Electrophoresis is a method of physiotherapy in which tissue is exposed to a constant electric current. Electrophoresis is performed with a medicinal substance that penetrates the body through the skin. Electrophoresis with Karipazim (Karipain) is used in the treatment of the spine and joints. This substance has a fairly good effect and can significantly improve the condition of patients (especially in the presence of an intervertebral hernia). Electrophoresis is a fairly safe method of therapy, however, in any case it requires a doctor’s prescription. You should not use electrophoresis without the recommendations of your doctor, but a specialist will inform you about its need.
At the Yusupov Hospital you can get qualified advice on methods of treating the spine and the use of electrophoresis. The doctor will perform an examination and draw up a plan for the most optimal therapy, which will eliminate the disease as much as possible and return the person to a full life.
Description of the procedure
When Karipain is applied to the body, direct current acts as a directed conductor to the source of pain. As a result of varying the current strength, session duration, number of electrodes, and medication concentration, the severity of the therapeutic effect varies.
Karipazim consists of salts, magnesium, calcium, amino acids, sodium and potassium. It destroys protein in cartilage and bone tissue without affecting collagen, thereby reducing the size of the tumor. The medication acts only on the diseased area, without affecting healthy areas of nerve endings and bones.
The main (basic) method of treatment is electrophoresis with papain
The papain treatment method was developed by V.L. Naidin, Doctor of Medical Sciences, Professor, Head of the Department of Neurorehabilitation.
and has been used at the Institute of Neurosurgery for more than 20 years. The ODA LCC has been using this technique for more than 15 years! The effectiveness of the method for osteochondrosis and many (even complex) disc herniations reaches 85%. Papain contains biologically active substances of plant origin (papain, chymopapain, etc.), which have a positive effect on collagen cartilage tissue. These tissues make up the intervertebral discs and, accordingly, the hernia.
At a certain concentration, papain, introduced by electrophoresis, affects the hernia itself. It begins to gradually decrease, becomes soft, and then disappears completely. Even a slight reduction in the hernia is enough to free the nerve ending that it pinches, and the pain in the spine gradually goes away.
To a greater extent, the medicine acts on the entire intervertebral disc. It loosens, becomes more elastic, increases in height, as if rejuvenated. The drug enhances the regeneration of disc tissue, which restores its normal shape and its function as a shock absorber. Neighboring discs and ligaments are also strengthened.
The procedure takes 20 minutes and is compatible with other treatment methods used at the ODA LVC. Treatment is contraindicated only for those patients for whom physiotherapy, in particular electrophoresis, is contraindicated.
Papain can also be used for joint contractures (post-traumatic and post-stroke), keloid scars of various origins, arthrosis-arthritis of large joints (including coxarthrosis), humeroscapular periarthritis, cerebral and spinal arachnoiditis, some forms of neuritis of the facial nerve, tunnel syndromes.
In some cases, ultrasound (phonophoresis) with Papain ointment is used in combination with electrophoresis.
When osteoporosis is combined with osteochondrosis, two drugs are used for electrophoresis - papain and xidifon. In the presence of osteophytes, the combination of Papain and lithium electrophoresis is very effective.
A course of treatment
To treat a spinal hernia confirmed by computed tomography or magnetic resonance imaging, it is necessary to undergo 3 courses of electrophoresis with papain, 30 procedures each course. Between courses the break is from 2 weeks to 2 months.
It is more advisable to do a control examination after all three courses, since during the 1st course, under the influence of papain, the hernia changes in structure, becomes softer, and at this time the nerve roots pinched by the hernia are already being released, as a result, pain disappears, sensitivity is restored. And in the second and third years the size of the hernia decreases.
Clinical example
Patient A-v N.V., 45 years old, came to the ODA LCC on September 30, 2003 with complaints of pain in the lumbar region, which radiated along the lateral surface of the leg to the foot, numbness of the foot, especially 1-2 toes, right foot "dangling"
He completed 3 courses of electrophoresis with Papain, 30 procedures each, received drug therapy Traumeel S, Tsel T, exercise therapy, and gentle traction of the spine with the Ertract device. After 3 months, on a control MRI, the hernia sharply decreased (photo), movements in the right foot were completely restored, and the numbness disappeared.
CONCLUSIONS
Indications
Most often, the procedure is prescribed by traumatologists, neurosurgeons and orthopedists for diseases of the back and spine. The reason to sign up for electrophoresis with Karipazim is:
- bedsores and necrosis stage I,
- inflammation of the nerve roots of the spinal column,
- inflammation of the hard membranes of the brain,
- burns, abrasions, severe wounds,
- joint fractures,
- pinching of the facial and other nerves,
- excessive brain tone.
Prevention
A herniation of the cervical spine is diagnosed if the substance of the disc core comes out and protrudes with pressure on the nerve structures located at the level of the hernia.
Although a herniated cervical spine can have different origins (degenerative or traumatic), symptoms usually begin spontaneously.
Upper extremity pain due to a cervical herniated disc occurs when the herniated disc material compresses the root, causing pain that travels along the nerve pathway down the arm. Along with pain in the hands, symptoms such as numbness and tingling in the hand and fingertips may appear. These symptoms may be accompanied by muscle weakness.
Why do you need electrophoresis with Karipazim?
The procedure has the greatest effect in cases of intervertebral hernia. The clinical picture improves, the tumor decreases in size, the nerve endings are pinched and because of this the pain subsides. In addition, the technique is prescribed for the treatment of:
- osteochondrosis,
- periarthritis,
- arthritis and arthrosis,
- radiculitis,
- intercostal neuralgia,
- neuritis.
The positive effect of electrophoresis with Karipazim is observed in the treatment of postoperative scars and adhesions, and pelvic inflammation.
Treatment of hernias in our clinic
Various surgical and conservative treatment methods are used to treat herniated intervertebral discs. Surgical methods mainly involve mechanical “cutting” of the disc and it is clear that in this case the functions of the disc cannot be fully restored. Surgical methods are used when the hernia has already reached a large size, and conservative treatment has failed to produce positive results.
Treatment of hernias without surgery
In our clinic, for the treatment of intervertebral hernias, we successfully use only conservative methods that are highly effective - more than 90% and allow us to do without expensive operations.
What needs to be done to make hernias disappear?
Naturally, there is no universal answer that would be suitable for all patients. But the general principles of hernia treatment are well known to us, and the specific program is selected individually.
When treating hernias it is necessary:
- Relieve pain syndrome
- improve nutrition of the affected area
- relieve possible muscle spasms
- Strengthen the muscle corset
- improve metabolic processes
To achieve these goals, our clinic doctors have all the necessary equipment at their disposal:
- Shock wave therapy Zwave,
- Pulse currents, electrophoresis,
- Detensor - therapy (traction),
- Ultrasound Phonophoresis,
- Hiwamat deep massage,
- Acupuncture physiotherapy
- Laser therapy,
- Pressotherapy,
- Magnetotherapy,
- Bubnovsky simulator,
Efficiency
Karipazimam has a prolonged effect, so to achieve pronounced results you need to take several courses consisting of 30 daily procedures.
The medication, under the influence of direct current, softens cartilage and removes calcification deposits, strengthens and increases shock absorption of intervertebral discs, and regenerates tissue.
Advantages of electrophoresis
When a drug is administered under the influence of a direct electric current, a certain depot is formed, from which the drug disperses evenly and gradually throughout the tissues.
The body receives the minimum effective doses of the drug in its most working ionized form, which does not require an additional portion of metabolism.
Electrophoresis acts at the local level, the medicine does not enter the bloodstream, which helps to avoid side effects and complications.
The drug is not destroyed uselessly in the stomach, intestines and liver. This helps to use smaller doses of the medication.
The excretory system and liver are not exposed to the toxic effects of the drug.
The medicine immediately gets to the place where the pathology develops. This cannot be achieved even with the use of injections into a vein due to the formation of swelling and circulatory disorders.
Iontophoresis ionizes the active substance in the medication, this makes it most effective.
The current, which is galvanic in nature, has healing properties in itself. It helps blood circulation, reduces inflammation, relieves swelling, and improves the functioning of the immune system.
Electrophoresis helps reduce the risk of drug allergies, since the drug enters the body in its purest form, without the use of solvents and various additives.
The effect of electrophoresis for osteochondrosis is completely painless, extremely comfortable and does not damage the skin.
CT scan
CT (MSCT) for diagnosing disc herniation in the cervical spine is significantly inferior in information content to MRI, but in some cases it can be used as an instrumental research method, especially in cases where there are contraindications for MRI.
EMG (ENMG) -
these research methods are used to determine and differentially diagnose nerve conduction disorders. An EMG may also help rule out other nerve compression syndromes such as carpal tunnel syndrome, brachial plexitis, ulnar neuritis, and thoracic outlet syndrome.
MRI
MRI of the cervical spine is the best method for diagnosing disc herniation. MRI scans can be performed with or without contrast. MRI can detect which disc is damaged and whether there is root compression.
MRI also makes it possible to clearly visualize changes in the structure of bone tissue or tumors, abscesses, and changes in the spinal cord (stenosis). In addition, MRI is absolutely harmless and can be prescribed repeatedly (to monitor dynamics).
Causes
- A herniated disc in the cervical spine occurs due to repetitive stress or, less commonly, a single traumatic incident. The risk of disc herniation may increase due to vibration stress, heavy lifting, prolonged sitting, accidents, and whiplash injury to the cervical spine.
- Osteochondrosis (degenerative disc disease) can be caused either by the natural processes of aging or by poor nutrition, smoking, lifestyle and work patterns.
- Cervical disc herniation can occur as a result of neck trauma, including whiplash, or traumatic brain injury, and due to repetitive stress.
- Cervical radiculopathy occurs secondary to nerve root compression by herniated disc material, stenosis, or inflammation mediated by proteoglycans released by the herniated disc. Smoking and a certain set of movements associated with the profession can also contribute to the development of cervical radiculopathy.
- Genetic determination. Several genes have been shown to be associated with intervertebral disc degeneration. Mutations in genes encoding proteins involved in extracellular matrix regulation, such as MMP2 and THBS2, have been shown to contribute to the development of disc herniation.
Differential diagnosis
A herniated disc in the cervical spine must be differentiated from the following conditions:
- Cervical stenosis
- Cervical zygapophyseal (facet) arthropathy
- Discitis
- Epidural, subdural, or intradural abscess
- Osteomalacia
- Parathyroid disease
- Polymyalgia rheumatica
- Ankylosing spondylitis
- Reiter's syndrome
- Enteropathic arthritis
- Diffuse idiopathic skeletal hyperostosis
The effect of physiotherapy for back and joint pain
Physiotherapy can achieve the following therapeutic effects:
- immunomodulatory – hyposensitization, immunostimulation;
- decrease or increase in the functional activity of the central nervous system;
- activation of blood circulation in the extremities;
- normalization of metabolic processes;
- elimination of spasms and swelling;
- increased or decreased blood clotting;
- changes in microcirculation, metabolism and cell activity due to hyperplasia and defibrolysis;
- decreased tone of the skeletal structure;
- elimination of limited joint mobility;
- restoration of natural muscle function.
Treatment
Exercise therapy
Exercise can improve proprioceptive skills and help maintain a stable, safe, and pain-free neck posture during strenuous activities.
Cervicothoracic stabilization requires strengthening and coordination of the neck, shoulder and scapular muscles. For lasting stabilization, it is also necessary to strengthen the muscles of the lumbar region and lower extremities.
Stabilization exercises should be carried out systematically, from simple to complex. Isometric and isotonic resistance exercises are performed on special machines, using elastic bands and free weights. The exercise program allows you to redistribute load vectors to other parts of the spine.
Systematic physical exercises according to a selected program help to form the correct stereotype of movements and rapid automatic cervicothoracic stabilization in everyday activities.
- Traction therapy
. Traction on special traction tables can reduce pressure on the nerve root and reduce symptoms. But the treatment method is not effective in all patients. - Manual therapy
. Gentle manual manipulation can help reduce vertebral joint dysfunction. This type of gentle manipulation is called mobilization. Intensive manipulation of the neck is not recommended as it may worsen neurological symptoms - Osteopathy. Gentle osteopathic manipulation and special techniques to restore normal movement of the neck joints may be helpful in reducing pain from a cervical herniated disc.
- Change in activity. Certain activities can aggravate the pain of a herniated disc, and it is wise to avoid these activities to avoid irritating the nerve root: heavy lifting (eg, over 20 kg), activities that may cause increased vibration and pressure on the cervical spine (boating, snowmobiling, running, etc.), as well as movements associated with intense rotation or throwing back of the head.
Corseting
. In some cases (especially if there is severe muscle spasm and pain), wearing a cervical collar may be recommended, which can reduce the strain on the neck.