Physiotherapy for osteochondrosis is one of the most effective treatment methods. With the help of physiotherapeutic procedures, medications are delivered directly to the site of destruction. They do not affect neighboring areas and the body as a whole. After physiotherapeutic procedures for osteochondrosis, allergic reactions and side effects are not detected. At the Yusupov Hospital, rehabilitation specialists use the latest physiotherapeutic methods for the treatment of osteochondrosis.
Doctors at the rehabilitation clinic take an individual approach to choosing a treatment method for each patient. An excellent addition to physiotherapy are other methods of restorative therapy: massage, therapeutic exercises, acupuncture, manual therapy. Complex therapy for lumbar osteochondrosis allows you to quickly eliminate pain, relieve muscle spasms, and restore the function of the pelvic organs.
Physiotherapy for osteochondrosis of the lumbar spine
Osteochondrosis is a spinal disease that is widely known to virtually every person.
Painful sensations in the back, lower back and neck are more often experienced by older people, but young people are not immune from it. At first glance, an innocuous disease can have a serious negative impact on the intervertebral discs, causing changes and a decrease in their height. It is difficult to say what exactly contributes to the appearance of osteochondrosis; there are only different opinions and guesses. This may be due to previous injuries or age-related changes in tissue, or it may be due to poor segmental circulation. It is noted that most often osteochondrosis affects the lumbar spine, and this can cause muscle pain, headaches, and disruption of blood circulation and the functioning of the vestibular apparatus.
There is no need to consider osteochondrosis as a disease that will resolve on its own; it requires complex medical treatment with medications and physiotherapeutic procedures.
Let's look at what physiotherapy is, what are the advantages and types of this method, who is indicated and who is contraindicated for such treatment.
Spondyloarthrosis
Spondyloarthrosis (facet syndrome) is a particular form of osteoarthrosis, which is a heterogeneous form of diseases, different in clinical picture and outcomes, which are based on damage to all the constituent elements of the joint - cartilage, subchondral bone, ligaments, capsule and periarticular muscles. The most common localization of osteoarthritis is spinal arthrosis. In the latter case, both the joints between the vertebral bodies and the facet joints of the vertebral segments are affected.
The main clinical manifestation of spondyloarthrosis is back pain, periodically radiating to the legs, occurring when moving, changing body posture and passing at rest; but as the disease progresses, morning stiffness may appear.
The radiofrequency ablation method is based on the physical principle of thermocoagulation and is based on the effect of the release of thermal energy when ultra-high frequency currents pass through biological tissues.
An electrode connected to a current generator is brought to the anatomical area, the site of destruction, through an insulated cannula needle. The intensity of heating of the fabric depends on its resistance. A Multigen radio frequency generator from Stryker is used, which provides voltage to the circuit and is connected by wires between two electrodes. Electric current passes between an active or damaging electrode immersed in body tissue and an indifferent or scattered electrode. Heat production, and as a result, nerve ablation, occurs only around the non-insulated tip of the active electrode.
Radiofrequency treatment is carried out with insulated needles 100–150 mm long with a working bare end at a cut of 5–10 mm. Under visual guidance, the needle tips are placed precisely lateral to the intervertebral joints at the site of the median branch of the intervertebral nerve.
Once the needles are in place, low current stimulation is applied at a frequency of 100 Hz for sensory fibers and 2 Hz for motor fibers, with a buzzing or tingling sensation at less than 0.5 V indicating optimal needle approximation to the nerve. After injecting a small amount of local anesthetic, the tip of the needle is heated to 80 C for 90 seconds. This leads to coagulation of the nerve, but also causes minor damage to surrounding tissue. A small amount of a mixture of local anesthetic and methylprednisolone is then injected and the needle is removed. This process is repeated with each painful joint above the level.
What is achieved by physiotherapy for osteochondrosis?
Physiotherapy is a modern and effective method to combat osteochondrosis. It acts specifically on the area of inflammation without affecting neighboring organs and tissues. Physiotherapy for osteochondrosis of the lumbar spine is aimed at eliminating pain and restoring the affected vertebrae.
After a series of physiotherapeutic procedures, inflammation is significantly reduced. The mobility of the affected vertebrae is restored. Tissue swelling is eliminated. Blood circulation in the inflamed area is normalized.
The functioning of all internal organs returns to normal. The body’s immune system is strengthened.
Physiotherapy for osteochondrosis of the lumbar spine.
Impact on a specific area. In the case of pharmaceutical drugs, this cannot be achieved, since they are carried by the blood, affecting almost all organs.
There are no sharp exacerbations of chronic diseases. Most drugs provoke the appearance of side effects that transfer the disease from a passive state to an active one.
Possibility of use in case of unsuccessful drug therapy. When extensive inflammation does not make it possible to deliver active components using conventional methods.
Types of treatment for osteochondrosis
Detensor therapy - with the help of a special mat equipped with elastic ribs, the spine is stretched. Located on the mat, special ribs begin to influence the spine, muscles relax, and spasms are relieved. The correct position of the vertebrae is restored, and the back muscles become toned.
Magnetic therapy - low-frequency pulses of a magnetic field are applied to tissues. Blood viscosity changes, swelling is relieved, blood vessels dilate, all this has a positive effect on metabolic processes in inflamed tissues. This procedure is performed only on an outpatient basis.
Ultraviolet irradiation - special equipment eliminates inflammatory foci, providing a bactericidal effect. Treatment begins with small doses of ultraviolet rays, which are increased with each procedure. But before that, you need to do an ultraviolet sensitivity test.
Phonoresis - Drugs are administered using ultrasound vibrations. This makes it possible not only to eliminate swelling and inflammation, but also to deliver active substances to the damaged area. Metabolic processes are accelerated, tissues receive the necessary nutrients.
Ultrasound - micromassage of tissues is performed, which activates blood circulation, providing an analgesic and anti-inflammatory effect.
EHF is a high-frequency therapy that stimulates active points of the body and does not damage the skin as is the case with acupuncture. After several sessions, the movement of the spinal discs increases.
Laser therapy - a special laser is directed to the damaged area, it helps reduce inflammation, pain, and helps the body recover. An improvement in general condition and a decrease in pain is observed after the first sessions. The duration of the procedure is 15 minutes.
Exposure to vibration - treatment is carried out by mechanical vibrations produced by a belt vibrating massager.
Physical therapy is probably the most commonly used method of treatment and prevention of the initial stage of osteochondrosis. A special set of exercises is selected for each patient.
The doctor chooses which method to use after first discussing this with the patient and conducting the necessary health research. For example, for severe pain, laser therapy and phonoresis are indicated, and for osteochondrosis with vascular problems, magnetic therapy is indicated. Physiotherapy procedures are prescribed only during the period of remission and subsidence.
It is believed that over time, physical therapy procedures will replace certain medications. After all, even now, using only physiotherapy and physical exercise, it is possible to cure such an ailment as osteochondrosis. Of course, this will be possible by contacting a specialist at the first sign of a problem.
What physical therapy methods are suitable for treating spinal disorders?
Let us briefly list the main possibilities of physiotherapy in the treatment of certain diseases of the spine. Of course, in each specific case, the final technique, duration and intensity of the procedure should be prescribed by the attending physician, but this list will allow you to at least roughly understand where you can start:
Magnetotherapy is treatment with magnetic fields. The method is suitable for the treatment of: damage to peripheral nerves, diseases of the spine and joints, bone fractures, sprains, soft tissue bruises.
As a result of exposure: inflammation and swelling are reduced, nutrition and blood supply to tissues are improved, pain is reduced, and recovery is stimulated.
Magnetic laser therapy is a combination of laser radiation and magnetic field treatment. Both factors are aimed at improving nutrition and tissue restoration, reducing swelling and inflammation, while reducing pain, improving microcirculation and blood properties, and stimulating the synthesis of necessary substances to renew the cartilage tissue of joints and intervertebral discs.
The method is suitable for: inflammation and joint injuries, bone fractures, muscle and joint pain, neuropathies, vertebrogenic pain.
Galvanization is exposure to direct current.
The method is suitable for the treatment of plexitis, neuralgia, radiculopathies, polyneuropathies, chronic inflammatory processes in joints and other organs and tissues
This physiotherapy improves the functioning of all cells, improves immune activity, reduces inflammation, dilates blood vessels and relaxes muscles.
Electrophoresis of drugs is the use of direct current to deliver drugs to the desired location electrogenically, bypassing the bloodstream. Suitable for treating most diseases.
Short-pulse electroanalgesia (transcutaneous electrical neurostimulation - TENS) - pulsed current therapy. Gives the following effects:
- spinal neurons of analgesic structures are activated (analgesic effect);
- endorphins are released;
- blood flow improves;
- perineural edema decreases;
- metabolic processes are enhanced.
Can be used for: neuropathies, inflammation of the nerve plexuses, radiculopathy, ganglionitis, phantom and causalgic pain.
Electromyostimulation. Electrical muscle stimulation is necessary for: peripheral paresis, muscle atrophy (after removal of the cast), 1 month after surgery on the nerve, tendons and muscles, for scoliotic postural deformities.
Darsonvalization is aimed at improving blood circulation, improving tissue metabolism, and has the ability to reduce inflammatory manifestations. Indicated for: neuropathies, vertebrogenic radiculopathies, autonomic polyneuropathies, neuromyositis.
Diadynamic therapy is the use of sinusoidal currents.
- Therapeutic effects:
- blood circulation improves;
- swelling decreases;
- metabolic processes improve.
Indicated for use in: vertebrogenic radiculopathies, neuropathies, neuromyositis, bruises, ligament damage, deforming osteoarthritis, epicondylitis, periarthritis, muscle atrophy, bone fractures.
Interference therapy is the use of several alternating currents.
- Therapeutic effects:
- blood circulation is stimulated,
- micro massage,
- tissue trophism improves.
Indications for use: neuropathies, vertebrogenic radiculopathy, injuries of the musculoskeletal system, arthritis, contractures.
Ultrasound therapy. Under the influence of ultrasound, microvibration occurs, deep micromassage of cells. This stimulates the functioning of the entire cell, improves microcirculation, loosens connective tissue, accelerates metabolism and renewal. The effect of ultrasound is analgesic, vasodilating, and is used for the treatment and prevention of adhesions. Under the influence of ultrasound, vascular and epithelial permeability increases; with the help of ultrasound (ultraphonophoresis) it is possible to deliver drugs to the desired area, this is especially effective for joint diseases.
We can use it for: pain in the spine, neuropathies, neuralgia, diseases of the joints, muscles, tendons, bursitis, tendonitis, in the presence of adhesions of any localization.
It is important to know
Physiotherapy is not suitable for everyone; it is contraindicated for:
- people with general serious illnesses of the body,
- patients with oncology, at different stages,
- those who have serious problems or changes in the cardiovascular and respiratory systems,
- people with weakened liver and kidney function,
- pregnant women,
- people with skin diseases,
- having mental disorders.
By noticing the disease in time and seeking qualified help, you can eliminate it at the initial stage, before serious problems arise with the spine and the entire body.
Indications
- Back pain (facet syndrome);
- Pain in the spine and coccyx for at least six months (worsens after active extension, prolonged sitting or standing);
- Absence of other neurological symptoms;
- Unstable effect of conservative therapy;
- Convincing effect of joint blockade with local anesthetics and steroids.
The duration of the procedure is 20-30 minutes under local anesthesia. After the procedure, you can go home.
Postoperative period: Limiting physical activity (lifting weights, bending over, active sports), course use of non-steroidal anti-inflammatory drugs COX-2 inhibitors. The procedure is effective in 90% of cases.
Radiofrequency treatment has 2 effects:
1) Immediate effect – pain decreases or disappears immediately after the procedure.
2) Long-term effect - developing over 6-8 weeks. The latter is associated with synaptic restructuring of the dorsal horns of the spinal cord (pain gate). The radiofrequency destruction technique impresses with its simplicity, effectiveness and low trauma.