue abscesses, although it can also be used for joint problems.

Heparin ointment is an anticoagulant and is used in the treatment of varicose veins, thrombophlebitis, phlebitis, hemorrhoidal cones, subcutaneous hematomas.

Dolobene ointment, in addition to heparin, contains dimexide and dexpanthenol; it is advisable to use it for bruises, hematomas, muscle or ligament sprains.

Joint balm or Dikul ointment is recommended for use as a massage agent, which is carried out in the presence of myositis, arthritis and osteochondrosis. The composition of this product includes sea buckthorn and tea tree oils, plant extracts (rose hips, nettle, chamomile, aloe, etc.), propolis and mumiyo, bee venom and bear bile, as well as collagen hydrolyzate (medical gelatin) and dexpanthenol.

Horsepower ointment is not a pharmaceutical product; it is a foot gel with menthol, vitamin E and lavender essential oil.

And the so-called miracle ointment of Elena Seimova (in other versions the name Valentina appears) is a homemade mixture of vegetable oil, beeswax and boiled egg yolk, which is offered to treat everything from stomach pain and constipation (taken orally) to trophic ulcers and ovarian cysts. Most likely, for joint pain, a folk recipe for fly agaric ointment is more suitable, for the preparation of which the crushed dried mushroom (100 g) must be mixed until smooth with 100 g of lard or melted butter.

The cheapest ointments for osteochondrosis, from those presented in the review: Menovazin, turpentine ointment, Bom-benge, Diclofenac ointment, Chondroitin ointment and Chondrasil ointment (while Chondroxide ointment, which contains the same chondroitin sulfate, is twice as expensive).

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• Effective pills for back pain
• Ointments for back pain

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Pharmacodynamics

The pharmacodynamics of various ointments used for osteochondrosis allows us to get an idea of how these drugs act with these symptoms.

Pain-relieving and anti-inflammatory ointments for osteochondrosis based on NSAIDs (Diclofenac, Ketonal, Ibuprofen, etc.) affect inflammatory mediators (prostaglandins), inhibiting their production and, thus, reducing inflammation and pain.

The analgesic effect of all local irritants is based on their effect on skin receptors and nerve endings (which interrupts pain signals), reflex expansion of capillaries and blood flow to the damaged area. Turpentine ointment contains turpentine oil from pine resin, and bee venom in Apizartron ointment acts in the same way.

The active ingredients of Kapsikam ointment are vanillyl nonamide (a synthetic substitute for the alkaloid of bitter pepper capsaicin), turpentine and camphor. Ointments with menthol also contain: methyl salicylate, i.e. acetylsalicylic acid (Bom-benge), which relieves inflammation; camphor, clove and eucalyptus oil (Efkamon); local anesthetics benzocaine and novocaine (Menovazin ointment).

Chondroprotector ointments (Chondroitin ointment, Chondrasil, etc.) contain chondroitin-4-hydrogen sulfate of animal origin, similar to endogenous sulfated glycosaminoglycans (from which cartilage tissue is formed). Chondroitin sulfate molecules penetrate into cartilage tissue and synovial fluid due to dimethyl sulfoxide (dioxin); stimulation of chondrocytes leads to a slowdown in the process of their degradation and activation of the synthesis of proteoglycans - the basis of the matrix of cartilage tissue.

The homeopathic ointment Ziel T, which also belongs to chondroprotectors, contains more than fifteen components, including: extracts of arnica, poison ivy Rhus toxicodendron (irritating to the skin), extracts of bittersweet nightshade Solanum dulcamara (containing triterpenoids and steroids), colloidal silicic acid (Acidum silicicum), sublimated sulfur (Sulphur), coenzyme A, extracts from the umbilical cord tissue and placenta of cattle, etc. The manufacturer claims that this homeopathic ointment for osteochondrosis not only has an analgesic effect, but also stimulates the restoration of cartilage tissue by activating the formation of new chondrocytes.

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Pharmacokinetics

Diclofenac ointment and Ketonal ointment are quickly absorbed into the skin, partially enter the systemic bloodstream and bind to plasma proteins. The time to reach the highest concentration of active substances is almost 120 minutes. The metabolism of these drugs occurs in the liver, the transformation products are excreted by the kidneys within 1.5-2 hours.

After application of the ointment, chondroprotectors (Chondroitin ointment) also penetrate into the blood and accumulate in the intra-articular fluid and cartilage; the bioavailability of chondroitin sulfate is slightly more than 12%, and its maximum content is noted after about 3.5 hours. It is excreted from the body within 24 hours with urine

The pharmacokinetics of other ointments (turpentine, Ziel T, with menthol or bee venom) are not explained in the instructions for the drugs.

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Dosing and administration

Ointments for osteochondrosis are applied externally by applying a small amount of the preparation to the skin in the area of the diseased joint (lightly pressing in):

• ointments containing camphor, turpentine ointment and ointment with bee venom - once a day;
• Diclofenac, Ketonal, Kapsikam ointments – twice a day (1-2 g);
• chondroprotective ointments – 3-4 times a day (the column of ointment squeezed out is 1-1.5 cm);

Homeopathic ointment for osteochondrosis Ziel T – up to five times a day.

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Use ointments for osteochondrosis during pregnancy

Most often, the use of ointments for osteochondrosis by pregnant women is not recommended. Diclofenac ointment is prohibited in the last three months of pregnancy, Ketonal ointment, as well as ointments with turpentine, menthol, camphor and bee venom - throughout pregnancy.

According to the instructions, chondroprotective ointments (Chondroitin ointment, etc.) should be prescribed during pregnancy and lactation only when absolutely necessary.

No homeopathic ointment for osteochondrosis should be used in the treatment of pregnant women, as most drugs of the homotoxic group.

Contraindications

Ointments with NSAIDs (Diclofenac ointment, Ketonal ointment, etc.) are contraindicated in cases of bronchial spasms and allergic rhinitis and dermatitis.

Ointments with menthol, Kapsikam, Bon-benge, turpentine ointment, Ziel T ointment are not used in case of increased reaction to the components of these products.

Contraindications for Apizartron ointment include skin damage and dermatological diseases, as well as kidney problems; chondroprotective ointments for osteochondrosis - acute inflammatory processes in the area of application, allergies, skin diseases, thrombophlebitis.

Side effects ointments for osteochondrosis

Skin itching and rashes may occur when using ointments based on NSAIDs, Kapsikam and Ziel T ointments, Chondroitin ointments, ointments with bee venom (Apizartron) and turpentine ointments.

Side effects of menthol ointment may include general weakness, decreased blood pressure, and dizziness.

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Overdose

The instructions for the described drugs do not mention their overdose.

Interactions with other drugs

Diclofenac ointment and Ketonal ointment potentiate the action of antibacterial and antifungal drugs for external use.

Information regarding the interaction of other ointments is not provided by manufacturers, however, it is recommended to avoid the simultaneous use of other ointments and any local agents.

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Storage conditions

Diclofenac, Ketonal, Ziel T, Apizartron ointments should be stored at t< +25°C; chondroprotective ointments – at t< +20°C; ointments with menthol and turpentine ointment – at t< +15°C;

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Shelf life

The expiration date of the drugs is indicated on the packaging.

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