Goals of drug treatment Drugs for effective treatment of osteochondrosis: release form What drugs should be taken for osteochondrosis?
Conservative treatment of osteochondrosis includes various therapeutic measures - from massage and diet to therapeutic exercises and physiotherapy. All of them help improve the patient’s condition and prevent the development of complications. But the leading method has been and remains the use of pharmaceutical drugs for osteochondrosis.
Drugs for osteochondrosis are the main way to combat the disease.
Indications for use
Peripheral vasodilator drugs are indicated for circulatory disorders in peripheral organs and tissues associated with narrowing of the lumen of the vessel: atherosclerotic plaque (vascular atherosclerosis obliterans), inflamed vascular wall (endarteritis obliterans), pathological reflex spasm (Raynaud's disease).
Peripheral vasodilators are used for circulatory disorders in the vessels of the lower extremities, which are accompanied by intermittent claudication, trophic ulcers, pain in the legs at rest, sensory disturbances, and spasms in the calf muscles.
Peripheral vasodilators are also used for vascular complications due to diabetes mellitus (diabetic angiopathy), up to the initial stages of gangrene of the foot.
In addition, drugs of peripheral vasodilators are used for chronic disorders of cerebral circulation - cerebral atherosclerosis, dyscirculatory encephalopathy, chronic cerebral vascular insufficiency.
Peripheral vasodilators are indicated for behavioral and mental disorders in old age, in patients after stroke, coma, and insufficient blood supply to the retina and inner ear.
Certain drugs of peripheral vasodilators (bendazole and its combinations with papaverine) are used for arterial hypertension and hypertensive crisis.
Goals of drug treatment
Treatment of osteochondrosis with drugs is so effective in the early stages of the disease that, with a properly selected treatment regimen, it can completely cure osteochondrosis or permanently eliminate its most unpleasant symptoms. In the later stages, drug control of the disease is possible.
Medicines for osteochondrosis are designed to influence the disease not only symptomatically, but also to eliminate its causes systemically. Therefore, therapy is carried out in the following directions:
- anesthesia of affected areas;
- relieving inflammation and stopping the acute period of the disease;
- restoration of microcirculation in affected tissues;
- improving metabolic processes and protecting cartilage from further destruction (for example, by free radicals);
- regeneration of cartilage tissue in intervertebral discs;
- restoration of mobility in the vertebral joints.
In cases where the disease is accompanied by depression or emotional stress, therapy is also aimed at restoring a normal psychological state.
During the period of remission, patients can do without medications or take them in courses in prophylactic dosages.
Classification of peripheral vasodilator drugs
Peripheral vasodilator drugs are classified according to their chemical structure and origin into:
- 2-amino-1-phenylethanol derivatives: isoxsuprine;
- nicotinic acid preparations: nicotinic acid;
- purine derivatives: xanthinol nicotinate, pentoxifylline;
- ergot alkaloids: nicergoline;
- Vinca alkaloids: vincamine;
- others: naftidofuryl, bendazole, bencyclane.
In addition, magnesium sulfate, hydralazine, antihypertensive drugs - calcium antagonists (amlodipine, nifedipine, felodipine, isradipine, nitrendipine), nitric oxide donors (sodium nitroprusside), potassium channel activators (minoxidil, diazoxide) have a peripheral vasodilating effect.
There are also combination preparations of the peripheral vasodilator bendazole with the myotropic antispasmodic papaverine.
Features of treatment with peripheral vasodilator drugs
Due to the high risk of shock and collapse - a sharp drop in blood pressure with loss of consciousness - peripheral vasodilator drugs are prescribed with caution to people with hypotension (low blood pressure).
Peripheral vasodilator drugs, lowering blood pressure, with a sharp change in the horizontal position of the body to a vertical one, can lead to an outflow of blood from the brain, which is manifested by dizziness and even loss of consciousness. This condition is called orthostatic hypotension. To prevent the development of such an effect after taking peripheral vasodilator drugs, the patient should lie down or sit for about half an hour, without getting up suddenly.
Since peripheral vasodilator drugs thin the blood, having an antiplatelet effect, their use is contraindicated in patients with reduced blood clotting and uncontrolled bleeding.
When using peripheral vasodilator drugs, you should stop drinking alcohol and smoking.
Vasodilator drugs prescribed for osteochondrosis
The work of the muscles of the vascular highways is constantly regulated by nerve impulses passing through sympathetic fibers. These signals are responsible for the muscular activity of almost all internal organs and related functions.
Eliminating stagnation of blood fluid and improving microcirculation in the pathological area makes it possible to normalize metabolic processes and restore the patency of nerve impulses, as a result of which the treatment of osteochondrosis is more effective and the patient’s health condition is stabilized.
Features of the pathogenesis of osteochondrosis disease
Nowadays, osteochondrosis disease (age-related degenerative changes in intervertebral discs) is quite common among the population. This is due to a sedentary lifestyle or, on the contrary, excessively hard physical labor, back injuries, bad habits, poor diet and inadequate sleep.
Initially, the symptoms of osteochondrosis manifest themselves as minor discomfort in the back after physical activity, limited mobility, then pain syndromes become more intense and become chronic. Destructive processes in the intervertebral discs (dehydration and insufficient supply of nutrients) provoke inflammation and swelling of the pathological area (decreased blood circulation in it). The body’s protective reaction to irritation becomes even greater muscle stiffness and pain.
Soft tissue spasms compress sympathetic nerve endings and fibers, the transmission of impulses weakens, the muscle walls of blood vessels do not receive the necessary information and also find themselves in a compressed state. Poor circulation over time leads to oxygen starvation (hypoxia).
Complex conservative treatment of the spine, as a rule, includes taking vasodilating drugs. Results of action of pharmacological agents of the vasodilator group:
- normalization of blood circulation in the pathological area and throughout the body;
- improving the nutrition of soft tissues, saturating them with fluid, accelerating metabolic processes;
- reduction of inflammation and swelling of tissues, congestion and, consequently, pain;
- restoration of the passage of nerve impulses through the fibers.
Mechanisms of drug action
The group of vasodilator drugs used to treat osteochondrosis of the joints is conventionally divided into subgroups:
- substances with myotropic effects that directly affect the muscles of the vascular walls, changing their metabolic processes and reducing tone (caffeine, papaverine, no-spa);
- drugs with neurotropic effects achieve a vasodilating effect through nervous regulation of the tone of blood vessels;
- centrally acting drugs that affect the functioning of the vasomotor center located in the brain (aminazine, apessin);
- peripheral substances:
- blocking vascular adrenergic receptors (phentolamine);
- blocking the transmission of impulses (excitation) from the nerve endings of the sympathetic branches innervating the corresponding blood lines (ornid, octadin);
- improving the transmission of impulses from parasympathetic endings to blood vessels (acetylcholine, carbacholine);
- complicating the transmission of impulses in sympathetic nerve clusters, thereby reducing vascular tone (pentamine, tetamone);
- drugs with a mixed mechanism of action - central neurotropic and peripheral myotropic (nitroglycerin, amyl nitrite, reserpine, the latter weakens the sensitivity of central and peripheral adrenergic receptors responsible for the innervation of blood vessels, expands their lumen, and also lowers blood pressure).
List of main drugs prescribed for osteochondrosis
Actovegin. It has not so much vasodilating properties as stimulating tissue regeneration. It contains many nutrients: amino acids, saccharides, nucleosides. It has a positive effect on the transport, absorption and utilization of glucose and oxygen molecules, and stabilizes the plasma membranes of cells. Restores blood flow in peripheral systems, normalizes and stimulates nutrient metabolism throughout the body, develops and regenerates collaterals (small branches of blood vessels formed during compression or thrombosis of the main channel).
Eufillin. A bronchodilator, it helps relax the muscles of the bronchi, relieves spasms, dilates blood vessels, which makes it indispensable for patients suffering from asthma. Significantly improves blood circulation in the brain and peripheral vessels, and is used to treat diseases of the spine and neurological pathologies. Stimulates the action of the respiratory centers, increases the frequency and intensity of heart contractions, which makes it unsafe for patients with acute heart failure, angina pectoris and cardiac arrhythmias. Can be used for external use in the form of electrophoresis to improve blood microcirculation in pathological areas and restore trophic processes in intervertebral discs.
Pentoxifylline or trental. Improves microcirculation and regenerating properties of blood, thins the blood, reduces total peripheral vascular resistance, dilates the coronary arteries, which accelerates the transport of oxygen throughout the body. By expanding the blood vessels of the lungs, it significantly increases the tone of the muscle fibers responsible for breathing (diaphragm and intercostal muscles). Strengthens collateral blood circulation, increases the concentration of ATP in the brain, and has a beneficial effect on the bioelectrical functions of the central nervous system. The drug is contraindicated in patients with chronically low blood pressure, atherosclerosis and arrhythmia.
Xanthinol nicotinate. Improves cerebral circulation, peripheral (collateral) microcirculation, reduces the manifestations of cerebral hypoxia (insufficient oxygen supply to the brain), normalizes and improves metabolic (metabolic) processes in the brain. Thins the blood and has a beneficial effect on the functioning of the heart.
Thioctic acid, lipoic acid or berlithion. The drug is from a group of vitamin-like substances, similar to those produced by the body, and is close in biochemical properties to vitamin B group. Participates in the regulation of lipid (fat) and carbohydrate metabolism, prevents the deposition of glucose on the walls of blood vessels, improves blood flow and lowers blood viscosity. It has detoxifying properties and has a positive effect on the functions of peripheral nerves and neurovascular bundles innervating internal organs.
Medicines prescribed for cervical osteochondrosis
Symptoms of cervical osteochondrosis primarily affect the blood supply to the brain, the condition of the vertebral arteries, the vertebrobasilar circle, and then can affect the vessels and nerve endings innervating the upper limbs. They are manifested by dizziness, headaches, nausea, coordination disorders, general weakness and fatigue, disturbances in the functioning of the organs of hearing, vision, speech, and smell.
Treatment of cervical osteochondrosis quite often includes nootropic drugs (for example, piracetam, nootropil, vinpocetine), which improve blood circulation in the vessels of the head and improve metabolic processes (carbohydrate and protein) in the brain. They do not always have pronounced vasodilating properties, but they have a beneficial effect on the central nervous system, improve memory, attention, and increase productivity.
Piracetam. It has a positive effect on metabolic reactions in the body, improves blood circulation in the brain, and restores nerve cells. The drug increases energy potential through accelerated ATP metabolism, has a beneficial effect on the central nervous system and is prescribed for diseases of the blood vessels that wash the cerebral cortex.
Vinpocetine. A vasodilator, antihypoxic agent, helps to increase cerebral circulation, especially in ischemic areas by relaxing the smooth muscles of the walls of cerebral vessels. Improves oxygen transport, reduces platelet aggregation and thereby thins blood viscosity.
It is necessary to treat osteochondrosis with complex measures: medications (which, as prescribed by a doctor, may include vasodilators), physiotherapy and physical activity.
The main thing is not to endure the pain, not to delay time, but to contact osteochondrosis treatment clinics in a timely manner. Author: K.M.N., Academician of the Russian Academy of Medical Sciences M.A. Bobyr
