Treatment of autonomic disorders in the limbs
Last reviewed: 19.10.2021
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The treatment of autonomic disorders in the limbs is based on the effect on the primary factors that cause these disorders. Therapeutic effect in neurovascular syndromes of extremities should be directed, in turn, to the sources of vascular and trophic disorders: osteochondrosis of the spine, abnormalities and deformations of the skeleton, muscles, fascia, compression and edema of the roots, atherosclerosis of the vessels, etc. The main principle of treating patients with various manifestations osteochondrosis of the spine - a combination of orthopedic and physiotherapy measures, as well as pharmacological treatment.
Orthopedic measures include: special treatment (position on the shield, on the inclined plane), extension of the lumbar and cervical spine on special devices. Novocaine blockades are recommended: epidural according to Cutlene, paravertebral, muscular (anterior staircase, lower oblique muscle of the head, small thoracic, gastrocnemius, pear-shaped). To prolong the effect of novocaine and the local anti-inflammatory effect, hydrocortisone, vitamin B12, and lidase are added to the solution of novocaine. In addition, drug treatment should include analgesics, dehydrating drugs, ganglion blockers, vitamins, etc. Physiotherapy is used: electrophoresis of medicinal substances, sinusoidal-modulated currents, magnetotherapy, ultrasound, inductothermy, etc .; massage, exercise therapy, sanatorium treatment (hydrogen sulphide, sodium chloride baths, etc.).
Cases of persistent pain syndromes, prolonged unsuccessful conservative therapy, presence of signs of organic changes in muscles, compression of the neurovascular formations should be considered as indications for surgical treatment. Carry out various types of surgical interventions (various operations on the spine, the intersection and excision of pathologically altered muscles).
There are no effective methods of treating hereditary neuropathies. Nevertheless, supportive and symptomatic therapy plays an important role in their treatment. All patients are advised to avoid excessive weight gain and exercise regularly. Preventing the development of ulcers on the feet and their complications is paramount. For this purpose, patients are not recommended to walk barefoot; Foot should be regularly lubricated with petroleum jelly. Already developed ulcers should be protected from pressure of body weight until complete healing takes place. In case of infection, it may be necessary to use antibiotics.
Compression-ischemic neuropathies should not be considered as a purely local process, therefore their treatment should provide for the elimination of disturbances caused by both damage to the nerve itself and changes in other parts of the nervous system and the whole organism. Conservative therapy should begin as soon as possible; its tasks - to eliminate or reduce the severity of pain, stimulate nerve conduction and regeneration of nerve fibers, improve general and local blood and lymph circulation, prevent the formation of scars, trophic disorders at the site of injury. For this purpose, various types of blockades using novocaine, hydrocortisone, anticholinergics, ganglion blockers, as well as neuroleptics, tranquilizers are used. The use of antihistamines (suprastin, dimedrol, etc.), vasoactive drugs (nicotinic acid, euphyllin, etc.) is shown. To correct the endocrine and hormonal changes and change the electrolyte balance, it is recommended to prescribe calcium salts, hormones. Very effective, especially for relief of pain syndrome, acupuncture, percutaneous electrical stimulation.