Treatment with mustard plasters for cervical osteochondrosis: mechanism of action, regimens of use

Mustard plasters for osteochondrosis of the cervical spine.
In the treatment of osteochondrosis, systemic and local drugs are used to improve blood circulation. The use of such drugs can significantly reduce the severity of neurological symptoms characteristic of pathology localized in the cervical vertebral structures. By normalizing blood circulation, you can get rid of headaches, dizziness, and surges in blood pressure. One of the most therapeutically effective remedies for osteochondrosis of the cervical spine is mustard plasters.

CT scan of the lumbar spine for osteochondrosis.

How do mustard plasters work for osteochondrosis?

The therapeutic effect of mustard plasters for cervical osteochondrosis is due to their active ingredient - mustard powder. Its chemical composition contains sinigrin in high concentration. After wetting the mustard plaster and applying it to the neck area, this glycoside is hydrolyzed. Allyl oil (allyl isothiocyanate) is formed, which irritates the receptors located in the subcutaneous tissue.

As a result, blood vessels dilate and trophism improves, and due to the distracting effect, the severity of neck pain is reduced. In response to impulses coming from the surface of the skin, endogenous biologically active substances are released - endorphins, kinins and histamine, which improve human well-being.

Indications for use

Mustard plasters are not used for acute pain, often accompanied by inflammatory swelling and pinching of the spinal roots by osteophytes. It is advisable to use the drug to eliminate pain that occurs during the remission stage. Their appearance is usually preceded by hypothermia, excessive physical activity, and exacerbation of chronic pathologies.

Mustard plasters are also included in therapeutic regimens to reduce the intensity of vertebrogenic symptoms, which are caused by compression of the vertebral artery that supplies blood to the brain by displaced intervertebral discs. These are arterial hypertension, decreased visual and hearing acuity, and sensitivity disorders.

How to choose the right type

Pharmacies sell mustard plasters of various shapes and sizes, but they have the same therapeutic effect. Therefore, when choosing a medicine, you need to take the one that is most convenient to use. You should purchase small size products that do not need to be trimmed.

These drugs for external use are produced by many domestic pharmaceutical factories. Some manufacturers improve the composition of their products by adding new ingredients. For example, relatively recently mustard plasters with essential eucalyptus oil appeared on sale.

Mustard plasters in bags and plates.

Symptomatic therapy

For complex treatment of pneumonia, doctors at the Yusupov Hospital use drugs that affect the mechanisms of development of the pathological process and reduce the symptoms of the disease. These include:

• detoxification agents;
• bronchodilators and expectorants;
• immunomodulators.

Patients with severe symptoms of intoxication are given intravenous infusions of synthetic plasma-substituting solutions (hemodez, reopolyglucin) and protein hydrolysates.
Patients with pneumonia use non-steroidal anti-inflammatory drugs: voltaren, indomethacin, ibuprofen to reduce swelling and improve microcirculation of the lung tissue. In case of a sluggish course of the disease in combination with bronchospastic syndrome, glucocorticoid hormones are used. To improve the drainage function of the bronchi and restore bronchial patency, patients are advised to take bronchodilators (aminophylline, asthmapent, theophedrine, euspiran) and expectorants. At the onset of the disease, with a strong non-productive cough, antitussive drugs (codeine, libexin) are used. An integral component of complex therapy for pneumonia is the normalization of immune defense mechanisms and nonspecific reactivity of the body. To stimulate the immune system (thymalin, T-activin, prodigiosan, gamma globulin, aloe extract).

All patients with pneumonia are prescribed oxygen therapy. In case of severe disease, patients with pneumonia are hospitalized in the intensive care unit. If indicated, they are given artificial ventilation using the latest ventilators.

Symptomatic treatment of pneumonia at home is carried out in order to alleviate the patient’s general condition and level the symptoms of the disease. Doctors at the Yusupov Hospital prescribe mucolytic and bronchodilator drugs to patients. Mucolytics (ACC, carbocysteine ​​and ambroxol) help remove mucus from the respiratory organs. Ambroxol enhances the effect of antibiotics. For inhalation of bronchodilators, patients use nebulizers at home.

Antipyretics (analgin, acetylsalicylic acid or non-steroidal anti-inflammatory drugs) are prescribed only if the patient is intolerant of high temperature. In the room where a feverish patient lies, the temperature should be ensured no higher than 18 degrees and an air humidifier should be installed. To reduce symptoms of intoxication, patients are recommended to drink at least 2.5-3 liters of fluid per day.

During treatment, food that is difficult for the stomach and contains large amounts of fat is excluded from the diet. The diet includes steamed dishes from lean meats and fish, lactic acid products, cottage cheese, and cheese. The menu should include freshly squeezed fruit juices.

Application diagram

Before applying the mustard plasters packages to the back of the neck, shake them and remove the protective film from the plates. Then they are lowered into a container filled with water at a temperature of 40 °C for 5-7 seconds, shaken off and applied to the skin. To enhance the local irritating effect, the medicinal product is covered with a thick cloth (scarf, towel). The duration of the procedure is from 5 to 15 minutes. Patients with dry, sensitive, irritation-prone skin should remove mustard plasters when a burning sensation occurs.

It should be borne in mind that redness of the skin surface is not a side effect of the topical drug. This effect is due to the expansion of blood vessels and blood flow. After completing the treatment procedure, the skin is wiped with a cloth soaked in warm water to remove the remaining mustard oil.

The dosage regimen and duration of treatment are determined by the doctor. It takes into account the characteristics and intensity of clinical manifestations, the stage of cervical osteochondrosis and the necessary action.

Antibacterial therapy on an outpatient basis

Treatment of pneumonia in adults at home is possible in patients of two groups that differ in the causative agent of the infectious disease and the tactics of antibacterial therapy.

The first group included patients without concomitant pathology under the age of 60 years. In them, an adequate clinical effect can be obtained by using antibiotics for oral administration. Doctors at the Yusupov Hospital provide monotherapy to these patients with amoxicillin or macrolide antibiotics. In case of intolerance to β-lactams or suspicion of an atypical nature of the disease, preference is given to macrolides. Fluoroquinolones are used as alternative drugs.

The second group included elderly people and patients with concomitant diseases that are risk factors for poor prognosis in pneumonia. This:

• chronic obstructive pulmonary disease;
• diabetes;
• chronic renal or liver failure;
• heart failure;
• body weight deficiency;
• alcoholism and drug addiction.

Patients in this group obtain adequate clinical benefit when prescribed oral antibiotics. In the presence of concomitant diseases in the development of pneumonia in this category of patients, the likelihood of the presence of gram-negative microorganisms increases. Therefore, the use of amoxicillin clavulanate is indicated. Due to the high probability of the chlamydial nature of pneumonia, patients are treated with β-lactams and macrolides. An alternative to combination therapy is the use of respiratory fluoroquinolones (levofloxacin, moxifloxacin).

The advantage of parenteral antibiotics over oral administration in an outpatient setting has not been proven, so they are administered intramuscularly only in exceptional cases. For patients over 60 years of age in the absence of concomitant diseases, ceftriaxone is administered intramuscularly. The drug can be prescribed in combination with macrolides or doxycycline.

An initial assessment of the effectiveness of treating pneumonia at home is carried out 48–72 hours after the start of treatment, during a re-examination by a doctor at the Yusupov Hospital. The main performance criteria that allow doctors to conclude that there is positive dynamics are:

• normalization of temperature;
• reduction of symptoms of intoxication;
• reducing the intensity of shortness of breath and other symptoms of respiratory failure.

If the patient’s symptoms progress or high fever and signs of intoxication persist, the treatment is considered ineffective, the tactics of antibacterial therapy are reviewed, and the advisability of hospitalization is re-evaluated. If there is no adequate effect when treating with amoxicillin, it is replaced with a macrolide antibiotic.

In case of mild pneumonia, antibiotics are discontinued if the body temperature is stable for 3–4 days. With this approach, the duration of treatment is from 7 to 10 days. In patients with mycoplasma or chlamydial pneumonia, the duration of therapy is 14 days.

The persistence of individual clinical, laboratory or radiological signs of pneumonia is not an absolute indication for continued antibiotic therapy or its modification. In the overwhelming majority of patients with pneumonia, resolution occurs independently or under the influence of symptomatic therapy. If clinical, laboratory and radiological symptoms of pneumonia persist for a long time, doctors at the Yusupov Hospital carry out differential diagnosis with diseases such as tuberculosis, lung cancer, and congestive heart failure.

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Features of use for children

Osteochondrosis is extremely rarely diagnosed in adolescence or childhood. The cause of its development is usually congenital abnormalities of the spine or severe systemic pathologies of the musculoskeletal system, for example, rheumatoid arthritis. In the treatment of cervical osteochondrosis in children, mustard plasters are used, but with some restrictions. In a child, blood vessels are located closer to the surface of the skin, so the likelihood of a chemical burn is increased. How to use mustard plasters for children:

• plates or bags are placed not on the skin, but on dry sterile gauze;
• the duration of the procedure does not exceed 10 minutes;
• After removing and removing the remaining mustard oil, a small amount of moisturizer is rubbed into the skin.

Testing is carried out before using the medicine. A small piece of the plate or 1 package is applied to the wrist area. If within 10 minutes, in addition to redness, swelling or irritation of the skin appears, then mustard plasters cannot be used to treat cervical osteochondrosis.

Antibacterial therapy

The basis of treatment for pneumonia is antibacterial therapy. At the Yusupov Hospital, pulmonologists use the latest drugs registered in the Russian Federation. When a sick patient enters a therapy clinic, the choice of antibiotic is made empirically. Doctors take into account the epidemiological and clinical situation, and lung radiography data.

Since the disease is most often caused by pneumococci, initial therapy begins with penicillins and aminopenicillins. Second-line drugs are cephalosporins. If you are allergic to β-lactam antibiotics, all these medications are not used. Alternative agents are macrolides.

In cases of severe pneumonia, doctors at the Yusupov Hospital choose broad-spectrum antibacterial agents for initial treatment. They use combinations of antibiotics to suppress the maximum number of possible infectious agents. The drugs are administered intravenously and intramuscularly.

In the therapy clinic, doctors widely use a new generation of fluoroquinolones to treat pneumonia:

• levofloxacin;
• moxifloxacin;
• sparfloxacin.

They are highly effective, suppressing gram-positive and gram-negative microflora, as well as intracellular microorganisms (mycoplasma, chlamydia, legionella).

In nosocomial pneumonia, the most common pathogens are gram-negative bacilli and staphylococci. In these cases, combinations of metronidazole with third-generation cephalosporins or ciprofloxacin are used to treat pneumonia. Patients after traumatic brain injuries are treated with monotherapy with IV generation cephalosporins or ciprofloxacin; if necessary, a combination of a III generation cephalosporin with ciprofloxacin or aminoglycosides is used.

Contraindications

If you are hypersensitive to mustard powder, this remedy should not be used. A contraindication for therapy is a violation of the integrity of the skin on the back of the neck (scratches, abrasions). Mustard plasters cannot be used if there are moles, papillomas, or warts at the places where they were placed. They are not prescribed to patients if external clinical manifestations of neurodermatitis, dermatitis, pyoderma, and furunculosis are detected. Treatment is not carried out at high temperature, chills, or fever.

When not to use

Many people are interested in whether it is possible to put mustard plasters on at a fever if the neck hurts. Just like for colds, mustard should not be used at high temperatures. The question is often asked about why the product should not be used for skin diseases. I will answer that mustard easily eats away small ulcers or other lesions.

This method also cannot be used in the following cases:

• during pregnancy;
• oncological diseases;
• tuberculosis.

The list also includes other contraindications.