Physiotherapy for osteochondrosis of the spine

Osteochondrosis of the spine is degenerative-dystrophic disease of the spine, characterized by reflex, root, spinal, vascular-radicular-spinal syndromes, vertebral artery syndrome. The main clinical manifestations of this disease are the pain syndrome of the corresponding localization and severity, as well as various vegetative-vascular disorders.

The main task of physiotherapy for osteochondrosis of the spine is to eliminate or significantly reduce the characteristic pains, which predetermines the choice of the method of physiotherapeutic influence.

As already noted, the methods of physiotherapy, which have predominantly analgesic effect, include (listed in order of decreasing clinical effectiveness):

• diadynamic therapy;
• short-pulse electroanalgesia;
• amplipulse therapy;
• drug electrophoresis;
• ultrasound therapy and drug phonophoresis;
• laser (magnetolaser) therapy.

The main ones are short-pulse electroanalgesia, drug electrophoresis and laser (magnetolaser) therapy.

Short-pulse electroanalgesia is recommended for patients with the aid of the apparatus "Dia-DENS-T".

Affect the exposed skin surface alternately with two fields of paravertebral in the area of greatest soreness when palpation of the corresponding segment of the spinal cord. Technique of exposure is contact, stable.

The frequency of electrical impulses with a pronounced pain syndrome is 77 Hz; with mild pains, and also after a significant reduction in the pain syndrome in the course of 10 Hz treatment.

The voltage of the electric current is strictly individual (based on subjective sensations in the form of a weak "tingling" under the electrode).

The first 2 - 3 days the procedure is carried out 2 times a day (in the morning on an empty stomach and before dinner), then until the end of the course of treatment - once a day in the morning hours (up to 12 hours). The exposure time per field is 10 min. The course of treatment is 5 to 15 procedures daily.

Medicinal electrophoresis of anesthetics is expedient to be carried out with the help of the device "Elfor-I" ("Elfor ™") according to the generally accepted methods of exposure in this pathology.

Laser (magnetolaser) therapy of spinal osteochondrosis with neurological manifestations can be performed in any conditions with a sofa, couch, bed. Devices with infrared emitters (wavelength 0.8 - 0.9 μm) are used both in the continuous mode of radiation generation and in the pulsed mode with the appropriate frequency. The position of the patient during the procedure is lying on his stomach. Technique of exposure is contact, stable.

Using irradiators OR with an irradiation area with a contact technique of about 1 cm2, the effect is carried out on exposed skin along the spine on the corresponding segment of the spinal cord in three fields: one - between the spinous processes of the vertebrae, the other two - the paravertebral left and right.

Fields of influence:

• I - III - the region of the segment of the spinal cord corresponding to the greatest pain in palpation of the spine or during its movement;
• IV - VI - the region of the segment of the spinal cord is higher than the most painful;
• VII - IX - the region of the segment of the spinal cord is higher than the previous one;
• X - XII - area of the segment of the spinal cord below the most painful;
• XIII - XV - the region of the segment of the spinal cord is lower than the previous one.

Using a matrix emitter of 5-20 cm ^{2, the} effect is performed on the exposed skin on the corresponding segment of the spinal cord with a single field, with the transverse location of the matrix radiator along the midline of the spine.

Fields of influence:

• I - area of the segment of the spinal cord corresponding to the greatest pain when palpation of the spine or during its movement;
• II - area of the segment of the spinal cord lower than the previous one;
• III - the area of the segment of the spinal cord is higher than the previous one.

MRP OR 5 - 10 mW / cm ². Induction of the magnetic nozzle 20 - 40 mT. Generation frequency of pulsed laser radiation: with severe pain syndrome 50 - 100 Hz; with mild pains, and also after a significant reduction in the pain syndrome in the course of 5 to 10 Hz treatment. Time of exposure to one field: in the cervical spine 1 min, in the thoracic spine - up to 2 min, in the lumbosacral - up to 5 min. The total time for one procedure with a continuous radiation regime up to 30 minutes, with a pulsed radiation regime up to 20 min. The course of laser (magnetolaser) therapy includes 10 to 15 procedures daily 1 time per day in the morning hours (up to 12 hours).

It is possible to consistently perform procedures in one day at home with osteochondrosis of the spine (interval between procedures is not less than 30 min):

• drug electrophoresis + laser (magnetolaser) therapy;
• drug electrophoresis + magnetotherapy;
• short-pulse electroanalgesia (in the morning) + drug electrophoresis (in the evening hours).

[1], [2], [3], [4]