Clinical efficiency of comprehensive approach to the treatment of the chronic non-specific vertebrogenic cervicalgia
Clinical efficiency of comprehensive approach to the treatment of the chronic non-specific vertebrogenic cervicalgia
L.Yu. Shirokova1, M.V. Mokrousova1,2, V.A. Gorokhova1
1 Yaroslavl State Medical University
2 Clinical Hospital № 3, Yaroslavl
Aim: to evaluate pain and functional parameters, indicators characterizing the quality of life and severity of depressive disorders in patients with chronic non-specific vertebrogenic cervicalgia (CNVC) during chondroitin sulfate (CH) treatment in combination with elements of muscular energetic techniques.
Patients and Methods: 57 patients with a definite diagnosis of CNVC I and II grades received a comprehensive one-course treatment: intramuscular injections of the drug Сhondrogard, 400 mg per week (course dose — 2.4 g) for 6 weeks in combination with myofascial release and stretching. Pain characteristics, functional changes in the neck area and quality of life indicators were included in the study after three and six months of observation.
Results: after 3 months from the start of therapy, the daily pain in the neck, according to VAS, decreased by 57.5%, after 6 months — by 73.8%. Night pain decreased by 71.7% after 3 months, after 6 — by 80.3%. Palpatory soreness in the paravertebral points regressed by 65.7% and 77.1%, in the area of the spinous processes of the vertebrae — by 95.5% and 97.0% after 3 and 6 months, respectively. Head rotation amplitude along the central axis increased by 37.1% and 40.5%, while in the sagittal plane it improved by 62.9% and 80.2%. Positive progress of the mental component of health by 3 and 6 months was 26.4% and 21.7% (p<0.05). The physical component of health after 3 and 6 months from the start of therapy increased by 25.4% and 24.9% (p<0.05) in contrast with the baseline. After 3 months from the start of therapy, the Vernon index decreased by 56.6%, after 6 — by 69.2% (p<0.00001). The qualitative indicator of the depression severity on the Beck depression scale decreased by 44.6% and 60.9% (p<0.00001) after 3 and 6 months in contrast with the baseline.
Conclusion: data obtained in the course of the combined treatment demonstrate the stable long-term efficacy and safety of the proposed method.
Key words: vertebral cervicalgia, myofascial release, stretching, chondroitin sulfate, Chondrogard.
For citation: Shirokova L.Yu., Mokrousova M.V., Gorokhova V.A. Clinical efficiency of comprehensive approach to the treatment of the chronic non-specific vertebrogenic cervicalgia // RMJ. Medical Review. 2018. № 8(I). P. 27–31.
References
1. Имаметдинова Г. Р., Чичасова Н.В. Подходы к лечению боли в спине // Лечащий врач. 2013. № 4. С.27–30 [Imametdinova G.R., Chichasova N.V. Podkhody k lecheniyu boli v spine // Lechashchiy vrach. 2013. № 4. S.27–30 (in Russian)].
2. Насонов Е.Л. Болевой синдром при патологии опорно-двигательного аппарата // Врач. 2002. № 4. С.15–19 [Nasonov Ye.L. Bolevoy sindrom pri patologii oporno-dvigatel’nogo apparata // Vrach. 2002. № 4. S.15–19 (in Russian)].
3. Шостак Н. А., Правдюк Н.Г. Боль в спине как модель болевого синдрома смешанного генеза // РМЖ. 2015. № 17. С.1020–1024 [Shostak N.A., Pravdyuk N.G. Bol’ v spine kak model’ bolevogo sindroma smeshannogo geneza // RMZh. 2015. № 17. S.1020–1024 (in Russian)].
4. Яхно Н. Н., Кукушкин М. Л., Давидов М. Л. и др. Результаты Российского эпидемиологического исследования распространенности невропатической боли, ее причин и характеристик в популяции амбулаторных больных, обратившихся к врачу-неврологу // Боль. 2008. № 3. С.24–32 [Yakhno N.N., Kukushkin M. L., Davidov M. L. i dr. Rezul’taty Rossiyskogo epidemiologicheskogo issledovaniya rasprostranennosti nevropaticheskoy boli, yeye prichin i kharakteristik v populyatsii ambulatornykh bol’nykh, obrativshikhsya k vrachu-nevrologu // Bol’. 2008. № 3. S.24–32 (in Russian)].
5. Данилов А.Б. Новые подходы к лечению пациентов с хронической болью // Лечащий врач. 2009. № 4. С.36 [Danilov A.B. Novyye podkhody k lecheniyu patsiyentov s khronicheskoy bol’yu // Lechashchiy vrach. 2009. № 4. S.36 (in Russian)].
6. Пилипович А. А., Данилов А. Б., Симонов С.Г. Боль в шее: причины и подходы к лечению // РМЖ. Специальный выпуск. Болевой синдром. 2012. С.18–22 [Pilipovich A.A., Danilov A. B., Simonov S.G. Bol’ v sheye: prichiny i podkhody k lecheniyu // RMZh. Spetsial’nyy vypusk. Bolevoy sindrom. 2012. S.18–22 (in Russian)].
7. Подымова И. Г., Данилов А.Б. Фасет-синдром // РМЖ. 2014. № 12. С.47–50 [Podymova I.G., Danilov A.B. Faset-sindrom // RMZh. 2014. № 12. S.47–50 (in Russian)].
8. Тюрников В.М. Дегенеративно-дистрофические поражения позвоночника: диагностика, клиника и лечение // РМЖ. 2008. № 26. С.1739–1745 [Tyurnikov V.M. Degenerativno–distroficheskiye porazheniya pozvonochnika: diagnostika, klinika i lecheniye // RMZh. 2008. № 26. S.1739–1745 (in Russian)].
9. Hogg-Johnson S., van der Velde G., Carroll L. J. et al. The burden and determinants of neck pain in the general population: results of the Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders // Spine. 2008. Vol. 33 (Suppl. 4). P.39–51.
10. Воробьева О.В. Цервикальная радикулопатия: диагностика и терапия // Журнал неврологии и психиатрии. 2012. № 2. С.2–7 [Vorob’yeva O.V. Tservikal’naya radikulopatiya: diagnostika i terapiya // Zhurnal nevrologii i psikhiatrii. 2012. № 2. S.2–7 (in Russian)].
11. Иваничев Г.А. Миофасциальная боль. Казань, 2007. 392 с. [Ivanichev G.A. Miofastsial’naya bol’. Kazan’, 2007. 392 s. (in Russian)].
12. Вознесенская Т.Г. Хроническая боль и депрессия // Трудный пациент. 2004. № 2. С.40–42 [Voznesenskaya T.G. Khronicheskaya bol’ i depressiya // Trudnyy patsiyent. 2004. № 2. S.40–42 (in Russian)].
13. Данилов А.Б. Психопатология и хроническая боль // Consilium medicum. Неврология. 2008. № 2. С.50–55 [Danilov A.B. Psikhopatologiya i khronicheskaya bol’ // Consilium medicum. Nevrologiya. 2008. № 2. S.50–55 (in Russian)].
14. Meana M. The meeting of pain and depression: comorbidity in women // Can J Psychiatry. 1998. Vol. 43 (9). P.893–899.
15. Bussières A. E., Stewart G., Al-Zoubi F. et al. The Treatment of Neck Pain-Associated Disorders and Whiplash-Associated Disorders: A Clinical Practice Guidelinem // J Manipulative Physiol Ther. 2016. Vol. 39 (8). P.523–604.
16. Wong J. J., Shearer H. M., Mior S. et al. Are manual therapies, passive physical modalities, or acupuncture effective for the management of patients with whiplash-associated disorders or neck pain and associated disorders? An update of the Bone and Joint Decade Task Force on Neck Pain and Its Associated Disorders by the OPTIMa collaboration // Spine J. 2016. Vol. 16 (12). P.1598–1630.
17. Чичасова Н.В. Лечение боли у пациентов с остеоартрозом различной локализации // Медицинский совет. 2014. № 17. С.96–102 [Chichasova N.V. Lecheniye boli u patsiyentov s osteoartrozom razlichnoy lokalizatsii // Meditsinskiy sovet. 2014. № 17. S.96–102 (in Russian)].
18. Прокопенко С. В., Шанина Е. Г., Петрова М.М. Хондропротекторы в лечении болевого синдрома // РМЖ. 2014. № 22. С.1619–1621 [Prokopenko S.V., Shanina Ye.G., Petrova M.M. Khondroprotektory v lechenii bolevogo sindroma // RMZh. 2014. № 22. S.1619–1621 (in Russian)].
This work is licensed under a Creative Commons «Attribution» 4.0 License.
Previous article
Next article
