Drug treatment of spinal hernia: review of drugs and the effect of use

Intervertebral hernia is a common pathology of the spine. It is a protrusion of the disc nucleus located in the intervertebral space, resulting in damage to the integrity of the fibrous ring. It is diagnosed mainly in the lumbar and sacral spine, since they bear the main load when walking and performing most movements. One of the effective ways to treat pathology is injections. They are used for severe pain and progressive inflammation.

When are injections prescribed?

Injections for a hernia of the lumbar spine are prescribed almost immediately after diagnosis. They are aimed at eliminating symptoms, while additional treatment requires the cause of the pathological process. The formation of cartilage protrusion is usually provoked by injuries, excess body weight, dietary errors, various bad habits, a sedentary lifestyle, and incorrect posture.

A doctor usually prescribes painkillers in the following cases:

• Acute pain in the affected area.
• Inflammatory process in soft tissues.
• Presence of swelling.
• The use of tablets or capsules is contraindicated.

Intervertebral hernia is treated only under the supervision of a specialist. Patients usually turn to a neurologist. The disease provokes severe inflammation and pain, which requires the use of various means to relieve it. Along with the injections, therapeutic exercises and physiotherapy are also prescribed.

Endoscopic removal of spinal hernia in the lumbar region

The operation eliminates “open” surgical incisions on the skin and bleeding.
Access to the hernia is through a puncture in the skin (7 mm) and a natural lateral opening in the spine. Thus, endoscopic operations allow you to carefully remove a spinal hernia under excellent visual control and preserve the integrity of the fibrous ring of the disc (disectomy is not required). This method has other advantages:

• Hospitalization - 1 day;
• Rehabilitation period - does not require additional recovery procedures in most cases;
• The pain goes away immediately after the operation; within 2-3 hours after spinal surgery the patient can sit and move around the room independently;
• Endoscopic removal of a spinal hernia in the lumbar region in the presence of segment instability allows one to avoid additional installation of fixing implants, metal structures, and interbody cages.
• Maximum effectiveness according to statistics of hernia recurrence with minimal risks of surgical intervention.

Review of endoscopic surgery to remove a hernia from a patient of the leading spinal neurosurgeon at the Pirogov Clinic, Candidate of Medical Sciences. Sciences Mereji A.M.

Classification of injections

Injections for a herniated cervical spine are used during the period of exacerbation of the pathological process, if the patient experiences acute pain. All injections used by medical personnel differ in the method of application. They are classified as follows:

• Intravenously. This should include not only the standard method of introducing drugs into the bloodstream, but also droppers. Some drugs need to be introduced into the body very slowly in a dosage controlled by medical staff.
• Intramuscularly. This numbs the damaged area, so the injection is made into the buttock.
• Introduction to interdisk space. One of the most common methods of administering drugs for spinal hernia.

The doctor selects the appropriate method for each patient, taking into account the individual characteristics of the course of the disease, the severity of symptoms and the presence of chronic diseases in the anamnesis. Injections are not used for prevention or self-treatment, as they can cause serious health problems.

Epidural blockades are one of the most common methods of administering pain medication.

What drugs are used to treat hernia?

Today, a variety of injections are used for intervertebral hernia, aimed not only at eliminating unpleasant symptoms, but also at triggering the regeneration of cartilage tissue, improving well-being and restoring the functionality of the joint. Medicines from different groups are used in combination. They are prescribed at any stage of pathology development and have different effects on the body. Let's look at the main options.

Nonsteroidal anti-inflammatory drugs

NSAID injections are among the first prescribed for back pain due to a hernia. They are highly effective, quickly eliminate discomfort, relieve inflammation and swelling at the site of injury. The affordable price category of drugs from the list of the most popular ones is also a big advantage. A minimal number of contraindications and a low likelihood of developing side effects allow doctors to prescribe injections to different categories of patients. The main representatives of the category are:

• "Xefocam."
• "Diclofenac".
• "Movalis".
• "Ketoprofen".
• "Celebrex."

New generation products effectively eliminate pain, slow down the inflammatory process, and swelling becomes less pronounced. But injections of this group of drugs also have their disadvantages; their long-term use is contraindicated due to a possible negative effect on the functioning of the liver.

Various groups of drugs for the treatment of back pain are offered in the form of injections.

Steroid hormonal drugs

This group of drugs is prescribed for back pain if anti-inflammatory drugs from the NSAID category have not given the expected therapeutic result. Treatment with them is carried out only under the supervision of a specialist, since there is a high probability of developing side effects. What injections are given in this category for intervertebral hernia?

• "Diprospan".
• "Prednisolone."
• "Dexamethasone."

Drugs from this series cannot be called harmless, since they have a large number of contraindications, and their use implies caution in the presence of chronic pathologies or a high probability of developing an allergic reaction. It is not recommended to give such injections longer than 5 days, as they can quickly become addictive.

Among the advantages of the drugs, one should highlight high efficiency, rapid suppression of the inflammatory process, and elimination of swelling. Their use is unacceptable for gastrointestinal diseases, diabetes mellitus, tuberculosis or other serious disorders of the internal organs.

Muscle relaxants

If, with an intervertebral hernia of the lumbar region, there are restrictions in movements, stiffness, and blocks, then the doctor prescribes injections of muscle relaxants. They are able to effectively smooth out the muscle structure, eliminate spasms, and restore blood flow. From this series, experts most often prescribe:

• "Sirdalud".
• "Tizinidine."
• "Baclofen."
• "Atarax."

“Mydocalm” is especially popular, since in addition to eliminating tightness, it also effectively anesthetizes the damaged area. It contains lidocaine, which blocks all unpleasant sensations.

The use of muscle relaxants during pregnancy and lactation, disorders of the nervous system or psyche, pathologies of the kidneys and liver, bronchial asthma and tuberculosis is prohibited.

Epidural blockades are administered in a special room

Chondroprotectors

Treatment of intervertebral hernia cannot be accomplished without the use of drugs aimed at restoring damaged cartilage tissue. Their main purpose is to launch regeneration processes in the joint. The active substance penetrates the bloodstream and through it enters the damaged area. The most popular drugs are:

• "Teraflex".
• "Dona".
• Noltrex.
• "Aflutop".
• "Adgelon".

The drugs differ from each other not only in name, but also in composition. The course of treatment can be up to a year, and depends on the degree of progression of the disease. During the therapy period, it is recommended to reduce physical activity, do therapeutic exercises and visit a physiotherapist. Chondroprotectors effectively nourish tissues, and the results obtained last a lifetime.

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Drugs for restoring nerves

In addition to the listed groups of drugs, the attending physician in the final stages of hernia development prescribes the patient intravenous administration of drugs that improve nerve conduction. The roots are severely pinched, which causes severe pain to the patient. This is precisely what these remedies combat:

• "Actovegin".
• "Vinpocetine."
• "Euphilinn."
• "Caviton".

Injections are given intravenously, in some cases the use of droppers is acceptable. But the result obtained and the chosen method has virtually no effect.

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Vitamin B complexes

Complex therapy for intervertebral hernia often requires the use of auxiliary agents that normalize the balance of nutrients in the body. B vitamins have a beneficial effect on metabolism and metabolic processes in the body, and on immunity in general. Therefore, they help to recover faster and slow down the destructive process in cartilage tissue. Doctors prescribe the following types of drugs:

• "Nycomed"
• "Vitamol."
• "Combilipen".
• "Milgamma".

Vitamin complexes have virtually no contraindications, which allows them to be prescribed without risk to a wide range of patients. At the same time, they help reduce recovery time when treating a hernia.

Injections for spinal hernia are also administered through droppers

Homeopathic injections

Homeopathic medicines have proven themselves to be excellent in the treatment of intervertebral hernia. They are used not only in injections, but also in powders, tablets and granules. They contain natural products, so they have a minimum number of contraindications. The prescribed medications help resolve swelling, relieve inflammation, eliminate pain, and restore tissue nutrition.

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Ozone injections

Ozone injections are also used in the treatment of intervertebral hernia, as they do not cause negative reactions, but the whole process may be accompanied by symptoms such as dizziness, drowsiness or weakness. Ozone helps reduce the volume of a hernia and helps the body produce substances that promote the effective removal of toxins. These injections allow you to:

• Relax your muscles.
• Anesthetize the affected area.
• Eliminate the inflammatory process.
• Remove toxins from the body.

The main contraindications for this procedure include pregnancy and lactation, diabetes mellitus, cancer, diseases of the gastrointestinal tract, genitourinary system and heart failure. A large number of positive reviews indicate a positive attitude of patients towards this procedure.

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Spinal blocks

In case of serious damage to the intervertebral disc, in addition to intramuscular injections, the doctor may prescribe paravertebral or epidural blockades. They allow you to quickly and effectively relieve the patient of any discomfort, eliminate stiffness and restore normal spinal function. The result obtained lasts for a long time, after which the blockade is repeated. Each type of drug administration into the intervertebral space has its own differences.

Paravertebral blockade

A variety of the method of administering a medicinal substance is distinguished by a complex technique. The injection is given directly to the area where the nerve bundle is pinched through the intercostal space. In this case, it is important that the neurovascular bundle itself is not affected.

Epidural block

The drug is administered locally, to the directly damaged area. The medical professional must accurately find the gap between the periosteum and the membrane of the spinal cord. Otherwise, there is a high probability of developing side effects. Therefore, an epidural block is prescribed only if the patient has severe pain. The technique is complex and is carried out only in a specialized office, requiring a high level of professionalism from medical personnel. Therefore, doctors most often perform the procedure. The following types of drugs are used:

Instructions for use of Karipazim for spinal hernia

• "Lidocaine."
• "Novocaine".
• "Dexamethasone."
• "Diprospan".
• B vitamins.

Anesthetics, which include Novocaine and Lidocaine, have the fastest and most lasting effect. They relieve pain almost immediately, and the resulting effect lasts for a long time.

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Removal of lumbar hernia using microsurgical method

The hernia is removed through a small incision in the skin (2-3 cm). During the operation, the neurosurgeon uses special microsurgical instruments and magnifying optics. This method is indicated for patients with severe instability of the spinal segment, as well as osteophytes (growths on the bones). Only by microdiscectomy is it possible to gain access to the spinal hernia and install an interbody cage or implant.

Microsurgical removal of spinal hernia:

• Hospitalization - 1-3 days.
• The rehabilitation period is about 1 month.
• It is distinguished by high clinical effectiveness, thanks to the precision approach of neurosurgeons at the Pirogov Clinic.
• The pain goes away immediately after surgery.

View reviews about the removal of spinal hernias in our clinic

Use of droppers

For the treatment of intervertebral hernia of the lumbosacral region, droppers are often used at the initial stage. They allow you to slowly administer any medication intravenously. The main advantage of this type of injection is a high degree of effectiveness, since the gradual supply of the active substance spreads faster throughout the body, and the patient almost immediately begins to feel relief.

To eliminate back pain, droppers with analgesics are prescribed, for example, Aspirin or Paracetomol, aimed at reducing the manifestation of unpleasant symptoms. Vinpocetine is also used for gradual intravenous administration. This medicine normalizes blood flow and also eliminates stagnation at the site of the lesion. In addition to painkillers, patients are prescribed muscle relaxants, non-steroidal drugs, chondroprotectors and steroids in the form of droppers.

Another drug that is administered to patients with intervertebral hernias through droppers is Euphilinn. It has a pronounced analgesic and anti-inflammatory effect, and eliminates discomfort in the area of ​​pinched nerve endings.

Patient reviews

After diagnosis and treatment, patients often doubt the effectiveness of certain medications. Feedback from patients who use this dosage form in treatment will help you understand the issue.

Inna M., 32 years old “The hernia appeared after I injured my back. I didn’t see a doctor for a long time, until the pain became quite severe. He immediately prescribed intramuscular steroids and ointments for me. After several injections, the condition improved significantly. Of course, pills and injections alone cannot cure the problem, and besides them I do gymnastics and visit a physiotherapist, but it has already become much better.”

Tatyana K, 45 years old “For injections for a hernia, the doctor prescribed drugs to relax the tension, and vitamins, although painkillers in tablets did not help much, I still take them. Relief occurs almost immediately, which is a big advantage, because after taking the pill you have to wait some time for the drug to take effect. The only thing that’s inconvenient is the administration itself; you have to constantly look for a nurse who will come and give injections.”

Artem T, 28 years old “I’ve been treating a spinal hernia for a long time, but not a single drug in tablets has helped better than injections. It begins to help almost immediately, and there is no negative effect on the stomach. But it’s inconvenient to take courses while studying or traveling, since you constantly have to look for medical staff to administer the drugs, so I think they are not a complete replacement for pills.”

Injections are one of the most effective ways to treat a herniated disc. This serious disease manifests itself in the form of acute pain, inflammation and can lead to spinal deformation. Modern pharmacological agents will help eliminate all these unpleasant symptoms. Injections are carried out according to the recommended scheme by medical personnel. Self-medication or changing the dosage without consulting a doctor is unacceptable, as it can lead to serious consequences and complications.