List of the best and most powerful painkilling injections for back pain, lower back pain or spinal hernia

Content

• Blockade of a spinal disc herniation: benefits
• Who carries out the treatment?
• Why do they contact us?

• Expert opinion
• Reviews from our patients
• Sign up for treatment

Pain levels

0 — 3

Mild pain

- does not interfere with everyday activities, but you can adapt to the pain.

4-6

Moderate pain

- prevents you from doing business, prevents you from concentrating, the patient remains independent

7-8

Strong pain

- it is impossible to carry out daily activities, it is difficult to think about anything other than pain, the patient cannot function independently

9-10

Unbearable pain

- requires urgent care, bed rest, disables the patient

Blockade of a spinal disc herniation: benefits

Drug blockade is the administration of a drug to the site of compression of the nerve root in order to quickly relieve pain. The most important advantage of blockades is the speed of the drug’s effect on the body. Usually the patient feels relief immediately after the procedure, which lasts for a long time. If necessary, the procedure can be repeated several times - sometimes one is enough, and sometimes you have to do a course of 5-7 blockades.

The blockade also helps relieve inflammation and swelling of the nerve root, normalizes blood circulation and eliminates painful muscle spasms in the back.

To obtain the best effect, the drug is injected into 2,3 or 4 painful points, sometimes on both sides of the spine.

What are decongestant drips?

These are droppers containing decongestant components. These drip infusions use diuretics. These drugs are aimed at removing excess fluid from the body. They are actively used during rehabilitation after surgery and during the course of chemotherapy in the treatment of oncology. In the treatment room of the MRI center and clinic RIORIT, you have the opportunity to undergo treatment using drip administration of drugs under the supervision of experienced doctors and in comfortable conditions. If you need help choosing the right medications for your IVs, our clinic's therapist with 25 years of experience will be happy to advise you on this issue. Call! Your Health is Your RIORIT!

What kind of blockades are used for vertebral hernia?

Depending on the injection site, two types can be distinguished:

• Paravertebral - the medicine is injected into the area where the nerve passes under the transverse process of the vertebra.
• Transforaminal - the medicine is injected deeper into the intervertebral foramen to the site of root formation in the spinal cord.

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Depending on the drugs used during the procedure, we can distinguish:

• Anti-inflammatory

  . For example, when blocking an intervertebral hernia, Diprospan is used, a drug with powerful anti-inflammatory properties.

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• Painkillers

  . Novocaine spinal blockade or lidocaine blockade for spinal hernia, a local anesthetic instantly blocks the transmission of pain impulses along the nerve.

• Mixed blockades

  - used most often. The injection includes 2-3 components - anti-inflammatory + painkillers, this “cocktail” allows you to get the greatest effect from the blockade.

Paravertebral blockade is most often used.

Table 1 Recommendations for the prevention of complications associated with taking NSAIDs

Another drug that has a sufficient gastroprotective effect is the synthetic prostaglandin E1 - misoprostol, but its use is limited by its high cost.

The protective effect of the H2-histamine receptor antagonist, famotidine, has been proven only in combination with ibuprofen. A combination drug was created, which is currently not available in Russia. However, both of its components can be purchased and taken separately. They are affordable.

It is necessary to inform the patient that even despite intense back pain, his health is not in danger. The vast majority of patients have a favorable prognosis: within 3 months, more than 90% of patients do not seek medical help again.

Less significant are complications from the urinary and central nervous systems, hepatotoxic effects of drugs:

Adverse events from the urinary system

All NSAIDs can have nephrotoxic effects. When taking drugs of this group, the following types of complications may develop: Development of acute renal failure due to spasm of renal vessels. Other mechanisms of organ damage are also possible. NSAIDs cause a moderate increase in arterial hypertension, reduce the effectiveness of antihypertensive drugs, and can cause electrolyte disturbances (hyperkalemia, hyponatremia and edema). Taking NSAIDs is associated with an increased risk of kidney cancer.

Adverse events from the cardiovascular system

All NSAIDs, both selective and non-selective, increase the risk of developing cardiovascular complications: clinical manifestations of coronary heart disease, heart failure, increased blood pressure, and the development of atrial fibrillation. Naproxen has the lowest risk of developing complications from the cardiovascular system. (Daniel H Solomon, MD, 2015). NSAIDs interact with all classes of antihypertensive drugs except calcium antagonists, reducing their effectiveness. Their use may increase blood pressure in patients (White WB. 2007). Safety issues are more relevant for patients with a high risk of cardiovascular complications (old age, long-term hypertension, constant use of antihypertensive drugs, diabetes mellitus); in patients with a low risk, they do not limit the use of drugs in this group.

Adverse events from the blood system

Neutropenia is a rare complication of taking NSAIDs and develops in less than 1% of patients; no risk factors for the development of this condition or association with taking individual drugs from this group have been established. The antiplatelet effect is associated with inhibition of COX-1, which leads to a decrease in the production of thromboxane A2. It is necessary to avoid taking NSAIDs in patients with thrombocytopenia (less than 50 x 109/l). Before surgery, drugs should be discontinued within 3-5 half-life periods. For most NSAIDs, the antiplatelet effect disappears 3 days after discontinuation. The antiplatelet effect of ibuprofen is eliminated 24 hours after discontinuation of the drug. Highly selective COX-2 inhibitors have little effect on platelet hemostasis. Concomitant use of NSAIDs and aspirin may reduce the antiplatelet effect of the latter. Interaction with warfarin leads to a significant increase in INR when taken simultaneously. More frequent monitoring of the indicator is required.

Allergic and pseudoallergic reactions

Pseudoallergic reactions associated with inhibition of COX-1 can be caused by taking aspirin and all (“crossover”) NSAIDs that inhibit COX-1: Piroxicam, Indomethacin, Ibuprofen, Naproxen, Ketoprofen, Diclofenac, Ketoralac, and less commonly, drugs with weakly expressed properties of COX inhibitors -1 — paracetamol; and even less often when using drugs that selectively inhibit COX-2, nimesulide, coxibs, oxicams; a dose-dependent effect was noted for these drugs. Allergic reactions to NSAIDs develop in the form of angioedema, urticaria or anaphylaxis. Cross-reactions to drugs with similar chemical structures are possible. If pseudo-allergic and allergic reactions to any of the NSAIDs develop, it is necessary to avoid taking all drugs in this group; as an alternative, use paracetamol in a single dose of no more than 650 mg.

Adverse effects from the respiratory system

When taking aspirin and other non-selective COX-1 blockers, it is possible to develop bronchospasm, decompensation of bronchial asthma and other obstructive bronchial lesions of inflammatory origin.

Adverse events from the hepato-biliary system

Cases of liver failure when taking NSAIDs are quite rare (3.7 per 100,000 patients taking drugs of this group). Transient slight increases in the activity of liver enzymes (less than 3 upper limits of normal) are not prognostic signs of the development of acute liver failure associated with the action of NSAIDs. Ibuprofen is the safest NSAID and has not shown severe liver damage in large studies. Along with paracetamol and aspirin, the drug is one of the best-selling over-the-counter drugs in the world. Newer NSAIDs, selective COX-2 inhibitors, oxycams and coxibs have a relatively low risk of toxicity. In rare cases, piroxicam can cause severe liver damage.

The drug Nimesulide was withdrawn from sale in a number of countries (Japan, Finland, Turkey, Israel, India, Sri Lanka, and later Ireland), and was never put on sale in the USA and Great Britain, due to a pronounced hepatotoxic effect in a series of clinical observations , however, various epidemiological studies do not confirm this information.

The European Medicines Agency (EMA) recommends only short-term use of the drug (15 days), at a dose not exceeding 200 mg/day (100 mg x 2 times a day) in adults. Taking into account all the data obtained, the Agency believes that the potential benefits of the drug, subject to restrictions, outweigh the potential risks.

The economic feasibility of monitoring liver enzyme activity in patients taking NSAIDs has not been established.

In case of an increase in activity by more than 3 times compared to the upper limit of normal, a decrease in the concentration of serum albumin, or an increase in INR, it is necessary to assume the hepatotoxic effect of NSAIDs.

Adverse skin effects

The risk of developing toxic epidermal necrolysis and Stevens-Johnson syndrome (malignant exudative erythema) when taking NSAIDs is 1 in 100,000. The highest risk is when taking piroxicam, the lowest is when taking diclofenac and ibuprofen.

Adverse effects from the nervous system

Elderly patients taking NSAIDs, especially indomethacin, may experience worsening cognitive impairment and the development of psychosis. Taking ibuprofen and naproxen is associated with the development of aseptic meningitis. In a small proportion of patients, taking NSAIDs is accompanied by the development of tinnitus. The complication is reversible after discontinuation of the drugs.

Injections for a hernia in the back: Blockade technique

The paravertebral block procedure is performed with the patient lying on his stomach. The points of greatest pain on both sides of the spine are determined. Having retreated 3-4 cm from the line of the spinous processes of the vertebrae (central line), after preliminary anesthesia of the skin, the medicine is injected into the area of ​​the inflamed nerve to a depth of 5-7 cm. On average, to achieve the desired result, it may take from 3 to 7 injections, with an interval of 1 to 7 days.

The effect after paravertebral blockade can last up to several weeks. It is recommended to use it in combination with other treatment methods.

Orthopedic surgeon Timur Vyacheslavovich Kholikov comments:

Epidural anesthesia is carried out following the same steps, only the injection is made deeper, piercing the hard shell of the spinal cord. This blockade is done in a hospital setting. A similar technique is used for injections for hernia of the cervical spine.

You can find out the price of injections for the spine for a hernia or blocks for a hernia of the lumbar spine, read reviews, and also make an appointment with a specialist directly on our website.

Reviews

08/31/2021 I would like to note the good work of nurse Tatiana. She has a very light hand. I have complex veins, but she gave me a course of IVs without any problems. Clinic administration - pay attention to its high professional training.

Roman Gavrilyuk

08/31/2020 This is not the first time I have applied to your medical center for tests, IVs and more. The doctors are wonderful, the service is top notch. The staff is friendly and attentive.

Vyunova G.V.

02/15/2020 02/15/2020 I express my deep gratitude to neurologist Sergei Yuryevich Vasilenko. I asked for a consultation after an MRI of the spine. The doctor conducted the appointment very carefully and professionally. In the future I would like to visit Sergei Yuryevich if I suddenly need his consultation. He spent enough time and explained everything very clearly. I was 100% satisfied with the consultation. I wish there were more such attentive and professional specialists. PS Good luck to Sergei Yuryevich in his medical practice.

Reshetnyak V.N.

04/28/2018 I underwent IV drips at this clinic. She came “crawling” and left dancing. High level of professionalism and skill. Now only here. I recommend to all.

Evgeniya

05/27/2018 I contacted the RIORIT center based on a recommendation. I immediately noted the polite administrators, who provided complete, competent information at every visit. I would like to express my deep gratitude to therapist N.D. Telegina. Her recommendations, treatment and prescribed procedures literally lifted me to my feet. The magic droppers had a very strong therapeutic effect for me. After the first visits, I decided to bring my husband. He completed a course of IV drips with good effect.

Patient

04/16/2016 We, a family of 2, were examined at the “RIORIT” MC, we really liked the fast and good service, we had intravenous drips painlessly, and all the tests were ready on time. I would especially like to note the sensitive and attentive attitude of the doctor - a therapist from God - Natalya Dmitrievna Telegina. We wish you continued prosperity and excellent service.

Reutova Lina and Reutov Alexey

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Prices for drug blockades

Why do they contact us?

• No queues

  No need to wait, we work by appointment

• All in one day

  Doctor's appointment, diagnosis and treatment on the day of treatment

• Let's relieve the pain

  We relieve pain in just 1-2 visits to us

• We guarantee

  Professional approach, affordable prices and quality

• Doctor's appointment 0 RUB!

  If the cost of treatment is more than 20,000 rubles

• Three treatment options

  We will select several methods and offer optimal treatment

Compatibility of B vitamins in injections

B vitamins are antagonists, therefore, if you are prescribed drugs separately, and not in a complex, ready-made drug, they should be injected every other day. Otherwise, their effectiveness is lost. It is for this reason that B vitamins cannot be mixed in one syringe. Complex solutions work a little differently. Currently, pharmaceutical companies have learned to produce complex preparations of B vitamins, which contain special stabilizing substances that prevent the antagonists in the ampoule from being destroyed.