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Intercostal pain. Intercostal neuralgia - how to help yourself at home

Severe pain in the ribs prompts a person to go to the doctor to find out how to treat intercostal neuralgia and what medications to suppress the symptoms of the disease.

Intercostal neuralgia does not belong to the category of dangerous diseases. But it develops against the background serious pathologies and develops into serious complications. Neuralgia is caused by intervertebral protrusions and hernias, tuberculosis, diabetes mellitus, multiple sclerosis, tumors.

The symptoms of neuralgia are such that they can easily be confused with signs of renal colic, cholecystitis, and angina. Put correct diagnosis and only a doctor can prescribe treatment based on diagnostic studies.

Use of medicines – main way treatment of intercostal neuralgia. To treat the disease and the cause that caused it, the following is prescribed:

pills;
injections for intramuscular and intravenous administration;
ointments, gels or creams.

The form of medication for intercostal neuralgia is chosen by the doctor. Medicines are prescribed taking into account the severity of the disease, the patient’s well-being and contraindications.

Tablets are considered an ineffective treatment for intercostal neuralgia. In addition, they irritate the mucous membranes of the gastrointestinal tract, causing adverse reactions. Erosive gastritis and stomach ulcer - possible harm from uncontrolled use of tablets.

Pain relievers

The primary goal of drug therapy is to relieve pain – the main symptom of the disease. Pills and injections help get rid of prolonged debilitating pain. For pain relief the following is usually prescribed:

Spazgan;
Analgin;
Baralgin;
I took it.

To relieve unbearable pain that occurs with swelling of nerve fibers and root compression syndrome, the following is used:

Ketoprofen;
Ibuprofen;
Celebrex;

To relieve pain and prevent new attacks, analgesics are used:

Panadol;
Tylenone;
Pentalgin.

These drugs are available in tablets, injection solutions, in the form of ointments and gels. They are taken in tablets. To quickly relieve pain, injections are given and IVs are placed.

The course of treatment with anesthetics is short, it does not exceed 4-5 days. They disrupt the normal functioning of the gastrointestinal tract.

Local painkillers

Local anesthetics relieve swelling and pain of a neuralgic nature. They are prescribed for temporary relief of acute pain syndrome. Reduce pain and eliminate muscle tension with ointments, gels, and injection solutions.

The drugs are applied or injected directly into the lesion. They are used to make blockades. Pain is suppressed with injections of Lidocaine, Novocaine or Xylocaine. Application local anesthetics limited in time. They are highly toxic agents that can cause great harm body. Unbearable pain removed with one-time blockades.

Anti-inflammatory medications

Inflammatory processes occurring in nerve fibers lead to swelling and pain. The swollen tissue puts pressure on the nerves. Pinched nerve roots are accompanied by pain. Relieving inflammation, eliminating pain.

Inflammatory processes are suppressed with non-steroidal anti-inflammatory drugs:

Ortofen;
Nimesulide;
Ketoprofen;
Voltaren;
Movalis.

The products effectively relieve inflammation. If you use them correctly, according to the scheme given by the doctor, you can get a long lasting stable remission. To eliminate inflammation, take a tablet 2 times a day, give an injection, or use rectal suppositories.

The body's susceptibility to drugs is almost the same. But they are best absorbed through the mucous membranes. Long-term treatment anti-inflammatory drugs cause exacerbation of certain ailments (for example, gastritis or ulcers). They should not be used without a doctor's prescription.

Muscle relaxants

IN drug treatment intercostal neuralgia include muscle relaxants - drugs with a sedative effect. They eliminate pain, relax muscles, and improve the patient’s well-being. Which of them can be used for treatment:

Tizanidine;
Tolperisone.

The taken muscle relaxant eliminates congestion in muscle tissue and swelling. For treatment, use a drug prescribed by a doctor.

Vitamin therapy

To suppress inflammatory processes, replenishing vitamins and minerals, strengthening the immune system, you need to take special complexes. Medicines with B vitamins are involved in blocking acute inflammatory processes that erupt in nerve tissues. Vitamin complexes relieve muscle spasms, neutralize negative impact medications used.

Sedatives

Painful sensations worsen the well-being of patients, plunge them into a state of prolonged stress, create a feeling of discomfort, and reduce the quality of life. Taking sedative medications for intercostal neuralgia helps relieve nervous tension, relax skeletal muscles, normalize the condition of a sick person.

To this end, in drug therapy you can include a product with a sedative extract medicinal plant. Suitable for treatment:

Chamomile;
Mint;
Motherwort.

Herbs with sedative effect Use separately or prepare collections from them. It is worth drinking infusions and decoctions from them. Have an effective impact pharmaceutical drugs: syrups, tinctures.

They drink a sedative at night. It promotes good sleep, good rest, relieves nervous and muscle tension. Have an excellent relaxing effect essential oils: lavender and mint.

Medicines with bee and snake venom

Eliminate intercostal neuralgia with medicines based on snake oil and bee venom. The effectiveness of ointments and gels with these poisons is quite high. They're warming up skin, accelerate blood circulation, remove metabolic products, and saturate tissues with bioactive substances. The drugs regenerate damaged nerve tissue.

The product with poison is used externally, it is rubbed into the lesions with soft massaging movements, bypassing the heart area. For treatment use:

Apisatron. Ointment with bee venom suppresses pain and inflammation, restores blood flow.
Viprosal. Ointment with viper venom eliminates pain and improves blood circulation. Camphor and fir, which the drug contains, have an analgesic effect.

These ointments are used as prescribed by a doctor. They are not always used for treatment of:

lactation;
pregnancy;
allergies;
heart diseases.

Antiviral agents

Problem: how to treat intercostal neuralgia of a viral nature is easily solved. Antiviral medications are used to suppress it. Effectively fight pathology:

Amiksin;
Remantadine.

Ointments and gels

Remedies for neuralgia in the form of ointments and gels quickly relieve pain. They instantly penetrate through the skin pores into the deep tissues, to the lesion, reduce the severity of pain and eliminate swelling.

External agents stimulate blood circulation, distract from pain, clean up nervous tension. Thanks to them, blood supply to the sore spot improves, nutrition of damaged tissues, and pain goes away.

To treat intercostal neuralgia use:

Fastum-gel. The product relieves pain, stimulates blood flow, and eliminates swelling.
Capsicam. The ointment, due to its effective warming effect, accelerates the supply of blood to tissues. It restores tissue trophism and helps replenish nutrients.
Finalgon. The ointment warms up. Thanks to her blood vessels are expanding. Blood flow increases. Oxygen and nutrients enter the tissues.
Indomethacin, Ortofen, Naklofen, Ibuprofen. Ointments fight inflammation, swelling and pain.
Menovazin. The ointment has a pronounced analgesic effect.
Chondroxyl. The chondroprotector restores mobility to the spine.

Preference is given to ointments. Their rate of penetration into tissue is higher than that of gels. On early stages and for severe pain, use ointments that can relieve muscle spasms and relax muscles.

Patients suffering from sharp pain, try not to prescribe ointments with a burning effect. By increasing stimulation at the site of the lesion, it is possible to provoke the development of an ischemic crisis or heart attack due to excessive outflow of blood from the coronary vessels.

Antispasmodics

For neuralgia muscle tissue, surrounding the damaged nerve fibers, spasm, their tone is excessively high. Without eliminating muscle spasms, you cannot get rid of pain. Increased tone relieved with antispasmodics:

Besalol;
Halidor;
No-spy;
Papazol.

To eliminate spasms, they take pills and give injections.

Intercostal neuralgia requires comprehensive therapeutic treatment. Thanks to it, pain is quickly relieved, the patient’s well-being is improved, and the inflammatory processes that cause the disease are blocked. Prescription of treatment by the doctor - prerequisite. Prescribed medications will give maximum healing effect, will not allow complications to develop.

Intercostal neuralgia (or thoracic radiculitis, thoracalgia) is neurological disease, characterized by damage to the intercostal nerves, the main symptom of which is severe pain (on the pain scale it ranks third after pain during labor and renal colic). Most often it affects people aged 25 to 65 years; children practically do not suffer from this pathology. Men and women in equally may suffer from intercostal neuralgia.

In humans, there are 12 pairs of intercostal nerves. They are moving away from spinal cord and pass in the space between the ribs. Each such nerve bundle contains sensory, motor and autonomic nerve fibers. Any damage (compression, inflammation, irritation, etc.) can cause symptoms of neuralgia.

Causes

There are many reasons that can cause the development of intercostal neuralgia:

Symptoms of intercostal neuralgia

Signs and symptoms of intercostal neuralgia are quite typical for this disease:

Often, the symptoms of thoracalgia are in some way similar to other diseases: myocardial infarction, stomach ulcer or gastritis, pancreatitis, pneumonia (pneumonia), pleurisy and angina. However, each of them is characterized additional signs, including those identified on instrumental or laboratory research, which distinguish these pathologies from thoracic radiculitis.

Diagnostics

After the doctor has collected the patient’s complaints and anamnesis of the development of the disease, to confirm the diagnosis it is necessary to conduct additional examinations. The most informative and used of them:

Treatment of intercostal neuralgia

Treatment of intercostal neuralgia can be divided into medications and physiotherapy. When these treatment methods are combined, the duration of the disease and recovery processes are reduced several times.

Drug treatment of intercostal neuralgia

Physiotherapeutic treatment of intercostal neuralgia

Osteopathy. Eliminates the cause of deformation of the intercostal nerve, restores blood circulation and metabolism, relaxes muscles. Treatment duration is 5-15 sessions.
Exercise therapy. Performed after eliminating acute pain, strengthens the spine and muscular frame of the back, normalizes everything metabolic processes.

Surgical methods of treatment for intercostal neuralgia are not used. The exception is spinal pathologies, which cause neuralgia and require surgical intervention.

Complications

The only complication of intercostal neuralgia may be pain shock arising due to severe pain. It manifests itself as severe motor restlessness, the patient cannot sit, often changes positions, and walks. Screams or groans are also possible. After some time it decreases blood pressure, even to the point of fainting.

As treatment, the patient should be immediately given an anesthetic intramuscularly or intravenously, placed on a bed, and provided with access to fresh air.

Prevention

To prevent the development of intercostal neuralgia, you should pay attention to following simple and simple rules:

Avoid hypothermia;
At long work in a static and uncomfortable position, take breaks of 5 minutes every 30-60 minutes;
If any pathology of the spine and other organs and organ systems occurs, seek medical help from a specialist;
Maintain correct posture;
Monitor proper and balanced nutrition;
Doing physical exercises to strengthen the muscular frame of the back and chest(gymnastics, exercises, exercise equipment);
Avoid injury.

The most common causes of intercostal neuralgia are the following diseases and states:

degenerative changes in intervertebral discs(osteochondrosis thoracic spine, protrusion or herniation of the intervertebral disc);
muscle diseases, hypothermia or prolonged stay of the body in an uncomfortable position - all these circumstances can lead to muscle spasm and compression of the intercostal nerve by spasmed muscle fibers;
posture disorders;
curvature of the spine (scoliosis, kyphosis);
neoplasms in organs chest cavity or in the spine;
defeats nervous system any diseases or toxic compounds - conditions in which nerve conduction is disrupted;
long-term and severe deficiency of B vitamins;
chest or spine injuries;
chronic infectious diseases.

Symptoms of intercostal neuralgia

The main symptom of intercostal neuralgia is severe pain in the area of the affected nerve or throughout the chest if several intercostal nerves are involved in the pathological process. Neuralgia pain is described as sharp, burning. It can be constant or subside during rest and sharply intensify even with minor movements, coughing, laughter.
In addition, with intercostal neuralgia the following symptoms may be observed:

burning sensation in the muscles and/or skin in the area of the affected nerve;
sensory disturbances in a limited area of the chest, in the shoulder, arm, shoulder blade or neck on the corresponding side (numbness, a feeling of heat or cold, a feeling of crawling or tingling);
spontaneous contraction of muscles along the nerve (the muscles twitch on their own);
increased sweating;
redness or paleness of the skin.

Manifestations of acute intercostal neuralgia are extremely unpleasant, but never threaten human life. But they are capable of accurately simulating a heart attack, which requires emergency medical care. Only the qualified specialist Therefore, even if you have slight doubts about the origin of the pain, you should contact your doctor as soon as possible.

Content

Many people, especially older people, experience symptoms of intercostal neuralgia. This disease is the most common pathology of the nervous system. As a rule, neuralgia of this kind is caused by diseases of the spine, but it can also appear as a result of other pathological processes in the body. Doctors consider the disease not too dangerous for human health, but it provokes severe pain, which interferes with normal, quiet life. To cure neuralgia, you need symptomatic treatment and therapy that eliminates the cause of the disease.

What is intercostal neuralgia

Intercostal neuralgia (another name is thoracalgia) is pinching, irritation or compression of the spinal nerve. Due to the nature of the pain (on the left, in the heart area or under the heart), during the first attacks, many patients confuse the disease with cardiovascular pathologies, for example, a heart attack. It is also important to differentiate intercostal neuralgia from stomach pain, renal colic. From heart attack The pathology is different in that it does not change blood pressure or pulse, and nitroglycerin does not help relieve symptoms. The pain intensifies with movement.

Pain due to intercostal neuralgia may occur in different areas the patient’s body next to the spine: throughout the chest area, on the right or left side of the back, under the shoulder blades. Often painful sensations are encircling in nature. As a rule, intercostal neuralgia develops due to the course of other diseases of the spine: osteochondrosis, scoliosis, tumors and abnormal position of the vertebrae. In addition, the disease can be caused by the following factors:

Long-term exposure to low temperatures.
Inflammatory diseases.
Injuries to the ribs, chest, spine.
Tumors localized in the spinal cord.
Poisoning of the body.
Nerve damage.
Spondylitis, kyphosis, other diseases of the spine.
Diabetes mellitus.
Age-related changes.
Severe overvoltage spinal muscles.
Fatigue, stress.
Herpes.
Pleurisy.
Pathological changes chest.
Rib diseases.
Aortic aneurysm.
Hormonal changes.
Fast growth(in children).
Climacteric, post-menopausal period (in women).

You should not self-diagnose intercostal neuralgia when it appears. similar symptoms and begin treatment, because behind it there may be serious illness, which requires urgent medical intervention. Methods for diagnosing the disease include examination of the patient, tests and examination with special devices. How to determine the presence of intercostal neuralgia:

Ultrasound. Not the main method of examination for intercostal neuralgia (due to high bone density).
X-ray. Helps to see abnormalities in the structure of a person’s bones.
Computed tomography. The tomogram will show bone and soft tissue.
Myelography. During the examination, a contrast agent is injected into the spinal canal, with which you can see changes in soft tissues due to the disease.
Contrasting discography. Contrast agent is inserted into the area of the intervertebral disc.
MRI. Allows you to fully examine the structure of damaged tissue or bone structures.
Electrospondylography. Helps identify pathology initial stage occurrence.

Women who are pregnant and breastfeeding require a particularly careful approach to therapy after diagnosis of the disease, because many medications are contraindicated for them. Intercostal neuralgia can occur due to severe stress on the back. If the pain is tolerable, women should be prescribed physical therapy, yoga or other stress relief acute symptoms diseases.

Symptoms and signs of the disease

The nerves of the spine have large branches, so when they are damaged, the pain often mimics cardiovascular diseases. For example, there may be unpleasant sensations in the thoracic region on the left, radiating to the scapula. In the treatment of left intercostal neuralgia, in contrast to heart diseases, they help sedatives, such as Corvalol, Validol. The frequency of pain attacks is significantly reduced when taking them. Painful sensations may become stronger during turns, inhalations, changes in body position, and sudden movements.

The pain associated with intercostal neuralgia can be dull, sharp, burning, or paroxysmal. It can last from several minutes to several days, and often goes away after sleeping in a comfortable position. In addition, the disease is accompanied by: numbness of the affected areas, muscle tension, cramps, increased sweating, a feeling of “crawling goosebumps” on the skin, sleep disturbance, tearfulness. Intercostal neuralgia increases after physical exercise or loads.

Methods for treating the disease at home

Treatment of intercostal neuralgia at home is carried out different methods. Main task V acute period diseases - to relieve pain, which can be extremely painful for the patient. Along with taking painkillers, it is necessary to influence the cause of the pathology and carry out appropriate therapy.

Modern treatment of back pain has long moved away from simply eliminating unpleasant sensations. It is important to treat not the manifestations, but their cause. An example of this integrated approach NSAIDs can be supplemented with neurotropic vitamins (B1, B6, B12). B vitamins not only help eliminate pain faster than when taking NSAIDs alone (for example, sodium diclofenac), but also have a beneficial effect on physiological processes in the nerve fiber, stimulate nutrition and restoration of the structure of the nervous tissue. Thus, the optimal addition to NSAIDs is the drug Neuromultivit in injections, which includes three vitamins B1, B6, B12. therapeutic dosages. The use of neurotropic vitamins in high therapeutic doses helps to consolidate the analgesic effect and promotes recovery nerve fiber, thanks to which it is possible to achieve long-term remission of pain. Treatment with the drug begins with daily injections for 5-10 days, then switches to maintenance administration, 2-3 injections per week for two to three weeks.

To reduce pain, doctors recommend wearing a corset that supports the spine and relieves stress on the nerves. In addition, it helps cope with pain dry heat which does not harm the body - this method is suitable for pregnant women who do not resort to pill treatment. To prevent attacks, doctors advise patients to sit less, not take uncomfortable positions, sleep on a flat surface, and avoid severe episodes as much as possible. physical activity, but moderate strength exercises, on the contrary, should be made part of the daily routine.

Drug treatment

Drug treatment will help the patient quickly relieve excruciating pain. To get rid of intercostal neuralgia with the help of medications, therapy is approached in a comprehensive manner: analgesics, anti-inflammatory drugs, and muscle relaxants are prescribed. How to treat intercostal neuralgia with medications:

Relieve pain. Drugs such as ibuprofen, diclofenac, and ketoprofen help with this. These are non-steroidal anti-inflammatory drugs that quickly eliminate the symptom of intercostal neuralgia, but they should not be taken by people who have problems with gastrointestinal tract. In this case, the tablets Movalis, Sedalgin, Panadol, Pentalgin, Baralgetas will help. It is advisable to take the pill immediately after the symptoms of the disease appear - this will make the attack go away faster.
Make a blockade. This is necessary when the patient has severe pain from a disease for which conventional pills do not help. Then they give injections of novocaine, lidocaine, hydrocortisone or diclofenac.
Use pepper patch. It will help relieve pain from intercostal neuralgia for several days.
Eliminate back muscle spasm. Drugs from the group of muscle relaxants will help with this: Tizanidine, Mydocalm, Clonazepam.
Get rid of numbness. B vitamins often help restore the structure of nerves.
Apply ointment. There are drugs with a pronounced analgesic effect, for example, Finalgon, Fastum-gel. Products such as Apizatron and Viproxal will help improve blood circulation and metabolic processes of the skin. Chondroxide ointment will help correct spinal mobility with intercostal neuralgia.

Treatment of neuralgia with cupping

Cupping massage is effective procedure, helping to get rid of intercostal neuralgia together with medicines. This method improves lymphatic drainage, blood circulation, and promotes tissue regeneration. Before performing a massage, a person must thoroughly clean the areas of skin where the cups will be placed. Next, its surface is lubricated with heated oil - eucalyptus or olive. When attaching the cans, the method of igniting the cotton wool inside, and then placing them on the back, or the mechanical method of removing air (in modern cans) can be used.

Doing cupping massage at home for intercostal neuralgia, you need to remember that the devices should only slightly absorb the skin, lifting it no more than one and a half centimeters. After attaching the can, begin the massage: to influence the back, you need to move the device from bottom to top, as you go lymphatic vessels. You should not place jars on the spine itself. At correct execution the procedure will not cause pain to the patient, and the effect of treating the disease will not take long to arrive.

Physiotherapy and exercise therapy

Physiotherapeutic methods are no less effective than treatment medications. To get rid of neuralgia, doctors prescribe dynamic current to the patient, along with which they introduce into the body medicinal products. Intercostal neuralgia is also treated with ultrasound, which provides micromassage to the affected areas. So that the patient can painlessly cope with the disease, treatment with paraffin, mud, and ozokerite is prescribed. Medical physical culture will help the patient strengthen the back muscles, thereby relieving the load on the spine and coping with the pressure on the affected nerve.

Acupuncture

Acupuncture (acupuncture) is an ancient method of treating diseases, including neuralgia. During it biologically active points are pierced with special thinnest needles. Impact on certain areas with the help of these devices improves blood flow, metabolic processes, relieves pain, and eliminates muscle imbalance during exacerbation. For neuralgia, doctors usually prescribe two or three courses of acupuncture (one course is about ten procedures, but depends on the severity of the disease). To achieve the desired effect, take a break of two months.

Acupressure

Acupressure is a method of treating alternative medicine, which, however, has been proving its effectiveness in the treatment of intercostal neuralgia for many years. The essence of the method is to influence biologically active points associated with certain authorities. There are different methods of influence: light stroking or touching points, pressure with a finger or palm, strong deep pressure (can be done with a finger or with special devices, grains, matches).

Pressing and stroking should be carried out perpendicular to the surface of the skin. If this is stroking, it should be continuous and performed at the same pace from the beginning to the end of the procedure. For intercostal neuralgia, as a rule, about 10-15 procedures are needed to significantly reduce pain. The patient can do the massage independently after consultation with a professional. Diagram of the location of some points from intercostal neuralgia in the photo:

Folk remedies for pain relief

Indoor geranium. Tear off a leaf from the plant, rub it on the areas affected by pain, wrap yourself in a woolen blanket or scarf - this will help reduce pain in the area of intercostal neuralgia.
Product with beeswax, honey, onion. To prepare the ointment, mix the juice onions, juice from a white lily bulb, a little honey and beeswax. Apply the mixture to the sore area, wrap yourself well to provide warmth, and go to bed.
Mumiyo with propolis. These remedies have long been known for the treatment of intercostal neuralgia. Their joint use ensures restoration of affected tissues and relief of inflammatory processes. To enhance the effect, the mixture is used not only externally, but also taken internally.
Yarrow. To prepare an infusion with this plant, pour a glass of boiling water over a large spoon of the herb and leave for an hour, wrapped in a towel or blanket. Strain the resulting solution. When it cools down, take a tablespoon three times a day to relieve pain from intercostal neuralgia.
Turpentine with Vaseline. Mix the products in a ratio of one to two, rub into the affected areas. Over time, intercostal neuralgia will subside.

Video: how to recognize and treat intercostal neuralgia

It is extremely important to correctly recognize intercostal neuralgia so as not to confuse it with heart disease, stomach disease, kidney disease, or a heart attack. When the nerve is first damaged, people may panic, not understanding what is happening. The leading cardiologist talks in detail about the signs of intercostal neuralgia, which is characterized by a specific area of pain, its aching or stabbing nature, shortness of breath, worsening with inspiration, and helps to understand how it differs from heart disease. Watch the video, which will help you recognize pathologies and tell you how to treat neuralgia.

Attention! The information presented in the article is for informational purposes only. The materials of the article do not call for self-treatment. Only a qualified doctor can make a diagnosis and make treatment recommendations based on individual characteristics specific patient.

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Intercostal neuropathy (G58.0) is tunnel neuropathy, resulting from compression of the intercostal nerves.

Prevalence of intercostal neuropathy: 5-12 cases per 100 thousand people. More common in people over 50 years of age. The lesion is characteristically unilateral.

Predisposing factors are hypothermia, physical overload, back or chest injuries, surgical operations on the spine.

Clinical picture

Symptoms of the disease appear acutely. The pain is constant or paroxysmal along the intercostal spaces, intensifying with sudden movements of the body, coughing, sneezing. The pain is accompanied by burning, tingling, and numbness in the affected area. Unpleasant sensations can “give” to the heart, back, under the shoulder blade, in the lower back.

An objective examination of the patient reveals pain on palpation in the affected area, hyperesthesia, and local paresthesia. Characteristic is an increase in pain in the chest area with active movements of the body (bending, movement in the shoulder/acromial clavicular joints).

Diagnostics

Diagnosis includes computed/magnetic resonance imaging of the thoracic spine (to exclude tumors, vascular diseases, inflammatory changes spinal cord, spine, internal organs).

Differential diagnosis:

Postherpetic neuropathy of intercostal nerves.
Neuroma of the intercostal nerve.
Spinal cord tumors.
Pathological processes in the spine.
Visceral diseases: ischemic disease heart, pleurisy, acute pathology abdominal cavity.

Treatment of intercostal neuropathy

Treatment is prescribed only after confirmation of the diagnosis by a medical specialist. Shown local treatment, restriction of mobility of the thoracic spine in the acute period, wearing a corset, analgesics, non-steroidal anti-inflammatory drugs, vitamins, massage, physiotherapy, drug blockades, X-ray therapy.

Essential drugs

There are contraindications. Specialist consultation is required.

(anticonvulsant). Dosage regimen: orally at an initial dose of 0.1 g for 4-5 days, then the dose is increased to 0.4-1.2 g/day. After 3-4 weeks. the dose is reduced to 0.1-0.2 g per day.
(vitamin B complex). Dosage regimen: therapy begins with 2 ml intramuscularly 1 time per day for 5-10 days. Maintenance therapy - 2 ml IM two or three times a week.
Medical adhesive plaster Nanoplast forte (local anesthetic and anti-inflammatory agent). Dosage regimen: externally, it is recommended to keep it on the skin for no more than 12 hours. Use the next patch no earlier than 6 hours after removing the previous one. The duration of treatment is from 3 to 9 days.