Treatment of osteochondropathy

In addition to drug therapy, the patient is prescribed a course of physiotherapy: therapeutic massages, electrophoresis, paraffin baths, heating, exercise therapy, shock wave therapy.

With the ineffectiveness of conservative methods of treatment and the development of serious complications, osteoplastic operations are performed. The nature of the surgery depends on the type of degenerative-dystrophic process in the bones, its severity, the age of the patient.

Treatment of the degenerative-dystrophic process in the bones requires an integrated approach. Medicines for osteochondropathy are selected by the attending physician, individually for each patient. The doctor takes into account the localization of pathology, its stage, characteristics and course and a number of other factors.

Painkillers

Relieve discomfort and acute pain. Very often, patients are prescribed agents of complex action, which, in addition to analgesic, have antipyretic and anti-inflammatory properties.

• Metamizole

Drug from the pharmacological group of NSAIDs of the pyrazolone series. It has analgesic, anti-inflammatory and antipyretic properties. Each capsule contains 500 mg of metamizole sodium. The active ingredient blocks the synthesis of PG from arachidonic acid and reduces the severity of the inflammatory response. The analgesic effect is caused by blocking the flow of pain impulses along the conductive beams of Gaulle and Burdah.

• Indications for use: pain syndrome of different nature and localization, feverish state, infectious and inflammatory processes, insect bites.
• Method of application: inside or parenteral 250-300 mg 2-3 times a day. A single dose should not exceed 1 g, the maximum daily - 3 g. The dosage for children is selected by the doctor, individually for each case.
• Side effects: oliguria, anuria, proteinuria, interstitial nephritis, allergic reactions. Local reactions, infiltration of soft tissues.
• Contraindications: hypersensitivity to the components of the drug, a history of bronchial obstruction, signs of hematopoietic depression, glucose-6-FDG deficiency, renal and / or liver failure. Use during pregnancy and lactation is prohibited due to the pronounced hepatotoxic effect of the drug.
• Overdose: hypotension, tachycardia, hypothermia, nausea and vomiting, increased drowsiness, convulsions, tinnitus. Treatment consists of detoxification measures with subsequent symptomatic therapy.

Product form: tablets for oral administration in 10 capsules per pack and 1, 2 ml ampoules with a colorless injection solution. There are also rectal suppositories that are widely used in pediatric practice.

• Ketorolak

Pain reliever, antipyretic and anti-inflammatory agent. Suppresses prostaglandin synthesis, prevents platelet adhesion.

• Indications for use: pain syndrome, postoperative pain.
• Dosage and administration depend on the form of release of the drug. For acute pain, take 30 mg 2-3 times a day. The maximum duration of treatment is no more than 5 days.
• Side effects: nausea, vomiting, abdominal pain, increased anxiety, headaches, sweating. Local reactions, stomatitis, abnormal liver function, skin allergic reactions, asthma attacks.
• Contraindications: intolerance to the components of the medicine, erosive and ulcerative lesions of the gastrointestinal tract in the acute phase, renal dysfunction, pregnancy and lactation, patients under 16 years of age.

Product form: 10 mg tablets and injection solution in 1 ml ampoules.

• Dexketoprofen

Contains the active ingredient - dexketoprofen trometamol. It has analgesic, anti-inflammatory and antipyretic properties. Included in the class of NSAIDs.

• Indications: mild to moderate pain, musculoskeletal pain, toothache, dysmenorrhea.
• How to use: orally, the dosage depends on the severity of pain. For adults, 12.5 mg every 4–6 hours is recommended. The daily dose should not exceed 75 mg. The duration of treatment is determined by the attending physician.
• Contraindications: intolerance to dexketoprofen and other NSAIDs, bronchial asthma, bronchospasms, acute rhinitis, urticaria. Not used for bleeding or perforation in the digestive tract in history, chronic dyspepsia, heart failure, abnormal liver function, in the last trimester of pregnancy and during lactation.
• Overdose: disorders of the digestive tract, increased drowsiness and irritability, headaches, disorientation. Symptomatic treatment, hemodialysis is effective.
• Adverse reactions: neutropenia, thrombocytopenia, laryngeal edema, anaphylactic reactions, anxiety, sleep and appetite disturbances. Blurred vision, tinnitus, vertigo, tachycardia, various disorders of the gastrointestinal tract.

Form release: tablets of 10 pieces in a blister of 1.3 blisters in the package.

• Larfix

Non-narcotic analgesic with the active ingredient from the group of oxycams - lornoxicam. Effectively relieves and exhibits anti-inflammatory properties.

• Indications for use: moderate or moderate pain syndrome, pain in degenerative and inflammatory rheumatic diseases.
• How to use: orally, before meals, with a large volume of liquid. With severe pain, take 4-8 mg 2-3 times a day, the maximum daily dose is not more than 16 mg.
• Side effects: ulcerative stomatitis, nausea, vomiting, dyspepsia, increased gas formation in the intestines, exacerbation of colitis and Crohn's disease, allergic reactions, disorders of the cardiovascular system.
• Contraindications: intolerance to the components of the drug, thrombocytopenia, severe heart failure, hematological disorders, pediatric practice, peptic ulcer, bleeding tendency, pregnancy and lactation.
• Overdose: development of cerebral syndromes, nausea, vomiting, ataxia, seizures, coma, impaired blood clotting and liver function. There is no specific antidote, the treatment is symptomatic.

Form release: oral tablets of 10 pieces in a blister, in packs of 3, 10 blisters.

• Ibuprofen

Anesthetic medicine with anti-inflammatory and antipyretic properties. Contains the active ingredient - ibuprofen 200 mg.

• Indications for use: traumatic inflammation of soft tissues and musculoskeletal system, rheumatoid arthritis, osteoarthritis, bursitis, neuralgia, myalgia, sciatica, ankylosing spondylitis. Combined therapy of diseases of upper respiratory tract, headache and toothache.
• Method of application: 400-600 mg 3-4 times a day, the maximum daily dose of 2.4 g.
• Side effects: disorders of the gastrointestinal tract, headaches, increased anxiety and agitation, allergic reactions, bleeding from the gastrointestinal tract, bronchospasms, visual impairment.
• Contraindications: hypersensitivity to the components of the drug, erosive and ulcerative gastrointestinal lesions, ulcerative colitis, hematopoietic disorders, patients under 6 years of age, diseases of the optic nerve, marked impaired renal / liver function. Use during pregnancy and lactation is possible only for medical purposes.
• Overdose: abdominal pain, nausea, vomiting, increased drowsiness, headaches, metabolic acidosis, acute renal failure, bradycardia, respiratory arrest. Symptomatic treatment.

Form release: coated tablets, 100 pieces per pack. Each capsule contains 200 mg of active ingredient.

Anti-inflammatory

NSAIDs have an antirheumatic effect and, unlike analgesics, affect the joints. They are prescribed in conjunction with probiotics, because they adversely affect the digestive tract.

• Diclofenac

NSAIDs from the pharmacological group of phenylacetic acid derivatives. Contains the active ingredient - diclofenac sodium. It has pronounced anti-inflammatory, antipyretic and analgesic properties. Weakens pain in the joints, reduces morning stiffness and swelling of the joints, increases their range of motion.

• Indications for use: inflammatory diseases of soft tissues and joints, injuries of the musculoskeletal system, rheumatism, rheumatoid arthritis, ankylosing spondylitis. Acute attack of gout, arthrosis, lumbago, sciatica, primary dysmenorrhea. Postoperative pain syndrome.
• Method of application: intramuscularly, the dosage is selected by the doctor, individually for each patient. Duration of treatment is 4-5 days.
• Side effects: dyspeptic disorders, erosive and ulcerative lesions and bleeding in the gastrointestinal tract, allergic reactions, increased drowsiness, headaches, irritability. Local reactions at the injection site, burning, abscess, necrosis of adipose tissue. Overdose is manifested by increased side effects, symptomatic treatment.
• Contraindications: hypersensitivity to the components of the drug, gastric ulcer and duodenal ulcer, gastrointestinal tract bleeding, the last trimester of pregnancy and lactation, urticaria, bronchial asthma, patients younger than 6 years.

Form release: solution for injection in 3 ml ampoules. In packing 5, 10 ampoules for injections.

• Indometacin

Active nonsteroidal anti-inflammatory agent. Inhibitor of prostaglandin biosynthesis. Effectively numb.

• Indications for use: rheumatoid arthritis, periarthritis, ankylosing spondylitis, gout. Inflammatory lesions of the connective tissue and the musculoskeletal system, thrombophlebitis, nephrotic syndrome. Pain in the spine, neuralgia, myalgia, traumatic inflammation of the soft tissues and the musculoskeletal system. Diffuse diseases of the connective tissue, algomenorrhea.
• Method of administration: orally, after meals. The initial dosage is 25 mg 2-3 times a day with an increase to 100-150 mg, divided into 3-4 doses per day. The maximum daily dose of 200 mg. The duration of treatment is up to 4 weeks. For acute pain, intramuscular injection of 60 mg 1-2 times per day is possible.
• Side effects: headaches and dizziness, increased drowsiness, nausea, vomiting, loss of appetite, ulceration in the stomach, gastrointestinal bleeding, allergic reactions.
• Contraindications: intolerance to the components of the drug, pregnancy and lactation, peptic ulcer and duodenal ulcer, bronchial asthma.

Product form: 25 mg pills and capsules, 1 ml injection solution in ampoules, rectal suppositories.

• Nimesulide

NSAIDs from the class of sulfonanilides. Contains active ingredient Nimesulide 100 mg. It has a pronounced anti-inflammatory, antipyretic and analgesic effect. It has antioxidant properties. The therapeutic effect develops within 20 minutes after taking the drug, which is very effective in acute attacks of pain.

• Indications for use: rheumatoid arthritis, arthrosis, myalgia, bursitis, pain syndromes of different origin.
• Method of application: oral 100 mg 2 times a day, after meals. The maximum daily dose is 400 mg. The duration of treatment depends on the severity of the disease state. The drug in the form of a gel is applied to the affected tissue 2-4 times a day, easily rubbing it into the skin. Use under the bandage is contraindicated.
• Side effects: headaches and dizziness, nausea, vomiting, increased drowsiness, oliguria, urticaria, anaphylactic shock, hematuria, gastralgia, changes in the blood picture. If applied topically, local allergic reactions, itching, irritation, discoloration of the skin, peeling are possible.
• Contraindications: hypersensitivity to the components of the drug, the age of patients under 12 years, pregnancy and lactation, renal / hepatic failure, ulcers and gastrointestinal bleeding.
• Overdose: nausea, vomiting, gastrointestinal bleeding, epigastric pain, drowsiness, acute renal failure, arterial hypertension, respiratory depression. There is no specific antidote, the treatment is symptomatic.

Product form: 100 mg tablets, granules for the preparation of oral suspension, 0.1% gel.

• Meloxicam

Drug from the group of oxycams with the active ingredient - meloxicam. Provides a pronounced analgesic and anti-inflammatory effect.

• Indications for use: chronic polyarthritis, exacerbation of arthrosis, ankylosing spondylitis, rheumatoid arthritis.
• Dosing: orally 1 tablet per day with meals. The solution for injection is administered intramuscularly 1 time per day. The duration of treatment depends on the severity of the disease state.
• Side effects: changes in the blood system, headaches and dizziness, disorders of the gastrointestinal tract, increased blood pressure, tachycardia, renal dysfunction, asthmatic attacks, allergic reactions.
• Contraindications: intolerance to the components of the drug, ulcers in the digestive system, gastrointestinal tract bleeding, pregnancy and lactation, patients under 15 years old, heart failure, renal / hepatic failure, cerebrovascular bleeding.
• Overdose: nausea, drowsiness, abdominal pain, increased blood pressure. Symptomatic treatment.

Form release: tablets of 15 and 7.5 mg, 20 pieces per pack. The solution in ampoules for intramuscular injections of 1.5 ml in 5 ampoules per pack.

• Adtal

NSAIDs with the active substance - aceclofenac. It has anti-inflammatory, analgesic and antipyretic properties. Effectively relieves pain, morning stiffness and swelling of joints in rheumatic diseases.

• Indications for use: pain syndrome, a decrease in the intensity of the inflammatory process. Lumbago, shoulder blade periarthritis, rheumatic soft tissue diseases, toothache, osteoarthritis, ankylosing spondylitis.
• How to use: orally, squeezed with a small amount of water. Daily dosage 1 tablet 1-2 times a day. The duration of treatment is determined by the attending physician.
• Side effects: nausea, vomiting, impaired stool and digestion, intestinal spasms, erosive and ulcerative lesions of the mucous membrane of the gastrointestinal tract, stomatitis. Headaches and dizziness, irritability, disturbed sleep and wakefulness, emotional lability. Renal failure, edema, cardiac arrhythmia, anemia, allergic reactions.
• Contraindications: individual sensitivity to the components of the drug, pregnancy and lactation, ulcerative lesions of the gastrointestinal tract, gastric bleeding, impaired renal / liver function, blood formation disorders, patients under 18 years of age.
• Overdose: headache and dizziness, abdominal pain, nausea, vomiting, hyperventilation with increased seizure activity. There is no specific antidote, the treatment is symptomatic.

Form release: coated tablets, 10 pieces in a blister, 2, 6 blisters per pack.

[1], [2], [3]

Vasodilator

Normalize the processes of microcirculation in the affected limb, stimulate the processes of regeneration, including osteogenesis.

• Aktovegin

Deproteinized hemoderivat from the blood of calves. Activates cellular metabolism by increasing the transport and accumulation of oxygen and glucose. Strengthens their intracellular utilization. Accelerates the metabolism of adenosine triphosphate, increases the energy resources of the cell.

• Indications for use: cerebral blood flow insufficiency, craniocerebral injuries, disturbances of peripheral circulation, disturbance of vascular tone. Trophic disorders in varicose veins of the lower extremities, ulcers of various origins, bedsores, burns. Corneal and scleral injuries, skin radiation lesions.
• Method of application: orally take 1-2 tablets 3 times daily before meals. Intravenously / intraarterially administered 10-20 ml 1 time per day. The gel is applied to clean and treat ulcers and open wounds. The duration of therapy is determined by the attending physician.
• Side effects: urticaria, excessive sweating, fever, itching and burning in the area of application.
• Contraindications: hypersensitivity to the drug. Use during pregnancy and lactation is possible only for medical purposes.

Product form: drops of 100 pieces per pack, injection solution in ampoules of 2.5 and 10 ml, solution for infusions of 10 and 20%, gel 20%, cream 5%, ointment 5%, eye gel 20%.

• Solcoseryl

Extract blood of cattle. Improves metabolic processes in tissues, accelerates regeneration processes.

• Indications for use: obliterating vascular diseases of the extremities, chronic venous insufficiency of the lower extremities, diabetic angiopathy, burns of 2–3 degrees, bedsores, maceration, erosion.
• Method of application: intramuscularly, intravenously or topically in the form of ointment / jelly. The dosage is selected individually for each patient.
• Side effects: local allergic reactions that do not require cessation of therapy.

Product form: solution for injection of 2.5 and 10 ml in ampoules, ointment and jelly in tubes of 20 g, eye gel 5 g.

• A nicotinic acid

The drug with the active component is pyridinecarboxylic-3 acid. Takes part in redox processes in the body. It is used as an antipellara agent. Improves carbohydrate metabolism, accelerates the healing of wound surfaces, has a vasodilator effect.

Nicotinic acid is taken orally and parenterally. The dosage and duration of therapy is determined by the attending physician. Side effects are manifested by allergic reactions, a feeling of rush of blood to the head, paresthesias. The drug is contraindicated in hypertension and atherosclerosis. Available in the form of tablets, powder, solution for injection.

• Nicoscope

The vasodilator drug with the active ingredient is drotaverine hydrochloride and nicotinic acid. It is used to treat and prevent vascular spasms of the brain and peripheral vessels.

The drug is taken orally after meals 1 tablet 1-3 times a day. For intramuscular use, use 1-2 ml of the solution 1-2 times a day. For disorders of peripheral circulation, the drug is slowly injected into the femoral artery, 1-2 ml.

Side effects are manifested by allergic reactions, dizziness, heart palpitations, increased sweating. Nikoshpan contraindicated in angle-closure glaucoma, prostatic hypertrophy. The drug is available in the form of tablets and ampoules with a solution for injection.

• Dipyridamole

Vascular dilating agent, improves blood flow and supplies blood vessels with oxygen. Reduces systemic blood pressure and improves cerebral circulation.

Indications for use: prevention of postoperative thrombosis, disorders of cerebral circulation. Improving the metabolic processes in the body. The drug is taken in 25 mg 2-3 times a day. Side effects are manifested by allergic reactions, heart palpitations, facial flushing.

Dipyridamole is contraindicated for intravenous administration, for sclerosing atherosclerosis of the coronary arteries. Available in the form of tablets of 25, 75 mg and in the form of a solution of 0.5% in 2 ml ampoules.

Chondroprotectors and cartilage tissue modifying drugs

Restore the articular cartilage and protect it from damage. Contribute to the restoration of joint function, reduce the clinical manifestations of articular pathologies, relieve pain.

• Alflutop

Contains extract from marine fish. It has chondroprotective effect, regulates the metabolism in the cartilage tissue. It has analgesic and anti-inflammatory properties. The preparation includes such components: hyaluronic acid, mucopolysaccharides, dermatan sulfate, chondroitin sulfate, creatine sulfate, polypeptides, amino acids, micro and macroelements, rosemary essential oil.

• Indications for use: osteochondrosis, osteoarthritis, periarthritis, spondylosis, paradontopathy, fibromyalgia, traumatic dysostosis. The recovery period after joint surgery.
• Method of application: intramuscularly 1 ml per day. The course of treatment consists of 20 injections. With intraarticular lesions, the medication is injected into the joint by 2 ml per injection for 3 days.
• Side effects: allergic reactions, itching, irritation at the injection site, skin redness, arthralgia. Temporary increase in pain due to the activation of metabolic processes. Cases of overdose not recorded.
• Contraindications: hypersensitivity to the drug, pregnancy and lactation. It is prescribed with special care for the treatment of children and undergrowths, since there are no clinical data confirming the safety of the drug for this age group.

Product form: injection solution in ampoules of 1 ml and 10 ampoules in a package.

• Artra

Combined chondroprotective agent with chondroitin sulfate, glucosamine hydrochloride. Contributes to the restoration of cartilage and improves joint mobility. Reduces the severity of pain in degenerative-dystrophic diseases of the joints. In combination with glucosamine, it slows down degenerative processes, preventing the destruction of cartilage tissue.

• Indications for use: complex treatment of degenerative-dystrophic diseases of the musculoskeletal system, osteoarthritis of the spine and peripheral joints.
• Dosing: oral, 1 tablet twice a day for 3 weeks. Duration of treatment is 4-6 months.
• Side effects: epigastric pain, abnormal stool, flatulence, dizziness, allergic reactions.
• Contraindications: intolerance to the components of the drug, renal dysfunction, pregnancy and lactation. It is prescribed with special care for patients with asthma, diabetes, bleeding tendency and in pediatric practice.

Product form: film-coated tablets of 30, 60, 100, 120 pieces in polymer bottles.

• Terraflex

The combined agent contains two active ingredients: glucosamine hydrochloride and sodium chondroitin sulfate. Slows down the destruction of cartilage tissue. It reduces the activity of enzymes that promote degenerative processes in cartilage. Stimulates the regenerative processes of articular tissue.

• Indications for use: complex treatment of diseases of the musculoskeletal system with degenerative-dystrophic changes in the articular tissue. Osteoarthrosis, osteochondrosis, traumatic bone damage. Acceleration of regenerative processes and the formation of callus.
• Method of application: inside, from 1 to 21 days, 1 capsule 3 times a day, later on 1 capsule twice a day. The course of treatment for at least 2 months.
• Side effects: dyspeptic disorders, allergic reactions. Overdose is manifested by the same symptoms. For treatment, dose adjustment or withdrawal of the drug is indicated.
• Contraindications: intolerance to the components of the drug, pregnancy and lactation, phenylketonuria.

Form release: capsules for oral administration of 30, 60 and 120 pieces per pack.

• Structum

Chondroprotective drug with the active component - chondroitin sulfate sodium salt. Restores and maintains the normal structure of the cartilage matrix. Increases the anabolic activity of chondrocytes, stimulates the synthesis of proteoglycans. Stimulates the synthesis of hyaluronic acid, normalizes the viscosity of synovial fluid.

• Indications for use: complex therapy of degenerative dystrophic diseases of the spine and joints, osteoarthrosis, intervertebral osteochondrosis.
• Dosing: oral, 1 capsule 2 times a day. The course of treatment depends on the severity of the disease state and is determined by the attending physician.
• Side effects: nausea, vomiting, dyspeptic disorders, allergic reactions. Overdose has similar symptoms, symptomatic treatment.
• Contraindications: hypersensitivity reactions to the components of the drug, patients under 15 years of age, pregnancy and lactation.

Form release: capsules of 12 pieces in a blister of 5 blisters per pack.

• Wobenzym

Combined drug with enzymes of plant and animal origin. It has immunomodulatory, anti-inflammatory, fibrinolytic and anti-edematous properties. Improves resorption of hematomas, normalizes blood viscosity and its microcirculation. Provides tissue with oxygen and nutrients.

• Indications for use: rheumatoid arthritis, extra-articular rheumatism, thromboangiitis obliterans, thrombophlebitis, post-thrombotic syndrome, vasculitis, lymphedema. Urological and gynecological diseases. Treatment and prevention of postoperative complications, post-traumatic processes. Prevention of microcirculation disorders.
• Method of application: orally 5-10 tablets 3 times a day. The medicine is taken 30 minutes before a meal, washed down with plenty of water.
• Side effects: allergic reactions, changes in stool consistency.
• Contraindications: intolerance to the components of the drug, hemophilia, thrombocytopenia. Use during pregnancy and lactation is possible only for medical purposes.

Form release: tablets with an enteric coating of 40, 200 and 800 pieces per pack.

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Means to restore the intestinal microflora, improving the absorption of beneficial trace elements

1. Enterohermine

Drug with 2 billion spores of Bacillus clausii. Restores the normal qualitative and quantitative composition of the intestinal microflora, normalizes the endogenous synthesis of vitamins. It is resistant to antimicrobial agents, therefore it can be used during antibacterial treatment.

• Indications for use: intestinal microflora disorders, endogenous vitamin balance disorders, digestive disorders due to intestinal microflora disorders.
• Method of application: oral, for the preparation of suspensions, you can use water, juice, tea or milk. The dosage and duration of treatment is determined by the attending physician, for each patient individually.
• Side effects: allergic skin reactions, urticaria.
• Contraindications: intolerance to the components of the drug. Cases of overdose and adverse reactions have been identified. Use during pregnancy and lactation is allowed.

Form release: suspension for oral administration in vials of 5 ml, 10, 20 bottles per pack.

2. Bifidumbakterin

Dried live bifidobacteria with the addition of lactose, that is, bifidogenic factor. It exhibits antibacterial activity against a wide range of pathogenic and conditionally pathogenic microorganisms. Restores the intestinal microflora, normalizes the gastrointestinal tract, has an immunomodulatory effect.

• Indications for use: violation of the composition of the normal intestinal microflora, intestinal dysfunction. Sanitation of the genital tract during prenatal preparation.
• Method of application: 3-5 doses of the drug three times a day. The duration of treatment is determined by the attending physician.

Form release: powder for suspension in bags of 5 doses, in the package 5 bags.

3. Bifiquol

Dried raw materials of live bifidobacteria. It has antimicrobial properties, normalizes the intestinal flora.

• Indications for use: dysbacteriosis, acute dysentery, colitis, enterocolitis, ulcerative colitis, viral diarrhea on the background of dysbacteriosis. Restoration of intestinal microflora.
• Method of application: inside 30 minutes before meals. Per day take 1-5 doses, diluting the drug in boiled water (1 dose - 1 teaspoon of medication). The course of treatment of 14 days.

Form release: ampoules and vials of 3 doses.

4. Actiophilic simbiter

Multiprobiotic in a non-lyophilized form with a symbiotic association of 14-24 strains of bifidobacteria. Possesses a wide range of probiotic properties, shows antagonistic activity to pathogenic and conditionally pathogenic microorganisms. Activates specific and nonspecific immunity.

• Indications for use: normalization of intestinal microflora, improvement of digestion, normalization of stool and elimination of constipation. Strengthening the overall condition of the body. Normalization of microflora after antibiotic therapy.
• How to use: orally, the contents of the bag is diluted in 20 ml of water or boiled milk. The medicine is taken every 12 hours for 21-28 days.
• Contraindications: individual hypersensitivity to the drug. Does not cause symptoms of overdose and adverse reactions. Approved for use during pregnancy and lactation.

Form release: bags of 10 g in 10 pieces per pack.

Dimexide from osteochondropathy

A drug with pronounced local anesthetic, anti-inflammatory and antimicrobial properties is Dimexide. Contains the active ingredient - dimethyl sulfoxide 50/100 ml. Changes the sensitivity of microflora resistant to antibacterial drugs.

• Indications for use: osteoarthritis, sprain, arthropathy, ankylosing spondylitis, rheumatoid arthritis and other inflammatory lesions of the musculoskeletal system. It is prescribed for bruises, inflammatory edema, purulent wounds and abscesses, osteomyelitis, nodular erythema, streptoderma. Effective with cervical osteochondrosis.
• Method of application: externally, in the form of aqueous solutions of 30-50% for compresses. Moistened in the dressing bandage impose on the affected areas, capturing a bit of healthy skin.
• In aseptic necrosis, Dimexide is diluted in proportion of 1 part of 10% of the preparation and 9 parts of distilled water. Compresses are recommended to be covered with wax paper or wrapped with a bandage on top, changing them every 5-10 minutes. The duration of the procedure should not exceed 10-15 minutes. The prepared solution can be used within 12 hours.
• Side effects: erythema, pruritus, peeling of the skin, dizziness, insomnia, dermatitis, bronchospasm, adynamia. Overdose is more pronounced adverse reactions. Symptomatic treatment, there is no specific antidote.
• Contraindications: individual intolerance to the components of the drug, pregnancy and lactation, patients under 12 years of age. Glaucoma, cardiovascular insufficiency, diseases of the liver and kidneys, myocardial infarction and stenocardia, stroke, atherosclerosis

Product: liquid in bottles of 50 and 100 ml.

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Vitamins

One of the essential components of the treatment of aseptic necrosis of any location is multivitamin complexes. They are recommended to be taken during the period of active formation of the skeleton, that is, from 1 year to 25 years, as well as to increase the protective properties of the immune system.

1. Calcium

Among all the chemical elements in the body, calcium has the highest content. This trace element is involved in metabolic processes, promotes the transmission of impulses through the nerve cells, and also responds to healthy growth and regeneration of bone tissue. Partially blocks saturated fats in the digestive tract and lowers cholesterol levels in the blood.

• Kalcemin is a mineral-vitamin complex, containing: calcium citrate, calcium carbonate, copper, cholecalciferol, zinc, manganese, and other components. It is used for the prevention of diseases of the musculoskeletal system, dental pathologies. Restores the deficiency of vitamins and minerals in the body. Recommended for children during the period of intensive growth, as well as during pregnancy and lactation.
• Calcium D3 Nycomed - a combined agent, contains calcium and cholecalciferol. Regulates calcium phosphorus metabolism, compensates for the lack of calcium in the body. Regulates calcium absorption in the digestive tract and its distribution in the body. Used in complex therapy and for the prevention of osteoporosis, calcium deficiency, cholecalciferol.
• Osteogenone - regulates phosphorus-calcium metabolism, stimulates osteoblasts and inhibits osteoclasts. Restores the balance between the processes of bone resorption and bone tissue repair. Contains ossein-hydroxyapatite complex. It is used to treat diseases of the musculoskeletal system, dysplasia of the joints and connective tissue, osteoporosis. Combined therapy of rickets of the skeleton, scoliosis.
• Vitrum Calcium + Vitamin D3 - a complex drug to compensate for the lack of calcium in the body. Contains calcium carbonate from oyster shells, colecalciferol. It is used for prophylaxis, monotherapy and complex treatment of osteoporosis, to compensate for calcium deficiency and colecalciferol. Effective in the recovery period after injuries and fractures, during pregnancy, lactation, menopause.

2. The predecessors of the active form of vitamin D

Increase the absorption of calcium and phosphorus from the gastrointestinal tract. Increase the elasticity of bone tissue through improved protein synthesis.

• Alfaforcal is the precursor of the active metabolite of vitamin D3. It improves the absorption of calcium and phosphorus in the intestines, enhances bone mineralization, reduces the level of parathyroid hormone in the blood. Restores calcium balance reduces the incidence of bone fractures. It is used in osteoporosis, osteodystrophy, hyperparathyroidism, rickets, osteomalacia, Fanconi syndrome, psoriasis, renal acidosis.
• Oksidevit - normalizes calcium-phosphorus metabolism. It is used for osteopathic conditions, for the correction of calcium-phosphorus metabolism, for rickets and rickets-like diseases. Effective with bone pathologies to improve the supply of bone tissue and prevent its fragility.

3. Vitamins of group B

Increase the functionality of osteoblasts, improve protein synthesis in bone tissue and promote the penetration of magnesium into the bone.

• Neurobion is a complex remedy that contains neurotropic vitamins: thiamine, cyanocobalamin, pyridoxine. Takes part in intermediate metabolic processes in the central nervous system as coenzymes. It is prescribed for trigeminal neuralgia, intercostal neuralgia, cervical-brachial syndrome, plexitis, lumbago, sciatica, radicular neuritis, proplegia, herpes zoster.
• Neurorubin - contains water-soluble B vitamins that are involved in the body's metabolic processes. It is used in case of hypovitaminosis, pain syndromes, polyneuritis, neuralgia, damage to nerve structures, intoxication.

In addition to pharmacy vitamins, with osteochondropathy, a balanced diet is very important. In the diet of the patient must be rich in calcium and phosphorus products, and plenty of drinks.

Physiotherapy treatment

Combined therapy of aseptic necrosis includes physiotherapeutic methods of treatment. Physical therapy is aimed at:

• Improving the blood supply to the affected area.
• Reducing pain.
• Acceleration of regeneration processes.
• Reducing the severity of dystrophy.
• Decreased bone demineralization.
• Restoration of joint function.

Consider the most popular physiotherapy for osteochondropathy of various localization:

1. Laser therapy is one of the most effective and safe treatments. The course consists of 12-20 sessions held every other day. The procedure is contraindicated in blood diseases, tumor neoplasms, infectious pathologies, hyperthyroidism, heart attack, bleeding.
2. Thermal procedures - this category includes paraffin therapy, ozokerite, mud therapy. They improve blood circulation in the damaged area, promote the penetration of biologically active substances through the skin, improve metabolic processes. Treatment is contraindicated in acute inflammatory processes, oncological diseases, blood and kidney diseases, bleeding, purulent lesions of the body.
3. Decompression of the affected bone - using a large needle in the bone tissue makes a puncture. This allows you to increase the blood supply to this area through the growth of blood vessels inside the puncture. Also, intraosseous pressure is reduced, thereby reducing pain.
4. Manual therapy - is carried out in the event that necrosis is caused by the pinching of the joint during trauma, stroke. Massage improves blood circulation, improves the condition of tissues, warms. The procedure is contraindicated at elevated body temperature, inflammation of the joints in the active phase of the disease, blood diseases and a tendency to bleeding, thrombosis, various neoplasms, pronounced lesions of the skin of the treated area.
5. Hirudotherapy - treatment with medical leeches with aseptic necrosis is aimed at improving metabolic processes, increasing the elasticity of tissues and the immune properties of the body. Enzymes secreted by leeches dissolve blood clots and improve blood circulation.

In addition to the above physiotherapy, patients can be assigned to anesthetic methods (suf-irradiation, diadynamic therapy), tropostimulating, reparative-regenerative and defibroziruyuschie methods (electrophoresis, radon and sodium chloride baths).

Exercises for spinal osteochondropathy

In degenerative-dystrophic processes in the bones of the spine, the treatment consists of a complex of various methods. Particular attention is paid to exercises that are aimed at:

• Improving the blood supply in the spinal column.
• Restoration of metabolic processes in the vertebrae.
• Reducing pain.
• Restoration of the functionality of the muscular system of the back.

Features exercise therapy for osteochondropathy:

• In the preparation of a therapeutic complex, the degree of degenerative changes is taken into account. In severe forms of curvature before gymnastics conduct preparatory exercises aimed at relaxing muscles. Before and after exercise therapy can be massaged, which improves blood flow in the spinal column.
• In addition to therapeutic exercises, patients are shown wearing an orthopedic corset. It is prescribed with 2 degrees of curvature. Exercises are performed in the intervals between wearing corrective underwear.
• In the treatment of pediatric patients, not only exercise therapy and corsetting is prescribed, but also traction.
• Strength training in kyphoscoliosis 1, 2 degrees are not effective. Increased exercise can cause serious complications. Gym is better to replace the swimming, which is well strengthens the muscular frame of the back.
• In degenerative changes of grade 3 and 4, exercise therapy is used to prevent further progression of the disease. But the basis of the emphasis in treatment is on conservative methods.

Exercises in osteochondropathy of the thoracic spine are directed to the dynamic (muscular system) or stable component (bone and articular system) of the disease. Changes in muscles and ligaments without pronounced disorders of the vertebrae (1, 2 degree) need active gymnastics. Static changes (3, 4 degree) are difficult to correct and require surgical intervention.

Therapeutic complex for aseptic necrosis 1, 2 degrees:

• Swing your legs up and circular movements clockwise and counterclockwise from a standing position. Feet lift no higher than 45 °. For each limb, 10–12 repetitions in three sets.
• When lying down, alternately lift your legs up, bending at the knee joint and pressing to your chest. During the exercise, the second leg should be pressed to the floor. Perform 10 repetitions in 2-3 sets.
• Lift the right foot to the left knee and gradually extend in a bent position to the left and right. Run on the second leg. The exercise is repeated 10 times in 2 sets.
• Lying on your back, spread your legs shoulder-width apart. Alternately lift the legs, slowly summing the second. 10-15 times in 2-3 approaches.
• Lying on your stomach, fold your hands behind your head into a lock, spread your elbows to the sides. Lift the body up, slightly bending your knees and return to the starting position. Do 5-10 repetitions in 2 sets.

The orthopedist is engaged in drawing up complex medical gymnastics. The doctor makes recommendations regarding the load and frequency of classes. Before and after gymnastics, massage and douche are recommended.

[6], [7]

Alternative treatment

Another way to combat the degenerative-dystrophic process in the bones is alternative treatment methods. Nontraditional therapy is applied at the first stages of aseptic necrosis and only as an auxiliary method. Consider effective recipes to relieve pain.

• For severe pain, take a 0.5 liter glass jar and put pine buds into it. Mix vegetable raw materials with sugar and let it brew in a dark, warm place for a week. Strain the resulting syrup and take 2-3 teaspoons per day. Duration of treatment is 2-3 months.
• Take 50 g mint, eucalyptus and peeled aloe leaf. Chop everything thoroughly, pour 100 ml of water and put on medium heat. Boil until you get a homogeneous mass of consistency. Apply warm liquid to a sore spot as a compress, preferably before bedtime.
• Crush 3 leaves of ficus, shift into a glass container and pour 500 ml of vodka or alcohol. The tool should be infused in a dark place for 10-14 days. Then it is filtered and rubbed into the lesion.
• Analgesic and blood flow enhancing action has a tincture with sabelnik. Take 50 g of dry grass and cover with 1 liter of vodka, tightly close the lid and remove in a dark place for a month. Strain the prepared infusion and take 30 drops daily. The tincture can be rubbed into the skin.
• Take in equal proportions lard and nutria fat. Melt the ingredients and stir until a homogeneous mass is obtained. Rub the remedy into the affected joint every evening. The course of treatment must be at least 30 days.

Before applying the methods of alternative medicine should consult with your doctor. It should be borne in mind that the positive effect will be achieved with long-term, continuous use of therapeutic agents.

[8], [9], [10], [11]

Herbal medicine

Phytotherapy is a non-traditional treatment for aseptic necrosis. Herbal treatments are aimed at:

• Restoration of metabolic processes in the body.
• Improving the absorption of micro and macronutrients
• Accelerating the regeneration of damaged bone tissue.
• Anesthesia and improved blood supply.
• General toning and strengthening of the body.

When osteochondropathy can be used such recipes herbal medicine:

1. Take the sleep-grass, wood, and chernobylnik in the proportion 1: 1: 2. Fill the herbs with 500 ml boiling water and let it stand for 1 hour. Strain and take ¼ cup throughout the day. Infusion is suitable for the prevention of aseptic necrosis.
2. Take in equal proportions such herbs: St. John's wort, colza ordinary, calamus root, field yarutk and dandelion roots. Pour boiling water over raw materials, at the rate of a tablespoon of herbs per glass of water. Means insist hour, after straining drink in small sips during the day.
3. Daily take 1 part of the mummy the size of a match head. The tool should be consumed before meals, twice a day for 3-4 weeks.
4. To normalize the absorption of calcium and silicon, which are responsible for the strength of bones, use infusions of geranium, horsetail and knotweed. Plants accelerate regenerative processes and promote healing of fractures. Tablespoon of grass, pour a glass of boiling water and let it brew until it cools. Strain, take in small portions during the day, make compresses.
5. Also to speed up the healing of fractures help bath with infusion of horsetail, willow bark, hops, motherwort, knotweed. A liter of infusion is diluted in bathing water and take a bath for 10-15 minutes. Procedures can be carried out 2-3 times a week.

In order for herbal treatment to be effective, you should contact a herbalist. The doctor will select medicinal herbs and give recommendations on their use.

Homeopathy

Another alternative treatment for bone and joint damage is homeopathy. Homeopathic medicines are aimed at relieving acute pain and activating metabolic processes. When aseptic necrosis of any location can be prescribed such drugs:

• Abrotanum - rheumatic diseases, muscular rigidity, pain in the lower extremities.
• Arnica Montana - impaired local blood circulation, trauma, inflammatory reactions, suppuration, acute pain.
• Calcium fluoratum - frequent fractures, increased bone fragility.
• Calendula - open, difficult to heal wounds, fractures, injuries.
• Hypericum perforatum - acute pain due to damage or irritation of nerves, injury.
• Silicea Oligoplex - strengthens bone tissue, accelerates regenerative processes, is used for poorly growing fractures.
• Symphytum Oligoplex - relieves pain, stimulates the restoration of bone tissue
• Symphytum Officinale - stitching pains and increased sensitivity of lesions. Poor fractures.

All homeopathic medicines can be used only on prescription. The homeopath chooses the drug and makes recommendations for its use, determines the duration of therapy.

Surgery

If a conservative treatment of osteochondropathy did not produce the desired results, then surgical intervention is indicated. The operation can be assigned both in the early stages of the disease and in severe forms of aseptic necrosis. To date, there are many effective medical techniques, consider the most popular:

1. Decompression - in the bone, in the areas of lack of blood flow, drill neat channels. This allows to improve the blood supply due to the growth of new vessels in the holes created. The procedure reduces intraosseous pressure, effectively relieves acute pain.
2. Transplantation of a bone site is carried out with necrosis of stages 1, 2. Quickly relieves pain, strengthens the affected bone, improves blood circulation. When strengthening the femoral head, use a small portion of the fibula.
3. Endoprosthetics is a complete replacement of deformed bone tissue with artificial ones. Treats one of the most popular and effective medical methods. About 90% of all operations accounted for endoprosthetics. A special zirconium or titanium probe is inserted into the prepared articular cavity and fixed. In the second part of the articular articulation, a special bed is placed for the free movement of the joint. The operation allows you to fully restore the functionality of the lesion.

The most appropriate method of surgical treatment is chosen individually for each patient. The doctor takes into account the stage of the disease, symptoms and features of the patient.