Paravertebral block (for spinal pain)

Do blockades treat only pain or the cause of pain?

The answer to this question depends on the type of lesion. In cases where pain is caused by muscle spasm and nerve compression (dorsalgia, headache due to osteochondrosis, etc.), the introduction of an anesthetic helps relax the muscle, improve blood supply and tissue trophism, and reduce swelling. Thus, the cause of pain is eliminated, and the problem may not bother the patient for a long time.

If we are talking about arthrosis of the joint, destruction of cartilage, or persistent damage as a result of injury, the blockade will not lead to a reversal of the disease. The administration of an anesthetic will only bring temporary relief. Radiofrequency dereception and neurolytic techniques can prolong this effect for a long time. In some cases, when pain is the main symptom of the disease, the main cause of limited limb function and deterioration in quality of life, its elimination significantly improves the patient’s well-being and allows delaying the need for more radical, complex and risky treatment. At the same time, during the blockade, medications are administered that affect the cause of the disease (steroidal and non-steroidal anti-inflammatory drugs, antibiotics). The substances act directly at the injection site, which contributes to more effective treatment and minimization of side effects.

Indications

Contraindications

Indications for the blockade are varied and are determined by the doctor in each individual case. Most often, these are diseases in which pain persists for a long time and is not effectively relieved by taking tablet analgesics:

• lower back pain due to damage to the sacroiliac joint
• radiculopathy (compression and irritation of the sensory roots of the spinal nerves)
• non-inflammatory joint lesions - arthrosis
• inflammatory joint lesions - arthritis
• myofascial syndrome (muscle spasm)
• tunnel syndrome (compression of a nerve by a tendon or muscle)
• facet syndrome (arthrosis of the facet joints)
• pain or spasm after a stroke

• individual intolerance to the administered substance (allergy to the drugs used)
• severe general condition
• psychiatric illnesses
• bleeding disorders
• children under 12 years old
• infectious inflammation at the site of the proposed blockade
• cicatricial deformation of the area of ​​the proposed blockade

Types of novocaine blockades

Novocaine blockade can be local and segmental. The first is done at the lesion site, the second at the projection of the spinal segment.

Novocaine is administered intradermally, subcutaneously, intramuscularly and intraosseously. According to the technique of execution, the following types are distinguished:

• Novocaine nerve block. Involves blocking nerve impulses. It can be perineural (anesthetic solution is injected into the area of ​​the perineural sheath of the nerve trunk) and paraneural (into the tissue surrounding the nerve).
• Therapeutic spinal blockade. The drug is administered paravertebrally, epidurally and articularly.
• Case medicinal blockade according to Vishnevsky. The anesthetic is injected into the muscle sheaths. Used for traumatic damage to bone and muscle tissue.

Single-component and multi-component solutions are used. The former contain only a high concentration of novocaine, the latter contain auxiliary drugs that, in addition to pain relief, produce other therapeutic effects.

Mechanism of pain relief

Long-lasting pain causes not only subjective discomfort, but also triggers a number of processes in the nervous system, which often form a vicious circle and lead to chronicity and changes in the nature of pain, which can bother the patient even after the injury or inflammation that initially caused the pain syndrome , are long gone. One of the main components of this vicious circle is muscle spasm. The blockade allows not only to relieve pain at the site of the lesion, but also to relax the surrounding muscles, increase blood supply, improve trophism and metabolism, which in itself can bring relief. Pain significantly reduces quality of life, disrupts sleep and normal daily routine. Getting rid of pain improves the general condition of the body and sets it up for recovery. For these reasons, modern medicine recognizes prompt and effective pain relief as an important component of therapy. Doctors are confident that there are no rational reasons to endure pain; you need to seek help from professionals as soon as possible.

How does Diprospan blockade work?

After collecting anamnesis and consultation, the doctor prescribes a course of treatment. Usually this is no more than 10 sessions every 3-4 days, the pain decreases already at 1 appointment. The principle of the injection is very simple: before the injection, the skin is treated with a disinfectant, the specialist injects the solution into special points, directly into the very source of the exacerbation, so that the medicine immediately begins to act. At this time, the patient may feel unpleasant tension in the injection area. Depending on the source of pain, a blockade can be placed on the spine between the ribs, in the intercostal space, in order to immediately reach the affected nerve. This is done for osteochondrosis or pain in the back of the head.

The joint blockade with diprospan is inserted with a long and thin needle. This way you can not only relieve pain, but also restore motor activity to the affected area, for example, the hip joint.

Medicines used

Blockade is not only pain relief, it is a method of complex treatment of the problem, so a combination of several drugs is used for it.

• Anesthetic is the main component of the blockade (lidocaine, ropivacaine and other local anesthetics)
• NSAIDs (non-steroidal anti-inflammatory drugs) - reduce inflammatory activity, reduce swelling and pain
• glucocorticoid hormones - just like NSAIDs, have an anti-inflammatory effect, but more powerful, and are also effective for allergic inflammation
• auxiliary products (vitamins, hyaluronic acid preparations, etc.)

Joint blockades and their types

Drug blockade is used to treat joint diseases:

Medicines used as part of blockades:

Hormones.

Such medications help eliminate swelling, relieve inflammation and pain. Glucocorticosteroids do not have restorative properties, so they are recommended to be combined with other drugs and treatment methods.

Anesthetics.

Novocaine, lidocaine, trimicaine, etc. are used for blockades. They eliminate pain. The drugs are not addictive and do not have harmful effects on the body.

Chondroprotectors.

Used as joint fluid substitutes, especially in the treatment of arthrosis. Chondroprotectors help normalize metabolism and stop destructive processes in cartilage tissue.

Homeopathic medicines.

As part of complex therapy, Tzel-T and Traumeel-S are used to improve metabolism.

Vitamins.

B vitamins are most often prescribed.

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Features of blockades

• All interventional procedures are carried out under the control of a portable X-ray system (C-arm) or ultrasound, in some cases dual control is used;
• All procedures are performed under local anesthesia (only in rare cases is the use of general anesthesia necessary), so patients do not require hospitalization to perform the block;
• All procedures are carried out in a specially prepared operating room, under sterile conditions, with monitoring of the patient’s vital functions to ensure maximum safety;
• After the procedure, the patient has the opportunity to rest in a specialized ward on a chair or bed under the supervision of a nurse and doctor;

Prices for drug blockades

Our specialists

• Derevianko Leonid Sergeevich

  Head of the Center for Diagnostics and Treatment of Sleep Disorders.

  The doctor is a neurologist of the highest category. Vertebrologist. Somnologist. Epileptologist. Botulinum therapist. Physiotherapist. Experience: 23 years.

• Zhuravleva Nadezhda Vladimirovna

  Head of the center for diagnosis and treatment of myasthenia gravis.

  The doctor is a neurologist of the highest category. Physiotherapist. Experience: 16 years.

• Drozdova Lyubov Vladimirovna

  The doctor is a neurologist. Vertebroneurologist. Ozone therapist. Physiotherapist. Experience: 17 years.

• Mizonov Sergey Vladimirovich

  The doctor is a neurologist. Chiropractor. Osteopath. Physiotherapist. Experience: 8 years.

• Grikshtene Tatyana Viktorovna

  The doctor is a rheumatologist of the highest category. Experience: 25 years.

• Ogurtsov Denis Alexandrovich

  Traumatologist - orthopedist of the highest category. Candidate of Medical Sciences.

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  Experience: 23 years.

• Palagin Maxim Anatolievich

  The doctor is a neurologist. Somnologist. Epileptologist. Botulinum therapist. Physiotherapist. Experience: 6 years.

• Dyachenko Ksenia Vasilievna

  Head of the center for the treatment of dizziness and balance disorders.

  The doctor is a neurologist of the highest category.
  Angioneurologist. Neurorehabilitation specialist. Physiotherapist. Candidate of Medical Sciences.
  Experience: 19 years.

• Volkova Svetlana Anatolevna

  Head of the Center for Parkinsonism and Extrapyramidal Diseases.

  The doctor is a neurologist of the highest category. Epileptologist. Ozone therapist. Physiotherapist. Experience: 26 years.

How is the blockade going?

A blockade is a set of injections; the injections are given according to a specific pattern, which the doctor selects individually based on the patient’s condition, his illness, and data from the medical history. It is very important to choose the correct blockade scheme and the appropriate medicine for a particular case - this is the key to a good result after the blockade. This can only be done by a highly qualified doctor who is familiar with all the nuances of carrying out this procedure and the drugs recommended for carrying out the blockade.

The frequency of injections is also selected for each patient separately, most often the blockade is carried out once every 2-3 days.

Advantages of drug blockade:

• the blockade gives a quick analgesic effect, since the drug is injected directly into the affected area;
• The risk of complications and side effects is extremely small. Most drugs are well tolerated by patients;
• The blockade not only has an analgesic effect, it is also an effective therapy that has a beneficial effect on the general condition of the patient and contributes to the complete cure of the disease.

Indications for blockade

The most basic and main indication for the use of blockade injections is pain. When the pain is so great that the quality of life deteriorates significantly, a person cannot work, live, behave as before - a blockade is done.

Since pain requires causes, indirect indicators for blockade are:

• osteochondrosis of the cervical, thoracic, lumbar spine;
• joint pain of various etiologies;
• intercostal neuralgia;
• radiculitis;
• pinched sciatic nerve;
• osteoarthritis of various joints;
• tunnel syndrome;
• herpes zoster;
• rheumatoid arthritis;
• headache;
• pain in the neck and shoulders;
• pain in the spine due to intervertebral hernia;
• neuritis and neuralgia;
• pain in the spine due to disc protrusion;
• other diseases.