Nonsteroidal anti-inflammatory drugs for external use in the treatment of musculoskeletal pain syndromes

July 30, 2020

To talk about local inflammation, you must first understand what lymphadenitis is in general. This is an inflammatory process in the lymph nodes, sometimes accompanied by suppuration

To talk about local inflammation, you must first understand what lymphadenitis is in general. This is an inflammatory process in the lymph nodes, sometimes accompanied by suppuration. It manifests itself through enlargement of one or more lymph nodes and can occur in several regions of the body at once. Clinical signs of the disease depend on the form and type of lymphadenitis: acute or chronic, regional (damage to lymph nodes of one anatomical group) and generalized (involvement of several groups of lymph nodes), serous, purulent, gangrenous, hemorrhagic, phlegmonous.

In the body, lymph nodes create a protective barrier against viruses, infections, cancer cells, participate in the formation of lymphocytes (special cells that destroy foreign microorganisms) and the production of phagocytes, antibodies (immune cells), participate in digestion and metabolic processes, distribute intercellular fluid between body tissues and lymph.

Normally, the lymph nodes are not palpable or are palpated in the form of elastic, small-sized formations that are not fused with adjacent tissues or with each other. Depending on the prevalence, the following types of lymphadenitis should be distinguished:

• local - enlargement of one lymph node in one of the areas (single cervical, supraclavicular lymph nodes);
• regional - enlargement of several lymph nodes in one or two adjacent areas (supraclavicular and axillary, supraclavicular and cervical, occipital and submandibular lymph nodes, etc.);
• generalized - enlargement of lymph nodes in three or more areas (cervical, supraclavicular, axillary, inguinal, etc.).

With axillary lymphadenitis, enlarged lymph nodes in the armpit are palpated. Symptoms of axillary lymphadenitis:

• Enlarged lymph nodes
• Painful sensations when palpating the affected area, turning the body, or moving
• Inflamed nodes are fused together with each other and adjacent tissues into one dense conglomerate
• The skin over the inflamed lymph nodes is hyperemic
• Symptoms of body intoxication appear - fever, weakness, headache, lack of appetite, feeling weak, muscle pain

Often the disease is accompanied by symptoms of the underlying disease; in addition, the patient may be bothered by:

• night sweats;
• weight loss;
• prolonged increase in body temperature;
• frequent recurrent upper respiratory tract infections;
• pathological changes on a chest x-ray;
• hepatomegaly;
• splenomegaly.

Diagnostics

The difficulties of differential diagnosis for local lymphadenopathy lie in identifying a local inflammatory process of an infectious (usually) or non-infectious nature. Lymphatic vessels supplying the upper extremities of the body, the chest wall and the mammary glands pass through the axillary lymph nodes, and as a result, the inflammatory process in this part of the body can provoke enlargement of the lymph nodes. Much less often, the pathogen enters the lymph node and directly through the skin of the axillary region when its integrity is violated. Possible causes of axillary lymphadenitis:

• panaritiums;
• erysipelas of the upper limb;
• phlegmon of soft tissues of the hand, forearm and shoulder;
• osteomyelitis of the bones of the upper limb;
• boils of the same localization;
• purulent mastitis;
• cat scratch disease;
• lymphoma;
• mammary cancer;
• melanoma.

Bacterial axillary lymphadenitis is caused by the following infectious agents:

• staphylococci and streptococci;
• Proteus wand;
• coli;
• enterobacteria

In order to establish the correct diagnosis, it is necessary to take into account the anamnesis and all clinical indications. Diagnosis is usually made using puncture biopsy of lymph nodes; if necessary, lymph node excision can be performed, followed by histological analysis. Before making a diagnosis, a number of examinations are carried out:

• lymphoscintigraphy;
• computed tomography;
• radiopaque lymphography.

Often a patient has to go through several specialists at once to verify the diagnosis, from a general practitioner to an infectious disease specialist, a venereologist, an oncologist and a therapist. The examination begins with palpation (palpation) of the areas where the nodes are located. If primary signs of lymphadenitis are detected, an ultrasound examination is first prescribed. Differential diagnosis should be carried out with systemic blood diseases (leukemia, lymphogranulomatosis), storage diseases (Gaucher, Niemann-Pick), immunopathological diseases (chronic granulomatous disease, juvenile rheumatoid arthritis, systemic lupus erythematosus, dermatomyositis, etc.), tumor metastases. Sometimes it is necessary to carry out a differential diagnosis with other surgical diseases, for example, breast cancer can metastasize to nearby (axillary lymph nodes) and then treatment will be aimed at the underlying disease.

Causes of leg swelling

When there is too much fluid in the tissues, it means that there is a malfunction in the functioning of the body. Most often, swelling is caused by:

• protein metabolism disorder;
• damage to cell membranes, increasing their permeability;
• changes in pressure differences in tissues and vessels;
• impaired blood circulation.

There are many reasons for such failures. Some are temporary (allergic reaction, bruise, infection). Others indicate the development of pathologies of the lower extremities (varicose veins, thrombophlebitis). Still others indicate serious diseases of the internal organs (heart, kidneys, lymphatic system).

A person cannot independently determine why his foot is swollen: because of uncomfortable shoes or because of a blocked blood vessel. Therefore, you should not postpone a visit to the doctor for subsequent treatment.

Treatment of axillary lymphadenitis

Treatment tactics for axillary lymphadenitis depend on the form and cause of the disease. In most cases, lymphadenitis does not require special therapy and goes away on its own after the underlying disease is eliminated. If the process is complicated by suppuration, then the treatment tactics completely change.

General recommendations: maintain rest, immobilize the affected area (do not rub or injure the affected lymph nodes), proper nutrition, take painkillers, anti-inflammatory medications. Therapy for acute axillary lymphadenitis depends entirely on the stage of the disease. Conservative treatment is used for the initial stages: UHF therapy, sanitation of the source of infection (opening of abscesses, leaks, cellulitis, drainage of the abscess), antibiotic therapy taking into account the sensitivity of the microbial flora in the main focus.

Surgical intervention is necessary for purulent axillary lymphadenitis: adenophlegmon, abscesses are opened, pus is removed, and the wound is drained. It happens that a biopsy confirms the presence of a tumor process - benign or malignant. Treatment may include radiation and chemotherapy. In the case of lymphadenitis, as in the presence of any other diseases, it is extremely dangerous to self-medicate.

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Medicines for treating injuries and wounds

Injuries and wounds, unfortunately, do not happen as rarely as we would like. In summer, the most common injuries are burns, bruises and minor injuries such as scratches and abrasions. But it should be remembered that any wound or injury requires serious treatment . Under certain conditions, even minor damage can cause serious consequences.

Burns
We mainly encounter household burns of the 1st (redness of the skin) and 2nd (formation of blisters) degrees.
Most often these are thermal burns - i.e. received as a result of contact with fire, heated objects, liquids, steam. Burns can also occur from exposure to the sun. The first thing to do is cool the burn area with cold water or a hypothermic pack. This will reduce pain. If you need to take painkillers, a good choice would be drugs based on ibuprofen: Next, Ibuprofen Medisorb
in capsule form, or a drug based on naproxen Theraliv 275, which is safe for patients with cardiovascular problems.

MestaMidin-sense Home
is
suitable as an antiseptic - it effectively fights germs without causing pain or irritation;
Chlorhexidine
or
ramistin
may also be used .
2nd degree burns can cause scarring. To prevent the appearance of scars and restore the skin, you need to regularly apply healing products. Usually these are drugs based on dexpanthenol
, because
it increases collagen production. This can be a spray, aerosol or foam, for example Panthenol
,
Librederm Panthenol

AfaPlast
liquid patch . They do not cause pain or discomfort when applied.
Children's Pan tenol BC foam spray
.
If you are more comfortable using drugs in the form of ointments and creams, you can use Romalen cream, Panthenol 6%, Dexpanthenol Vertex
.
For buyers who trust products with herbal composition, it would be advisable to offer Cikaderma
, which promotes healing and relieves the inflammatory process.
The treatment of sunburn is not much different from the treatment of thermal burns, but it is quite possible to prevent their occurrence. In addition to sunscreen, offer the buyer a course of beta arotine
, which will help prepare for sunbathing by improving the condition of the skin and protecting against ultraviolet radiation due to increased antioxidant activity.
It is worth giving preference to such dietary supplements as the Complex of hyaluronic acid, vitamins and collagen
;
Solgar Beta Carotene
;
Nature's Bounty Beta Carotene. Bruises and contusions
Summer is a time for outdoor activities, which are very often accompanied by falls and bruises and, as a result, hematomas (bruises).
Initially, it is recommended to cool the site of the bruise; AfaFrost
is a freezing spray that instantly relieves pain and prevents the formation of a hematoma, as well as a hypothermic package.
Ketoprofen gel 5%
or
Diclogen 5%
is suitable as a local anesthetic , depending on purchasing power.
The release form (gel) allows the drugs to be easily distributed on the skin and quickly absorbed, which ensures a faster onset of the therapeutic effect. For removal, we recommend Arnigel gel
- thanks to its natural composition, it is suitable for the smallest (1+), and a large tube (120 g) will be indispensable in a family where fidgets live.
As a budget option, suggest Troxerutin DS
,
gel with badyagi “Simple recipe”
.

The combined use of external and internal agents will be more effective; for this we recommend using Arnica Montana granules (0+)

. Mountain arnica helps strengthen the walls of blood vessels and capillaries, due to the rupture of which the hematoma appeared.

Minor damage: abrasions, scratches, cuts

Since abrasions and scratches are considered accidental injuries, they are always contaminated with microbes to one degree or another.
Wounds contaminated with soil and caused by rusty nails are especially dangerous because of the possible development of tetanus. The first thing you should do is wash the wound with clean warm water and treat it antiseptic solution
, such as
MestaMidinsense Daily
in a convenient spray bottle - it does not sting and is suitable for pregnant women and children (0+).
Miramistin
or
Furacilin
tablets for preparing a solution
are also suitable hydrogen peroxide 3%; chlorhexidine bigluconate. After treatment, the damaged area is carefully dried by blotting with a sterile gauze pad. Then the wound must be treated with antibacterial agents to prevent the development of purulent-septic complications. It is best to use drugs in powder form, such as Baneocin, which can be used from birth. To speed up healing, use Cikaderma
, which has an antiseptic effect, and its herbal components relieve inflammation and reduce pain;
it is suitable for children from the first year of life. -
based products: Stellanin
,
Solcoseryl or
Emalan collagen hydrogel
.

If necessary, the wound can be sealed with a plaster or BF-6 glue

, which is suitable for shallow cuts.
Afa Plast (liquid patch)
has become a competitor to the regular patch : it creates a protective film and does not peel off like a traditional patch.
For mothers of active children, we recommend that you always carry disinfectants with you, such as Lekker hydrogen peroxide 3%
in the form of a spray - it does not take up much space in your bag and is easy to use.

Large wounds with bleeding bodies included

Such wounds require immediate medical intervention.
As first aid for heavy bleeding, you should raise the affected area above chest level and firmly press the edges of the wound with a sterile cloth until the bleeding stops. Next, you need to treat the edges of the wound with antiseptic agents, such as MestaMidin-sense Home
, hydrogen peroxide, and a weak solution of potassium permanganate.

The wound should be isolated from the environment using a gauze pad, and for fastening it is better to use a self- fixing Hartmann bandage

— unlike gauze bandages, it does not weaken and does not “crumple.” If blood leaks through the first bandage, you need to apply a second pressure bandage without removing the previous one. If you can see fat, muscle, or bone in the wound, or, for example, if the cut is very wide and has jagged edges, you will likely need stitches.

It is also important to remember that no objects should be removed from a wound containing foreign bodies (for example, glass fragments)! Wounds and injuries, whether we like it or not, will happen in our lives from time to time. Unfortunately, it is impossible to completely protect yourself and your family from receiving them. But you can and should be ready to provide first aid when it is especially needed.

THERE ARE CONTRAINDICATIONS, YOU MUST READ THE INSTRUCTIONS OR CONSULT WITH A SPECIALIST. Dietary supplement NOT A MEDICINE.

When general swelling indicates danger to life

Sometimes swelling of the lower extremities is a symptom of a general imbalance in the body's hydrobalance. In the case of heart failure, the body's main muscle cannot cope with pumping blood. The fluid in the body is distributed unevenly, and too much accumulates at the bottom. If the patient stands or sits in one position for a long time, his feet and legs swell.

Kidney failure can also lead to swelling. It appears not only on the legs, but also on the arms, face (mainly under the eyes), and abdominal wall.

If cardiac edema develops gradually (over weeks), then renal edema develops very quickly. With cardiac diseases, the skin becomes colder, with kidney diseases it maintains a normal temperature.

Fluid retention can also be caused by lymphedema, which is damage to the lymphatic vessels. The swelling in this case is dense; after pressing on the skin, there is no indentation.

Features of treatment depending on the cause

Swelling with a runny nose caused by a viral infection requires the use of local and (or) systemic immunomodulators and antiviral agents. Bacterial inflammation requires the use of antibiotics. Additionally, symptomatic treatment is used if necessary (antipyretics and other drugs).

Allergy, first of all, involves eliminating the factor that causes it, that is, a specific allergen. Medications include antihistamines and sometimes inhaled corticosteroids (hormones). Frequent showering and nasal rinsing will help relieve symptoms, as they reduce the concentration of the allergen on the person and in the nasal mucosa 2.

Vasomotor rhinitis can also be treated with nasal hormones. Additionally, physical therapy is encouraged. If the disease was caused by vasoconstrictor drops, then they must be abandoned and replaced temporarily with local hormonal therapy until the swelling is relieved. Such treatment has its own characteristics and must be prescribed by a specialist.

Relieving swelling during pregnancy

In the body of a woman carrying a fetus, the concentration of the hormone progesterone increases. It is one of the causes of edema during pregnancy. In no case should it be reduced, because it is this that ensures the attachment of the embryo.

There is no need to fight physiological swelling. The main thing is to prevent it from getting worse. To alleviate the symptoms, you can carry out the mentioned water procedures and adhere to a healthy lifestyle (moderate activity, water consumption within the daily norm, adjusted for restrictions imposed by pregnancy, rest on your side).

The pathological nature of edema can only be determined by a doctor based on test results (in particular, protein in the urine). Having discovered the cause, he will prescribe treatment. It is prohibited to take any medications on your own.

Why does one leg swell?

If the swelling is asymmetrical, its cause is localized directly in the affected limb. Swelling may occur due to bruises on the legs or more serious injuries:

• ankle joint injuries;
• meniscus tear;
• separation of the calf muscle;
• bone fracture;
• tissue compression.

Venous edema is also most often unilateral. Varicose veins cause fluid stagnation, but they are localized in one limb where the vessels are affected. This is indicated by the characteristic venous network.

Thrombophlebitis disrupts blood circulation, and at the same time the outflow of fluid from tissues. In this case, swelling is accompanied by other unpleasant symptoms: fever, pain, compaction in the blockage area.

How to relieve swelling after a bruise

Treatment for a leg bruise usually comes down to eliminating pain and swelling. The swelling in this case is caused by damage to the blood vessels and the accumulation of fluid from them under the skin. The latter puts pressure on the nerve endings, hence the pain. So eliminating swelling also helps to get rid of unpleasant sensations.

You can help a bruised limb at home:

• stretch and provide peace;
• apply a wet towel, ice or a heating pad with cold water;
• apply a tight bandage.

You can also resort to drug treatment. External agents containing troxerutin or heparin will help. They strengthen capillaries, optimize blood viscosity and relieve inflammation.

General principles for troubleshooting

• Rinse the nose with hypertonic saline solutions at room temperature;
• Use of vasoconstrictor drops;
• Avoiding hypothermia and drafts;
• Normalization of diet;
• Removing accumulations of mucus from the nasal cavities (especially important if we are talking about infants who begin to refuse mother's milk).

It is not recommended to use heating, as are any untested herbal, alcohol and other folk remedies.

Why do both legs swell?

If by the end of the day both lower limbs are swollen, it means that excess fluid is present throughout the body. Most often this condition is caused by:

• heat;
• excessive fluid intake;
• obesity;
• uncomfortable shoes (tight, high heels, completely flat soles);
• flat feet;
• unhealthy diet (lots of salty and spicy foods in the diet);
• standing on your feet for a long time or in an uncomfortable position.

Fluid stagnation in these cases is caused by improper load distribution. None of the above indicates a threat to life, and the swelling goes away in a day or two. For some, it is enough to take off their shoes and relax, while others resort to folk remedies to relieve discomfort. But symmetrically swollen legs can also indicate more serious diseases that require urgent treatment.

Treatment of leg swelling due to heart or kidney failure

Patients with heart or kidney failure should be under the supervision of a physician. In acute attacks, resuscitation is required. If the disease takes a chronic form, swelling is removed as it appears with the help of diuretics and nutritional correction. Medicines should:

• stabilize blood pressure;
• remove excess sodium from the body;
• prevent protein loss;
• normalize blood flow speed.

When using diuretics (diuretics), it is important not to exceed the permissible dosage. Otherwise, there is a risk of getting the opposite effect in the form of drug-induced edema during withdrawal. They are caused by the kidneys’ reaction to a sudden change in the mode of fluid excretion.

How to relieve leg swelling caused by heat

The best medicine in this case is gravity. Arriving home and throwing away the shoes that have become a vice, it is enough to lie down and place your feet higher (at a minimum - on several pillows, at a maximum - against the wall).

When it becomes easier to move, you need to take a shower. Ideally, a contrasting one that trains blood vessels, but you can limit yourself to just cool. In this case, you should direct the pressure to the feet: such a hydromassage will restore blood circulation.

You can disperse the fluid with light exercises: pulling the toe towards you and away from you, rotating your feet, squatting. But if you don’t have the strength to do this, and your legs hurt, it’s better not to torture them.

Foot baths are also useful. Even plain water will provide relief, but you can enhance the effects with additives. This could be sea salt or herbal infusions. Compresses made from cabbage leaves or bandages soaked in a decoction of birch leaves improve the condition of the limbs.