Treatment of joints: anti-inflammatory treatment, electrophoresis, chondroprotectors, manual therapy, diet

Our clinic specializes in the treatment of joint diseases; we have been successfully treating autoimmune and rheumatic diseases for many years. We use modern treatment methods and the latest generation drugs.

• Karipain and Karipazim. Electrophoresis of Karipazim and Karipain
• Anti-inflammatory treatment: hormones, NSAIDs, immunoglobulins, cytostatics
• Treatment of infections
• Joint injections
• Medicines for cartilage restoration. Chondroprotectors
• Manual therapy in the treatment of joints
• Nutrition and diet
• First aid for joint pain. How to relieve pain yourself
• When is it time to have a joint replacement?

Karipain and Karipazim. Electrophoresis of Karipazim and Karipain

Electrophoresis helps the medicine penetrate into hard-to-reach places, this ensures maximum treatment efficiency. Karipazim and Karipain are administered using electrophoresis. This simple and painless procedure can be performed at home. In order to save time and money (the duration of the course is 30 procedures), we teach patients to independently perform electrophoresis.

Karipain and Karipazim are enzyme preparations that have a strong absorbable effect and have a positive effect on the elasticity of cartilage and ligaments.

We have long and successfully used electrophoresis of these drugs to treat:

• consequences of joint injuries,
• meniscus damage,
• arthrosis,
• contractures,
• intervertebral hernias.

How is electrophoresis performed ? Are used:

• two cloth pads moistened with a heated 0.9% sodium chloride solution,
• electrophoresis apparatus
• Karipain (Karipazim).

A weak electric current conducts drug ions through the skin into a joint or spine. One pad is connected to the positive pole of the device, and the drug solution is applied to it.
The other gasket is wetted only with a heated 0.9% sodium chloride solution and connected to the negative pole of the device. The spacers are positioned so that the affected vertebra or joint is exactly between them. Then, with the help of a device, a weak electric current is passed through the pads, which conducts positively charged drug ions to the opposite pole. During the procedure, drug ions penetrate into the joint or spine and have a therapeutic effect.

Galvanization and medicinal electrophoresis

As a source of direct current, devices of the “Potok-1”, “AGN”, “GR” type are used, generating continuous currents, or the “Amplipulse” type, producing pulsating or intermittent direct currents.

1 - mains voltage switch and switch;

2 - signal light for turning on the mains voltage, and on the GR-2 device, the polarity of the output terminal sockets;

3 — device sensitivity switch;

4 — potentiometer handle;

5 - milliammeter;

6 — terminals for connecting patient wires;

7 — keys for fixing patient wires.

To supply direct current to the area of ​​the patient's body to be affected, electrodes of appropriate sizes and shapes are used. The electrode consists of a metal plate or other well-conducting material and a gasket made of hydrophilic fabric or conductive sponge material with a thickness of at least 1 cm, the dimensions of which are 1.5-2 cm larger than the dimensions of the metal plate along the entire perimeter. A gasket placed between the metal plate and the patient’s body protects the skin from burns and irritation by acidic and alkaline electrolysis products formed near the metal part of the electrodes during the passage of current. Multicore insulated wires are used to connect the electrodes to the terminals of the device.

When carrying out medicinal electrophoresis procedures, the devices listed above are used. In this case, the same electrodes and private techniques are used as for galvanization, but between the hydrophilic pad and the body surface (skin, mucous membrane) a thin intermediate pad made of filter paper, napkin paper or gauze (1-2 layers) soaked in a solution of the medicinal substance is placed . For the simultaneous introduction of like-charged but different ions, for example Ca+ and Mg+, separate electrodes are used, connected to one pole.

Ions of the drug substance or its electrically charged particles are introduced from the pole whose polarity corresponds to the charge of the administered ingredient, i.e., negatively charged ions are introduced from the cathode, and positively charged ones from the anode. It is possible to simultaneously introduce oppositely charged ions of both poles.

The solvent that provides the best dissociation, and therefore the largest number of drug ions in the solution, is distilled water. Usually 2-5% solutions are used. The exception is for potent substances, which in their generally accepted dilution are taken for one procedure in the amount recommended by the pharmacopoeia for a single dose.

For some substances that are insoluble in water, aqueous solutions (up to 50%) of dimethyl sulfoxide (DMSO), which also has independent permeability into tissue, are used as a solvent that ensures the dissociation of molecules.

For electrophoresis of amino acids and some proteins, the penetration of which into tissues is very small, their solutions are given a certain pH value, which, without disturbing the activity of the substance, promotes optimal electrophoresis. To do this, either acidified (introduction from the anode) or alkalized (introduction from the cathode) distilled water is used as a solvent.

In preparation for the galvanization treatment procedure, as well as other methods using direct current, hydrophilic pads are immersed in hot tap water, then they are moderately wrung out and applied to the areas of the body to be treated along with conductive plates connected to stranded wires. The latter are connected to the plates with special spring clips, soldered or placed on the plate along with a metal “flag”. All together they are tightly bandaged with an elastic bandage, and sand bags are pressed. The tight and even fit of the gaskets to the body and the impossibility of the metal part of the electrode coming into contact with it must be carefully checked, as well as the absence of abrasions, scratches and other violations of the epidermal layer on the skin under the electrodes (in extreme cases, a small skin defect can be covered with a piece of cotton wool or gauze with Vaseline).

Transverse, longitudinal or oblique placement of electrodes on the patient's body is used. The distance between the edges of both electrodes facing each other must be no less than the width of one of the electrodes.

Typically, equal-sized electrodes are used. However, in some cases, if it is necessary to strengthen the effect of the current on a particular part of the body, an electrode of a smaller area is placed on it compared to the second.

If it is necessary to influence the area of ​​​​the small joints of the fingers and toes, use flat baths (single- or double-chamber bath). In this case, the metal electrode is lowered into the water of the bath as far as possible from the area of ​​the body being immersed in such a way as to prevent accidental contact of the body with the metal part of the electrode; the second electrode is placed proximally - on the patient’s arm or leg, in the cervical-scapular or lumbar region of the spine. The switching on of the current should start from zero, increase very gradually and smoothly, without jerks or jolts, and not reach the specified value by 1-2 mA, since the resistance of the skin when it is heated with wet pads decreases and the current gradually increases. The shutdown should also be carried out very smoothly to zero. At the end of the procedure, the device must be turned off and the wires disconnected from it. The duration of procedures, frequency and total number of them per course of treatment depend on the nature, stage and phase of the disease, the general condition of the patient and his individual characteristics.

Electrophoresis and galvanization with fronto-occipital placement of electrodes.

Impact with fronto-occipital location of electrodes.

An electrode with an area of ​​about 50 cm2 is placed on the forehead, a second electrode of the same size is placed on the back of the neck in the area of ​​the upper cervical vertebrae if it is connected to the anode, or in the area of ​​the lower cervical vertebrae when it is connected to the cathode. Current strength is 2-5 mA, duration of procedures carried out daily or every other day is 10-20 minutes; for a course of treatment 10-20 procedures.

Electrophoresis and galvanization with orbital-occipital placement of electrodes (according to Bourguignon).

Impact with orbital-occipital arrangement of electrodes (according to Bourguignon).

Two round electrodes (about 5 cm in diameter) are placed on the skin of the closed eyelids and connected to one pole of the device, the second electrode with an area of ​​50 cm2, when connected to the positive pole, is placed on the back of the neck in the area of ​​the upper cervical vertebrae, with a negative polarity - in the area of ​​the lower cervical vertebrae vertebrae The current strength is 1-5 mA, the duration of procedures carried out every other day is 10-20 minutes; for a course of treatment 10-15-20 procedures.

Electrophoresis and galvanization with bitemporal arrangement of electrodes.

Impact with bitemporal arrangement of electrodes. Each of two electrodes measuring 5x6 cm is placed on the skin of the right and left temporal region. The current should be increased to 1-3 mA, and at the end of the procedure, reduced especially smoothly to avoid possible dizziness. The duration of procedures carried out daily or every other day is 10-15 minutes; per course of treatment - 10-15 procedures.

Electrophoresis and galvanization on half the face.

Impact on half of the face. A three-bladed electrode (Bergonier half mask) with an area of ​​250 cm2 is placed on the affected side of the face so that each blade fits tightly to the forehead, cheek and chin, leaving the eyes and mouth free; a second electrode of the same area is placed in the interscapular region or on the opposite shoulder.

When indicated, a gauze turunda soaked in water or a solution of a medicinal substance is inserted into the external auditory canal.

The free end of the turunda is placed under the facial electrode pad. If it is necessary to influence both sides of the face, the procedures are performed alternately on each side. Current strength is 10-20 mA, duration of procedures carried out daily or every other day is 10-20 minutes; for a course of treatment 15-20 procedures.

Electrophoresis and galvanization on the area of ​​innervation of the trigeminal nerve.

Impact on areas of the face innervated by the branches of the trigeminal nerve.

One electrode measuring 5x10 cm is placed in the area innervated by the affected branch of the trigeminal nerve (if two or three branches of the trigeminal nerve are involved in the pathological process, 2 or 3 electrodes are placed on the corresponding zones), and connected to one output terminal of the device (for galvanization - with positive); the second electrode, equal in area to the first or the sum of the area of ​​the first, is connected to the second terminal of the device.

The current strength is set based on the smaller area or sum of the areas of the electrodes connected to one pole of the device (no more than 0.1 mA per 1 cm2); the duration of procedures carried out daily or every other day is 10-20 minutes, for a course of treatment from 12 to 20 procedures.

Electrophoresis and galvanization on the eye area.

Impact on the eye area. A special electrode in the form of a bath with a capacity of 3-5 ml is filled with a medicinal solution heated to 30°C (antibiotics are not heated) or water, placed on the orbital area with the eye open so that its edges fit tightly to the edges of the orbit.

a - electrode-bath for applying current to the eye: 1-bath body; 2 - carbon electrode; 3 — metal tip of the electrode; 4 - channel in the metal tip for connecting the electrode to the current source; 5 — control tube made of transparent glass; b — location of electrodes when applying current to the eyes: 1 — using a bath electrode; 2 - using conventional electrodes.

The patient's open eye is immersed in the solution and washed with it. The patient's position is sitting, slightly leaning forward. The electrode is fixed with a bandage or held by hand. Through a hole in the bath, closed with a rubber stopper, a platinum or carbon electrode is inserted into the bath, with a little cotton wool wrapped around the tip (if the electrode is not pressed into the bath). You can use an oval-shaped electrode measuring 2.5x4 cm, consisting of a metal plate and a hydrophilic pad about 1 cm thick, which is placed on closed eyes. The second electrode with an area of ​​50 cm is placed on the back of the neck in the area of ​​the upper cervical vertebrae when connecting it to the anode or in the area of ​​the lower cervical vertebrae when connecting it to the cathode. The effect begins at a current strength of 0.5 mA, then it is increased to 1-1.5 mA. The patient should experience a uniform tingling sensation in the eye. The duration of procedures, carried out daily or every other day, is 8-20 minutes, for a course of treatment there are 5-20 procedures.

Electrophoresis and galvanization on the ear area.

Impact on the ear area (extraural). One electrode measuring 3x4 cm in the form of an arc is placed around the lower half of the ear and connected to one pole of the device; the second electrode measuring 6x8 cm is placed on the opposite cheek and connected to the second terminal of the device. Current strength 0.5-1.2 mA; the duration of procedures performed daily (or every other day) is 10-15 minutes; for a course of treatment 8-15 procedures.

Electrophoresis and galvanization of the outer and middle ear.

Impact on the outer and middle ear (endaural). A gauze turunda moistened with warm water or a solution of a medicinal substance is loosely inserted into the external auditory canal, which is deepened by 1-1.5 cm in case of disease of the outer ear, and when applied to the middle ear, until it comes into contact with the eardrum. The second end of the turunda is filled into the auricle and an electrode measuring 4x4 cm with a gasket soaked in water or medicine is placed on it, and this electrode is connected to one pole of the device. A second electrode measuring 6x8 cm is placed on the opposite cheek and connected to the other terminal of the device. If it is necessary to influence both ears, the procedures are carried out alternately on each of them.

Endaural exposure can also be carried out through an ebonite or porcelain funnel, which is filled with water or a medicinal solution heated to 36-37°C. A metal or graphite rod with a slightly larger diameter than the outlet of the funnel is inserted into the funnel. The rod is connected to one of the terminals of the device. A second electrode measuring 6x8 cm is placed on the opposite cheek and connected to the second terminal of the device. Current strength 0.5-2 mA; procedures lasting 10-15 minutes are carried out daily or every other day; for a course of treatment 10-12 procedures.

Electrophoresis and galvanization on the area of ​​the maxillary cavities.

Impact on the area of ​​the maxillary cavities.

One electrode measuring 3.5x17 cm is placed on the surface of the nose and the projection of the maxillary cavities; the second electrode measuring 7x10 cm is placed on the back of the neck in the area of ​​the upper cervical vertebrae, if it is connected to the positive pole, or in the area of ​​the lower cervical vertebrae, if it is connected to the cathode. Current strength 3-6 mA; the duration of exposures carried out daily or every other day is 10-20 minutes; for a course of treatment 8-15 procedures.

Electrophoresis and galvanization - intranasal exposure.

Intranasal exposure.

A. Using tweezers, gauze turundas are loosely inserted into both nostrils, as deeply as possible, abundantly soaked in water or a solution of a medicinal substance. Their free ends are laid on top of a small oilcloth on the upper lip, and a conductive plate measuring 1.5x2-3 cm connected to the terminal of the device is placed on them. The lower edge of the oilcloth is folded over a conductive plate (to prevent it from coming into contact with the body) and the whole thing is secured with several turns of the bandage. The second electrode with an area of ​​80-100 cm2 is placed on the back of the neck in the area of ​​the upper cervical vertebrae, if it is connected to the positive terminal of the device, or in the area of ​​the lower cervical vertebrae, if it is connected to the negative terminal of the device.

B. Another option for intranasal exposure is also possible. The soldered end of the wire, loosened at a distance of 2-2.5 cm from the insulation, tightly wrapped in a layer of cotton wool moistened with water or a solution of a medicinal substance, is inserted into each nostril and placed under the inferior turbinate. Both wires are connected to one output terminal of the device. A dry cotton swab is placed between the upper lip and the wires. The second electrode is placed as in the previous version.

Note. When performing intranasal electrophoresis of vitamin B1, it is advisable to adhere to the following procedure scheme (Table 2).

Electrophoresis and galvanization with endaural-endonasal arrangement of electrodes.

Impact with endaural-endonasal arrangement of electrodes. One electrode in the form of a gauze turunda soaked in water or a medicinal substance is inserted into the external auditory canal (as in method No. 8 - Electrophoresis and galvanization for the outer and middle ear), the second electrode in the form of a gauze turunda soaked in water or a medicinal substance is inserted into the nasal cavity corresponding to the affected ear (as in method No. 9 - Electrophoresis and galvanization in the area of ​​the maxillary cavities and method No. 10, and - Electrophoresis and galvanization - intranasal exposure). The polarity is set depending on the medicinal substances used. Current strength is from 0.5 to 2 mA, duration of procedures carried out daily or every other day is 10 minutes; for a course of treatment 10-15 procedures.

Electrophoresis and galvanization on the area of ​​the cervical sympathetic nodes.

Impact on the area of ​​the cervical sympathetic nodes. Two electrodes measuring 3x6 cm each are placed on the lateral surfaces of the neck along the anterior edge of the sternocleidomastoid muscles and connect them to one of the terminals of the device, another electrode with an area of ​​40-50 cm2 is placed on the back surface of the neck in the area of ​​the upper cervical vertebrae, if it is connected to the anode, or in the area of ​​the lower cervical vertebrae when connecting it to the cathode. Current strength is 2-3.5 mA, exposure lasting 10-20 minutes is carried out every other day; for a course of treatment 6-12 procedures.

Electrophoresis and galvanization on the cervico-facial areas.

Impact on the cervical-facial areas. Two identical Y-shaped electrodes with an area of ​​about 150 cm2 are placed on the lateral surfaces of the neck and face on the left and right so that the ears are between the electrode blades.

The short blade behind the ear should reach the mastoid process, the long blade in front of the ear should reach the brow ridge. The lower rounded part of the electrode reaches the middle of the neck. When exposed to direct current, the polarity of the electrodes should be the reverse of the polarity in the previous procedure. It is advisable to set the current strength and duration of procedures in accordance with table. 3. The procedures are carried out daily, for a course of treatment there are 12-14 procedures.

Electrophoresis and galvanization on the tonsil area.

Impact on the tonsil area. Two round or rectangular electrodes measuring 3x6 cm, connected by one wire, are placed in the submandibular region on the projection of the tonsils on the neck at the angle of the lower jaw, the wire is connected to one of the terminals of the device. The second electrode with an area of ​​40-50 cm2 is placed on the back of the neck in the area of ​​the upper cervical vertebrae, if it is connected to the anode, or in the area of ​​the lower cervical vertebrae, if it is connected to the cathode. Current strength 2-5 mA, duration of exposure 15-30 minutes; for a course of treatment 10-12 procedures.

Electrophoresis and galvanization on the larynx area.

Impact on the larynx area. Either one electrode measuring 6x10 cm (on the front surface of the neck) or two electrodes measuring 3x6 cm are placed on the larynx area - each on the side surface of the larynx, connected by one wire to one of the terminals of the device; the second electrode measuring 6x10 cm is placed on the back of the neck in the area of ​​the lower cervical vertebrae. The current strength in the first option is 4-7 mA, in the second - up to 5 mA, the duration of exposure is 10-15 minutes; for a course of treatment 8-10 procedures.

Electrophoresis and galvanization on the collar area (according to A.E. Shcherbak).

Impact on the collar zone (according to A.E. Shcherbak). An electrode in the shape of a shawl collar is placed on the upper back so that its ends cover the shoulder girdle and collarbone to the second intercostal space in front.

The second electrode with an area of ​​300-400 cm2 is placed in the lumbosacral region. When exposed to direct current, the collar electrode is connected to the positive terminal of the device. After each procedure, the duration of exposure is increased by 2 minutes, and the current strength is increased by 2 mA: starting from 6 minutes and 6 mA, they are brought to 16 minutes and 16 mA, from the 11th procedure the duration of the procedures and the current strength do not change; for a course of treatment 15-20 procedures.

Electrophoresis and galvanization on the chest area.

Impact on the chest area. Electrodes with an area of ​​200 cm2 are placed according to the location of the pathological focus in the lung.

Note. During drug electrophoresis in patients with pulmonary tuberculosis, electrodes with an area of ​​up to 250 cm2 each are placed on the extensor surfaces of both shoulders.

Electrophoresis of novocaine on areas of cardiac hyperalgesia.

Novocaine electrophoresis of cardiac hyperalgesia zones.

One or two electrodes with an area of ​​about 100 cm2, under the pad of which sheets of filter paper moistened with a freshly prepared 5% novocaine solution are placed, are placed in the area of ​​hyperalgesia zones and connected to the anode, the second electrode with an area of ​​about 200 cm2 is placed in the lower back symmetrically with respect to the first two electrodes and connect it to the cathode. During treatment, the localization of electrodes with novocaine is changed as hyperalgesia disappears or significantly decreases in the affected areas (approximately 3-4 procedures per zone). The current strength is 5-10 mA, the duration of procedures performed daily is 15-20 minutes.

Electrophoresis and galvanization on the oral mucosa.

Impact on the oral mucosa. One electrode, consisting of a round lead plate with a diameter of 1-1.5 cm, soldered to a current-carrying wire, is tightly wrapped in cotton wool, serving as a hydrophilic gasket, the cotton wool is impregnated with water or a solution of a medicinal substance and placed in a finger-shaped bag of thin rubber, on one side in which a round hole with a diameter of 1-1.5 cm is cut out. A rubber bag (finger cap) with an electrode is placed with a round hole on the area of ​​the oral mucosa or on the gum, fixed with the patient’s finger and connected to the terminal of the device. The second electrode with an area of ​​25-30 cm is placed on the forearm. The current strength is 1-2-3 mA, the duration of the procedure is 10-20-30 minutes daily. The course of treatment consists of 8-12 procedures.

Electrodes of other shapes are used to influence the gums. A rubber tube with a diameter of 10 mm and a length of 6-8 cm is cut lengthwise into two parts. A hole with a diameter of 2 mm is made in the middle of each of the resulting grooves. A lead plate 4-5 cm long and 0.5-1 cm wide is placed on the bottom with a current-carrying wire soldered to it in the middle, which is pulled out through the hole in the groove. The lead plate is covered with 5-6 layers of gauze, which is soaked in water or a solution of a medicinal substance, and placed in a rubber trench. The electrodes are placed with a gauze pad on the gum area: one on top under the upper lip, the other under the lower lip. They are connected to one terminal of the device with a forked wire. An electrode with an area of ​​20-25 cm2 is placed in the forearm and connected to the second terminal of the device.

Electrophoresis and galvanization on the mammary gland area.

Impact on the mammary gland area.

Electrodes in the form of a ring with an outer diameter of 10-15 cm and an inner diameter of 5 cm or rectangular with an area of ​​​​about 180 cm2, connected to the cathode, are placed on the mammary glands, leaving the nipples with areolas free. The third electrode, equal in area to the sum of the first two, and when affecting one gland - to one, is placed in the interscapular region or above the pubic symphysis and connected to the second terminal of the device - the anode.

Electrophoresis and galvanization on the joint area.

Impact on the joint area.

a - shoulder; b - elbow; c - wrist; g - hip; d - knee; f — knee (area of ​​the lower inversion), g — knee (area of ​​the upper inversion); h - ankle.

Two electrodes of the same area, depending on the size of the joint, are placed transversely with respect to it so that the distance between the adjacent edges of both electrodes is no less than the size of one of them.

They are placed on the anterior and posterior surfaces of the shoulder joint, on the inner and outer surfaces of the elbow joint, on the flexor and extensor surfaces of the wrist joints, on the anterior surface of the hip joint and in the lower gluteal region posterior to the greater trochanter, on the outer and inner surfaces of the knee joint in the area of ​​the upper and lower inversions of the knee joint, on the outer and inner surfaces of the ankle joints.

To influence small joints of the hands and feet, it is possible (and even better) to use a chamber bath filled with water at a temperature of 36-37 ° C as one electrode; the second electrode is placed in the form of a cuff proximally on the arm or leg.

In case of multiple lesions of the joints of the hands and feet, it is advisable to use two-, three-, four-chamber baths.

Electrophoresis and galvanization are a common effect on the body.

General effect on the body. General exposure is most often carried out using the Vermeule method.

To do this, with the patient lying down, an electrode measuring 15x20 cm is placed in the interscapular area and connected to one of the terminals of the device; two other electrodes, each measuring 10x15 cm, are placed on the calf muscles and connected with one wire to the second terminal of the device.

If it is necessary to use electrophoresis of two drugs administered from one pole, then two electrodes of 150 cm3 each, connected to one terminal of the device, are also placed on the interscapular area.

General effects are carried out in the same way, using four-chamber baths, especially in cases where they want to have a direct effect on the joints of the arms and legs.

To do this, the patient, sitting on a special chair, immerses his arms (up to the middle of the shoulder) and legs (up to the middle of the shin) in baths filled with water at a temperature of 36-37 ° C, each of which has a carbon electrode closed from direct contact with the body.

The wires from each electrode are connected through a switch to the device. The switch allows, when exposed to direct current, each bath to be connected to the positive or negative pole of the device. The exposure is carried out at a current strength of up to 30 mA. During the effects, the patient should sit quietly and not remove his arms or legs from the baths.

Electrophoresis and galvanization on the panty area (according to A. E. Shcherbakov)

Impact on the panty area (according to A.E. Shcherbak).

The patient's position is lying down. One electrode measuring 15x20 cm is placed in the lumbosacral region and connected to the positive terminal of the device, two other electrodes measuring 10x15 cm each are placed on the front surface of the upper half of the thighs and connected with a forked wire to the negative terminal of the device. The procedures are carried out daily or every other day, starting with 6 minutes and 6 mA and increasing them by 2 minutes and 2 mA every other day to 15-30 minutes and 15-30 mA; for a course of treatment 15-20 procedures.

Electrophoresis and galvanization on the spine area.

Impact on the spine area.

A. Electrodes measuring 4x12-15 cm are placed paravertebrally on both sides of the spine, current strength is up to 5 mA.

B. Electrodes measuring 8x15 cm are placed: one on the sternum area, the other opposite the first on the spine area. Current strength is 10-12 mA.

B. One electrode measuring 8x15 cm is placed in the region of the lower cervical and upper thoracic spine, the second of the same size is placed in the lumbosacral region. Current strength is 10-15 mA. Procedures lasting 15-20 minutes are carried out daily or every other day; per course of treatment 12-20 impacts.

Electrophoresis and galvanization on the brachial plexus area.

Impact on the brachial plexus area. The patient's position is sitting or lying down.

For longitudinal exposure, one electrode measuring 10x12 cm is placed in the supraclavicular region of the diseased side, capturing the lower parts of the posterolateral surface of the neck, the second electrode of the same size is placed on the palm of the hand of the same side. With transverse exposure, one electrode measuring 10x12 cm is placed in the supraclavicular region of the diseased side, and the second electrode of the same area or slightly larger size is placed on the opposite shoulder girdle. Current strength up to 12 mA. Procedures lasting 15-20 minutes are carried out daily or every other day; per course of treatment 12-20 impacts.

Electrophoresis and galvanization on the area of ​​intercostal nerves.

Impact on the area of ​​intercostal nerves. The patient's position is lying down.

A. One electrode measuring 5x8 - 12 cm is placed paravertebrally on the painful side in the area where the roots of the affected intercostal nerves exit, the second electrode of the same size is placed along the intercostal nerves of the same side. The polarity is set depending on the medicinal substances used.

a — along the course of the affected intercostal nerves; b - a bifurcated electrode is placed on the areas of the roots and branches of the intercostal nerves, the second - on the body.

B. Two electrodes with an area of ​​100-120 cm2 are placed: one - paravertebral in the area of ​​the root of the affected nerve, the second - along the intercostal nerve on the anterior surface of the chest. Both of these electrodes are connected to one of the terminals of the device using a forked wire; the second electrode, the area of ​​which is twice as large, is placed on the same side of the body at the same distance from the first two electrodes. Current strength is 10-12 mA. Procedures lasting 10-20 minutes are carried out daily; for a course of treatment 10-20 procedures.

Electrophoresis and galvanization on the area of ​​the sciatic nerve.

Impact on the sciatic nerve area

A. One electrode measuring 3x15 cm is placed on the back surface of the thigh in the area of ​​the sciatic nerve, the second electrode with an area of ​​100 cm2 is placed on the front surface of the same thigh. Current strength is up to 4-5 mA. The duration of procedures performed daily or every other day is 8-15 minutes; for a course of treatment 10-15-20 procedures.

a - on the projection of the sciatic nerve on the back of the thigh; b - in the area of ​​the gluteal fold and popliteal fossa; c — in the lumbosacral region and the area of ​​the gluteal fold.

B. One electrode measuring 3x5 cm is placed in the area of ​​the gluteal fold in the projection of the sciatic nerve, the second electrode measuring 6x12 cm is placed paravertebrally in the lumbosacral region of the same side. Current strength up to 2 mA. The duration of procedures performed daily or every other day is 8-15 minutes; for a course of treatment 10-16 procedures.

B. One electrode measuring 3x5 cm is placed in the area of ​​the gluteal fold in the projection of the sciatic nerve, the second electrode of the same size is placed in the popliteal fossa slightly lateral to the midline. Current strength up to 2 mA. The duration of procedures performed daily or every other day is 8-15 minutes; for a course of treatment 15-20 procedures.

Electrophoresis and galvanization on the area of ​​the femoral nerve.

Impact on the femoral nerve area. One electrode measuring 10x15 cm is placed on the anterior surface of the thigh in the projection of the femoral nerve and its branches, the second electrode with an area of ​​150 cm2 is placed in the lumbosacral region. Current strength up to 15 mA. The duration of procedures carried out daily or every other day is 15-30 minutes; for a course of treatment 10-15 procedures.

Electrophoresis and galvanization on the area of ​​the tibial nerve.

Impact on the area of ​​the tibial nerve. The patient's position is lying on his stomach. One electrode measuring 5x8 cm is placed in the area of ​​the popliteal fossa and connected to one of the terminals of the device, the second electrode with an area of ​​150 cm2 is placed in the lumbosacral region or measuring 5x10 cm is placed in the area of ​​the ankle joint along the back surface of the lower leg and connected to the second device terminal. Current strength up to 5 mA. The duration of procedures carried out daily or every other day is 10-20 minutes; for a course of treatment 10-15 procedures.

Electrophoresis and galvanization on the area of ​​the peroneal nerve.

Impact on the area of ​​the peroneal nerve. One electrode measuring 6x12 cm is placed in the popliteal fossa and connected to one of the terminals of the device, the second electrode with an area of ​​150 cm2 is placed in the lumbosacral region or measuring 6x12 cm is placed on the lateral surface of the lower leg above the ankle. Current strength up to 7 mA. Procedures lasting 15-20 minutes are carried out daily or every other day; for a course of treatment 15-20 procedures.

Electrophoresis and galvanization on the lung area.

Impact on the lung area. Electrodes measuring 12x15-20 cm are placed on the lateral surfaces of the chest on the left and right; Anteroposterior placement of electrodes in the projection of the pathological focus is also possible. Current strength is up to 15-20 mA. Procedures lasting 15-20 minutes are carried out daily or every other day; for a course of treatment up to 20-30 procedures.

Electrophoresis and galvanization in the area of ​​the liver and gall bladder.

Impact on the area of ​​the liver and gallbladder.

The patient's position is lying down. One electrode measuring 10x15 cm is placed in front in the projection of the liver and gallbladder and connected to one of the terminals of the device, the second electrode of the same size, connected to the second terminal of the device, is placed on the back opposite the first. Current strength up to 15 mA. The duration of the procedures is 15-20 minutes, carried out daily or every other day; for a course of treatment up to 20 procedures.

Electrophoresis and galvanization on the stomach area.

Impact on the stomach area The patient's position is lying down.

One electrode measuring 15x12 cm is placed in the epigastric region, the second electrode of the same area is placed on the back in the lower thoracic region. Current strength up to 18 mA. Procedures lasting 8-15 minutes are carried out daily or every other day; for a course of treatment 10-15 procedures.

Electrophoresis and galvanization on the spleen area.

Impact on the spleen area. The patient's position is lying down.

One electrode measuring 10x20 cm is placed above the left hypochondrium area up to the posterior axillary line and connected to one of the terminals of the device, a second electrode of the same size is placed on the back opposite the first and connected to the second terminal of the device. Current strength up to 20 mA. The duration of procedures carried out daily or every other day is 15-20 minutes; for a course of treatment 10-15 procedures.

Electrophoresis and galvanization on the intestinal area.

Impact on the intestinal area The patient's position is lying down. Two electrodes with an area of ​​about 300 cm2 each are placed: one in the abdomen and connect it to one of the terminals of the device, the second in the lumbar region, connecting it to another terminal of the device. Current strength up to 30 mA.

The duration of procedures carried out daily or every other day is 15-30 minutes; for a course of treatment 10-20 procedures.

Electrophoresis and galvanization on the bladder area.

Impact on the bladder area. The patient's position is lying down. One electrode with an area of ​​100-150 cm2 is placed on the abdominal wall above the symphysis pubis and connected to one of the terminals of the device, the second electrode of the same area is placed in the lumbosacral region and connected to the second terminal of the device. Current strength up to 15 mA. Procedures are carried out daily or every other day; for a course of treatment 10-15 procedures.

Electrophoresis and galvanization on the kidney area.

Impact on the kidney area. Two electrodes with an area of ​​150 cm2 each are placed on the back in the area of ​​​​the projection of the kidneys and connected to one terminal of the device, the third electrode with an area of ​​300 cm2 is placed on the abdominal wall in front. Current strength is up to 30 mA. Procedures lasting 10-15 minutes are carried out daily or every other day; for a course of treatment 10-15 procedures. When influencing the area of ​​one kidney, electrodes with an area of ​​150 cm2 each are placed: one on the projection of the kidney, the second on the abdominal wall in front and connect them to different poles of the device. Current strength up to 15 mA.

Electrophoresis and galvanization on the pelvic organs in women.

Impact on the pelvic organs in women.

With the abdominal-sacral arrangement of electrodes, one of them measuring 10x20 cm is placed above the pubic symphysis, the second of the same size is in the sacral area.

When the electrodes are placed sacrovaginally, one of them measuring 20x20 cm is placed in the sacral area (anode), the second (cathode) - a special one - is inserted into the vagina.

When the electrodes are placed abdominally-vaginally, one of them measuring 20x20 cm is placed above the pubic symphysis (anode), the second (cathode) - a special one - is inserted into the vagina.

With the abdominal-sacral-vaginal arrangement of the electrodes, one of them with an area of ​​200 cm2 is placed above the pubic symphysis, the second of the same area is placed on the sacral area, both electrodes are connected to the terminal of the device; the third electrode - a special one - is inserted into the vagina. Current strength is 10-15 mA. The duration of procedures carried out daily or every other day is 20-30 minutes; for a course of treatment 10-15 procedures.

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Anti-inflammatory treatment: hormones, NSAIDs, immunoglobulins, cytostatics

Inflammation of the joints is dangerous because... it leads to the destruction of articular tissues and threatens loss of mobility . That is why we pay great attention to anti-inflammatory treatment . Our main task is to achieve a balance between the effectiveness and safety of treatment.

Symptoms of joint inflammation (may be one or more of the following):

• pain,
• stiffness,
• swelling,
• redness.

Anti-inflammatory drugs relieve inflammation, but do not treat its cause.

Therefore, your attending physician will perform research, determine and treat the causes of inflammation. The cause of inflammation may be:

1. Immune aggression towards healthy tissue of the joints or spine (rheumatoid, lupus, psoriatic arthritis, ankylosing spondylitis, etc.);
2. Microbial or viral aggression (reactive, fungal, bacterial and viral arthritis);
3. Accumulation of biochemically aggressive substances in the joint (gout and other storage diseases);
4. Mechanical overload of a joint or cartilage, ligament, tendon;
5. Joint injury (cartilage, ligament, tendon).

Symptomatic treatment in most cases is not the best solution. Modern means for basic therapy and treatment of concomitant infections help to better control autoimmune aggression against the joints and spine.

Anti-inflammatory treatment:

• Nonsteroidal anti-inflammatory drugs (NSAIDs, or NSAID drugs). These are drugs for reducing the activity of inflammation and pain, most often used in relatively simple cases and in addition to the main treatment. Depending on the situation, we recommend taking NSAIDs in tablets, suppositories, and injections. Today we use safer selective NSAIDs (nimesulide, meloxicam, etc.), they block inflammation and do less damage to the digestive tract. If necessary, we use them under the guise of anti-ulcer therapy, since NSAIDs have their own contraindications (peptic ulcer, etc.).
• Steroid (hormonal) anti-inflammatory drugs (glucocorticosteroids or GCS) are the most powerful anti-inflammatory drugs, used mainly in complex and severe cases. The main advantage is the ability to relieve inflammation and pain within a few hours or days. We are able to use steroidal anti-inflammatory drugs with minimal risk, and if necessary, we will offer you intra-articular injections. We recommend medications in this group, if absolutely necessary, and carry out treatment under the control of laboratory data, thereby ensuring the safety and effectiveness of treatment. One of the most dangerous complications is suppression of the immune system and the addition of infection, which is why steroidal anti-inflammatory drugs are often used under the guise of immunoglobulin preparations.

Modern steroids are much safer than their predecessors. And the experience accumulated by doctors helps to get by with minimal doses.

• Normal human immunoglobulin is a human immune protein. They effectively counteract immune aggression and at the same time help cope with pathogenic microbes, fungi and viruses. Can be used in cases where the use of hormonal anti-inflammatory drugs is limited or impossible, incl. for infections. We have accumulated extensive positive experience in the use of immunoglobulins for autoimmune joint inflammation and chronic infections.
• Drugs for disease-modifying therapy , including modern “biological therapy” (medicines, disease-modifying antirheumatic drugs, slow-acting drugs). This is the basis of the treatment of autoimmune diseases. We use them to control inflammation associated with immune aggression. Drugs for basic therapy reduce excessive immune activity, including reducing the production of aggressive immune cells and autoantibodies to the body’s own tissues and, accordingly, reduce inflammation. These drugs are generally easier to tolerate and reduce resistance to infection less than steroidal anti-inflammatory drugs.

When prescribing treatment with NSAIDs, NSAIDs, hormones (glucocorticosteroids or corticosteroids), the doctor takes into account many factors: the presence of chronic diseases (especially in older people), compatibility with other medications, etc.

Electrophoresis (electrophoresis with Karipazim)

Medicinal electrophoresis is a complex method of electrotherapy in which the patient’s body is exposed to a unidirectional current and a medicinal substance introduced into the body through this current. The main routes for the penetration of drugs into the body during electrophoresis are the excretory ducts of the sweat and sebaceous glands or mucous membranes. The permeability of the drug substance depends on the area of ​​administration. The most permeable skin is the face, armpits, abdomen, then the forearm, lumbar region, thigh, and lower leg. This is due to different electrocutaneous resistance, the state of the excretory function of the skin and the pH value of its individual areas.

From the skin and subcutaneous tissue, the drugs received during the procedure gradually diffuse into the lymphatic and blood vessels and are delivered to all organs and tissues.

In electrophoresis, 90-92% of drugs are administered due to electrogenic movement, 1-3% due to electroosmosis and 5-8% due to diffusion.

Physical principles of electrophoresis

Charged atoms and molecules move to the opposite pole within the galvanic field. This method allows a fairly large amount of medication, compared to ointments and applications, to penetrate the skin.

The medication accumulates in the skin, from where it spreads and acts for a long time. Due to this, the frequency of applications depends on the half-life of the medication

The medication must conduct electric current and be applied under an electrode of the same polarity - positive ions under the anode, negative ions under the cathode.

The recommended treatment time is 15-30 minutes to ensure that more ions of the substance penetrate the skin.

Advantages and types of electrophoresis

Medicinal substances introduced into the body by electrophoresis retain a specific effect for a long time and are less toxic, while electrophoresis can in some cases reduce the allergic setting from medicinal substances administered by another method.

Electrophoresis is divided: according to the type of electricity (galvanophoresis, electrosonphoresis, aeroiontophoresis, etc.); according to the method and place of exposure (through the skin, intracavitary, carried out mainly through the mucous membranes: intranasal, intraocular, intravesical, etc.). Interstitial or intraorgan drug electrophoresis has now found effective use.

At the moment, almost all hospitals use intrapulmonary and interstitial electrophoresis - the combined use of pharmacological drugs introduced into the body through the mouth, subcutaneously, into the pulmonary artery and other routes. The increased supply of medicinal substances to the tissues located in the interelectrode space is due to an increase in the permeability of the vascular wall, cell and tissue membranes, improved blood circulation, interpolar movement of ions and charged molecules and increased adsorption activity of tissues.

Depending on the location of the electrodes, there are: transverse, longitudinal and segmental electrophoresis.

Indications for electrophoresis

Currently, the most common disease that is treated with interstitial electrophoresis is osteoarthritis deformans. Almost every fifth patient who goes to the hospital has this disease. Diclofenac in combination with electrophoresis gives a good treatment effect. Electrophoresis is also successfully used in the treatment of various diseases of the central and peripheral nervous system, a number of gynecological diseases, scarring of the skin, stroke, atherosclerosis and other diseases.

Electrophoresis has anti-inflammatory, analgesic, absorbable, antibacterial and other effects.

Contraindications to the use of electrophoresis

Contraindications to the use of electrophoresis are skin damage, allergies to medications, dermatitis, bleeding tendency, severe bronchial asthma, and oncology.

Electrophoresis with Karipazim

This type of electrophoresis has proven itself positively in the non-surgical treatment of herniated intervertebral discs, protrusions, and Schmorl's hernias. Karipazim and electrophoresis itself have a restorative effect on the cartilage tissue of the intervertebral disc and thereby reduces irritation of the spinal cord roots, reduces pain, and has a positive preventive effect on the discs.

The initial positive dynamics of treatment are usually observed after several sessions of electrophoresis with caripazim.

Typically, the course of treatment for a hernia with karipazimos drug consists of 15-20 electrophoresis procedures. Depending on the type and condition of the hernia, additional preventive sessions may be required at intervals of 1-2 months.

To enhance the therapeutic effect, therapeutic exercises are recommended, as well as several sessions of detensor therapy. Read more about detensor therapy... .

Karipazim (papain) is administered by electrophoresis, always from the positive pole. Before the treatment procedure, 1 bottle of Karipazim (papain) is dissolved in 5-10 ml of saline solution. 2-3 drops of Dimexide are also added there. The dimensions of the electrode gasket are 10x15 cm. The temperature of the electrode gaskets is 37-39C, and the current strength is from 10 to 15 mA. The procedure time should gradually increase from 10 to 20 minutes.

Electrode gaskets can be positioned both longitudinally and transversely. With a longitudinal arrangement, a positive electrode with caripazim (papain) is applied to the neck area, and a negative charge through an electrode with aminophylline is directed to the lumbar area or to the shoulder area (bifurcated electrode). If the electrode with caripazim (papain) is directed to the lumbar region, then the negative one is applied to the hips (bifurcated). When positioned transversely, the positive electrode (karipazim (papain)) is applied to the lumbar region, and the negative electrode (aminophylline) is directed to the abdominal area. The treatment procedure for a herniated disc consists of 2-3 courses of 15-20 procedures with a break between courses of 1-2 months

Want to learn more about electrophoresis? To search for materials, use the terms: electrophoresis with karipazim , medicinal electrophoresis, electrophoresis treatment, electrophoresis effects, electrophoresis reviews, Bibirevo, Altufyevo, Otradnoe, Timiryazevskaya, Medvedkovo, Babushkina, Moscow, Khimki, Dolgoprudny, Mytishchi.

Treatment of infections

Pathogenic microbes can be the cause of rheumatic disease, so we identify and treat chronic infections, overt or hidden .

Failure to treat infections may be due to reinfection due to weak immune defenses . We will perform immune status studies and find out what exactly your immune system lacks to function properly. The data obtained will help bring the immune system into working condition.

Chronic infectious processes rarely develop with healthy immunity

We find these infections most often:

• Sexually transmitted infections (STDs) (chlamydia, mycoplasma, ureaplasma, gardnerella);
• Viruses of the herpes group (herpes, cytomegalovirus, Epstein-Barr virus);
• Chronic intestinal infections and dysbiosis (helminthic infestations, Giardia, enterococci, salmonella, etc.), treatment of dysbiosis is especially necessary after long-term use of antibiotics because this can negatively affect bowel function;
• Chronic infections of the tonsils, pharynx and nose (tonsillitis, pharyngitis, sinusitis).

Joint injections

Injecting medication into a joint is an effective procedure. Using intra-articular injections, you can create a high concentration of medication directly in the diseased joint. In this case, the medicine almost does not reach other tissues of the body that do not need the medicine. In this way, we treat the joint and protect the liver and kidneys from drug load.

Treatment with a chondroprotector has a beneficial effect on the condition of articular cartilage.

What medications do we inject into the joints? Basically, these are drugs of two groups:

• Chondroprotectors, i.e. stimulators of cartilage restoration and intra-articular fluid substitutes (Alflutop, Sinvisc, Ostenil, Noltrex, Sinokrom, Fermatron, etc.);
• Long-acting anti-inflammatory glucocorticoids (Diprospan, Kenalog, Hydrocortisone, etc.).

We use intra-articular injections to treat the following diseases:

• Arthrosis.
• Acute inflammation in the joint or periarticular tissues, if it is necessary to quickly relieve inflammation and the injection of medicine into the joint is not contraindicated.
• Anti-inflammatory injections into the knee joint help with gonarthrosis.
• Epicondylitis.
• Humeroscapular periarthritis.

Drug electrophoresis

There are many health problems that can be dealt with by a properly prescribed regimen of EF use. For example:

• bath electrophoresis helps with diseases of the joints (arthritis, polyarthritis) and the nervous system (plexitis, polyneuritis);
• for intervertebral hernias, electrodes soaked in a solution of Karipazim are used;
• You can soften scars and improve microcirculation in the interstitial spaces with the help of lidase;
• aminophylline will provide an analgesic effect, help expand the bronchi, improve blood circulation in tissues and organs;
• administration of calcium through the skin is indicated for neuralgia, myositis and bronchitis; it is also effective for orthopedic problems, weakening of vascular walls, inflammation, allergies, intoxications;
• Potassium helps with bronchial asthma, respiratory diseases, and ophthalmological problems.

In addition to the listed drugs, bischofite, verapamil, lidocaine, novocaine, dimexide, caripain, various vitamins, etc. can be administered via electric current.

Most indications for the use of electrophoresis require a galvanic method of conducting it (fixing electrodes with pads soaked in drugs directly on the skin). This can be done using different techniques. The following techniques are considered to be most effective:

• ion reflexes according to Shcherbak (used for hypertension, gastrointestinal diseases, neuroses);
• ion collar (TBI, hypertension, neuroses, insomnia, apnea);
• ion belt (diseases of the female reproductive system, sexual dysfunctions);
• Vermeule method (hypertension, cardiosclerosis, neuroses, atherosclerosis, migraine);
• orbital-occipital EF (neuritis of the facial nerve, neuritis of the trigeminal nerve, pathological processes in the brain of vascular, inflammatory or traumatic etiology);
• EF according to Ratner (cerebral palsy, postpartum injuries, circulatory disorders in the cervical spine).

The choice of procedure technique and the medications used, as well as their dosage, depends on the nature of the existing pathology and the characteristics of its course.

Medicines for cartilage restoration. Chondroprotectors

New generation chondroprotectors are an effective and safe way to treat joints. We use modern chondroprotectors for oral administration, intramuscular and intra-articular injections . Improvement in the condition of the joints usually occurs within 2-4 weeks from the start of treatment, and faster with intra-articular administration of chondroprotectors. Based on ultrasound data (or MRI, x-rays) and tests, the doctor will select the most suitable chondroprotector for you.

Chondroprotectors are medications that stimulate the healing and restoration of cartilage and ligamentous tissue, menisci, and intervertebral discs. This is an important part of the treatment of almost any joint problem.

Chondroprotectors contain building material , vitamins, enzymes for the growth of healthy cartilage tissue. These include, for example: Artra, Structum, Teraflex, Chondroitin, Glucosamine, Adgelon, Piaskledin, Alflutop.

Some chondroprotectors are substitutes for lubricating intra-articular fluid/(prosthetic fluid). These include, for example: Noltrex, Ostenil, Sinokrom, Fermatron.

We will offer you intra-articular administration of new generation chondroprotectors for:

• arthrosis,
• osteochondrosis,
• metabolic disorders,
• inflammatory damage to the joint (after relief of inflammation),
• post-traumatic arthrosis.

Manual therapy in the treatment of joints

In our clinic, it is customary to select the necessary treatment procedures individually. We use a variety of manual therapy techniques for different ages and health conditions. Manual therapy is performed by neurologists who have completed clinical specialization in manual therapy and additional training in radiology, the basics of rheumatology and orthopedics. clinic specialists. Manual therapy is not permitted for all joint diseases, so we ask you to bring the results of previously performed studies, pictures, and test data to the doctor for your appointment.

Manual therapy is a way to restore proper mobility to joints and muscles and remove excess stress from them. For example, with curvature of the spine (scoliosis), the center of gravity of the body is shifted to the side, and the load on the joints of one leg significantly exceeds the norm (see figure). And this is the cause of increased wear and tear on joints (arthrosis). In this case, the chiropractor returns the center of gravity to its place.

Symptoms of arthrosis

Even if you are bothered by seemingly trivial symptoms, do not ignore them.

• Pain that subsides with rest (manifests itself with loads on the joint and walking up stairs);
• Restricted mobility and crunching in the joint;
• Muscle tension in the joint area;
• Periodic appearance of swelling in the joint area, gradual deformation of the joint (swelling occurs only during exacerbations and is accompanied by aching, not acute pain).

All this can be a manifestation of a serious disease - arthrosis! Contact your doctor! He will make a diagnosis and prescribe adequate treatment.

Please note that without treatment, a joint susceptible to arthrosis can not only collapse itself, but also lead to changes in the biomechanics of the spine and other joints. Because of this, herniated intervertebral discs or arthrosis of other joints occur.

Nutrition and diet

Your attending physician will select a comfortable diet plan, taking into account the underlying and concomitant diseases, taking into account the specifics of the medications you are taking. We are realistic about therapeutic nutrition: it must be feasible. We select meals individually, because... Nutrition and diet options for different joint diseases may vary.

The correct selection of nutrition is always individual and begins with a detailed examination, which may include:

• consultation with a rheumatologist,
• ​blood test,
• rheumatic tests and diagnosis of autoimmune diseases,
• Analysis of urine.

Diet for inflammatory diseases (arthritis) :

• Since harmful metabolic products are constantly formed in the body, it is necessary to take larger amounts of fluid than usual . If there is a problem of fluid retention in the body (and joint diseases often develop against the background of other heart diseases, hypertension, metabolic disorders that require control of fluid intake), then the doctor will recommend a special regime of water load, diuretic teas or fruit drinks.
• The diet should include vegetable dishes, preferably raw vegetables. But it is worth limiting fresh peppers, tomatoes, cabbage, onions, and irritating spices. Fruits are useful, however, if the doctor prescribed medications from the NSAID , then sour fruits, citrus fruits and juices from them are undesirable . They can further irritate the mucous membranes of the gastrointestinal tract. For diseases of the heart and blood vessels, such a diet should be discussed with your doctor; there may be restrictions associated with concomitant drug therapy.
• Protein foods should be easily digestible. If you eat meat, it is better to prepare dishes from poultry and rabbit; fish dishes. They need special attention, such protein is easier to digest. It is better to refrain from taking whole milk, giving preference to fermented milk products and fresh homemade cheese.

Diet for arthrosis :

• Sufficient amount of proteins , with a limit on meat from large animals (beef, pork, lamb).
• Limiting the caloric content of food by reducing the intake of fats and simple carbohydrates (see section on weight loss).
• Vegetable fiber is necessary; it is better to include in the daily menu dishes from thermally processed vegetables , for example, stewed or baked. Pay attention to zucchini, carrots, cauliflower, pumpkin. Other varieties of cabbage are heat-treated and in small quantities. Fresh vegetables that are especially useful for arthrosis are avocado and parsley.
• Fruits - bananas, apples (it is better to cook baked apples in the cold season), kiwi.
• It is better to limit dried fruits and cereals . For arthrosis, among different varieties of nuts it is worth choosing almonds (especially for women in adulthood) and pine.

Diet for gout . For gout, we recommend a diet that helps normalize weight and reduce uric acid levels. It is important not to overeat or starve. During all periods of the disease, diet No. 6 and periodic fasting days (compote, cottage cheese, milk, apple, carrot, watermelon) are recommended.

Prohibited:

• Meat of young animals and all parts of the animal that provide a sticky broth (head, legs, etc.);
• Broths (meat, chicken, fish, mushroom), meat sauces, jelly;
• Meat extracts (batch soups);
• Smoked meats;
• Offal (heart, kidneys, liver, brains, etc.) and dishes made from them;
• Fatty fish - during exacerbation, salted fish, fried fish; canned fish (anchovies, herring, sardines, sprats, sprat), caviar;
• Salty and sharp cheeses;
• Spices (pepper, horseradish, mustard) with the exception of bay leaf, vinegar and salt,
• Products that stimulate the nervous system: strong tea, coffee, cocoa;
• Cooking and other animal fats;
• Cream cakes, pastries, chocolate;
• Pork and pork products;
• Products containing a preservative (canned food, juices, water);
• Legumes (lentils, peas, beans, beans, soybeans);
• Raspberries, figs, grapes and all grape products (raisins, wine, cognac, etc.);
• Alcoholic drinks that increase the content of uric acid and impair its excretion by the kidneys.

Limited to:

• Salt;
• Sausages;
• Boiled meat and fish. Preference is poultry, salmon, salmon, haddock, trout, mackerel. There are quite a lot of purines in these products, but they also contain unsaturated fatty acids, which is very good for fat metabolism);
• Cauliflower, asparagus, sorrel, spinach, rhubarb, celery, pepper, radish, turnip (since gout is almost always accompanied by a disturbance in the metabolism of other salts - oxalates); Tomatoes (maximum 2-3 pieces per day);
• Green onions, parsley;
• Mushrooms (white mushrooms, mushrooms, champignons);
• Pickles and marinades;
• Plum;
• Salo;
• Butter;
• Milk (allowed in cereals, tea).

Allowed:

• Soups – vegetarian: borscht, cabbage soup, vegetable, potato, with the addition of cereals, dairy, cold;
• Chicken, turkey, rabbit;
• Squid, shrimp;
• Fish – low-fat varieties, boiled, 160-170 g up to 3 times a week;
• Dairy products: fermented milk drinks, cottage cheese, dishes made from it, sour cream, cheese (low-fat varieties, since cheese contains highly saturated fats that disrupt fat metabolism);
• Milk in small quantities when added to cereals and drinks;
• Eggs (from three pieces per week to 1 per day for any cooking);
• Cereals, pasta - any, in moderation;
• White cabbage, carrots, potatoes, cucumbers, zucchini, eggplants; allowed vegetables - in increased quantities, raw or in any cooking; vegetable, squash, eggplant caviar (freshly prepared);
• Dried fruits (except raisins), honey;
• Nuts (pine, avocado, almonds, pistachios, hazelnuts), seeds;
• Sweets – non-chocolate candies, jam, marmalade, marshmallows, marshmallows;
• Drinks - green tea, tea with lemon, milk, coffee (substitute) with weak milk, rosehip decoctions, wheat bran, fruit juices, berries, vegetables, fruit drinks, kvass, compotes. Drinks made from lingonberries and cranberries are especially valuable;
• Helps remove excess purines from the body: cucumber juice (up to 1 glass per day), alkaline mineral waters (low mineralized), as well as those containing organic substances (“Naftusya”, “Essentuki No. 17”, “Narzan”, “Borjomi”);
• Green apples, citrus fruits, gooseberries, berries (except raspberries), watermelons;
• Bread white, black;
• Dill;
• Vegetable oil (necessarily olive, linseed), butter.

We recommend that you discuss any type of diet with your doctor personally.

Indications for electrophoresis

The appointment of such a physiotherapeutic technique is justified for pathologies that require local drug therapy. These are diseases and disorders in the functioning of the following body systems:

• respiratory;
• digestive;
• cardiovascular;
• urogenital;
• reproductive;
• central nervous.

In addition, the method is widely used for chronic dermatological diseases, ophthalmological pathologies, and dental problems. EF has proven itself well in the fight against musculoskeletal disorders and the elimination of scar formations. Since Soviet times, the method has been known as one of the most effective types of physiotherapy for problems associated with the ENT organs.

Is electrophoresis indicated for children?

The painlessness and low concentration of medicinal substances when using EF makes it quite acceptable for use in pediatric practice. In pediatrics, there are indications and contraindications for electrophoresis. Children from 3 weeks of age to 18 years of age are prescribed it for:

• eliminating hypo- or hypertonicity of muscles;
• treatment of hip dysplasia;
• pain relief;
• therapy of diseases of the bronchi and lungs;
• combating neurological problems of various nature;
• treatment of diseases of the gastrointestinal tract, etc.

EF improves the absorption of various drugs, for example, magnesia, calcium, dibazole, papaverine, etc. It is often used in tandem with massage to achieve even greater results in infants.

A similar therapeutic technique for children is also applicable in combating the consequences of birth injuries, in diseases of the skin and navel, in the treatment of phlegmon, in the prevention and treatment of rickets. In addition to massage, EF can be combined with UHF therapy, electrical stimulation, physical therapy and some other tools of modern physiotherapy.

Electrophoresis during pregnancy

While pregnant, women may also be prescribed physical therapy. This happens in the following situations:

• If there is a threat of miscarriage after 8 weeks. In this case, magnesium sulfate is introduced using current, which relaxes the muscles of the uterus and reduces the sensitivity of the myometrium to oxytocin. The same procedure is indicated in later stages if there is a risk of premature birth. To achieve the desired result, 5 to 10 procedures are prescribed.
• With placental insufficiency. 5-10 sessions of EF restore normal uteroplacental blood flow, resume the process of oxygen saturation of the fetus and reduce the risk of developing hypoxia.
• For toxicosis. In the fight against mild manifestations of toxicosis, the method is effective in the first and second trimester. The introduction of B vitamins is indicated. Up to 10 visits to the physiotherapy room helps to get rid of vomiting, reduce nausea, increase appetite and generally improve the condition and well-being of the expectant mother. It is permissible to take a second course 2 weeks after the end of the first.

After childbirth, the assistance of a physical therapist may be needed to heal stitches from a caesarean section or for severe perineal tears. Also in the postpartum period, EF helps:

• heal cracked nipples, reduce the risk of mastitis;
• fight lactostasis, stimulate milk flow;
• improve contractile function of the uterus, intestinal peristalsis;
• perform endometritis prevention, etc.

According to the observations of specialists and reviews of patients, the administration of drugs through the action of electric current is well tolerated by pregnant women. The area of ​​influence, the current strength, and the type of drugs used are determined individually as prescribed by the treating specialist. The maximum that the patient can feel during the procedure is a slight tingling at the site where the electrodes are applied.

First aid for joint pain. How to relieve pain yourself

To relieve joint pain on your own, you can:

1. Give the joint rest. Until the condition of the joint or joints is clarified, it is better not to try to “work out” the joint through pain - in some cases you can damage the joint even more.
2. Comfortable temperature. Cold or excessive heating of the joint can increase pain. Warming procedures are especially undesirable, since they increase swelling during inflammation, and therefore pain.
3. For topical use, ointments containing non-steroidal anti-inflammatory drugs (NSAIDs) , such as Diclofenac (Voltaren, Voltaren-gel), Ketoprofen, Nimesulide, etc., are effective. At the stage of independent use, until the diagnosis is clarified, these ointments are better than ointments and massage creams, containing bee or snake venom, extracts of warming herbs. Anti-inflammatory drugs in this group are sold in pharmacies without a prescription, but may have contraindications, so we recommend that you discuss their use with your doctor.

If there is an exacerbation, you can contact a rheumatologist at our clinic, we will give preliminary recommendations and schedule an appointment for a consultation in the near future . If necessary, the doctor will perform an anesthetic and anti-inflammatory blockade at home.

When is it time to have a joint replacement?

In many cases we are able to solve the problem conservatively. Severe pain with preserved joint structure is not an indication for surgery. In this case, we look for and treat the source of pain. Conservative treatment of joints is possible with relatively intact cartilage structure. We have the necessary diagnostic and therapeutic tools to delay or prevent surgery as much as possible.

• Read more about the treatment of arthrosis
• Learn more about injecting medications into a joint

A joint is subject to prosthetics if it is so damaged that it cannot perform the function of support and movement.

Helps to delay or prevent the need for surgery:

• electrophoresis of karipazim,
• use of chondroprotectors,
• anti-inflammatory treatment.

Tomogram of the pelvis. Front view. The head of the right hip joint has a regular rounded shape. The head of the left joint is destroyed and requires prosthetics. Left hip joint prosthesis on radiograph.