Novocaine blockade of the shoulder. Blockades (punctures) of the joints

With severe pain in the joints, drug blockades can be carried out. Blockade of the shoulder joint is a great way to get rid of both traumatic pain and pain caused by joint pathologies. The procedure is carried out exclusively in a medical institution.

Indications

The blockade of the shoulder joint is performed exclusively according to indications. The recommendation for blockade is pain in the shoulder joint. It can be triggered by both inflammatory lesions, degenerative-dystrophic processes, as well as various injuries that have happened to the shoulder joint. Blockade in the shoulder joint will be useful in the following diseases:

tendinitis is an inflammation of the tendons that attach to the shoulder area. Tendinitis can be both infectious and non-infectious. For example, with increased activity in the shoulder joint in tennis players;
bursitis is a pathology of the bag of the shoulder joint, which can also be infectious and non-infectious. Most often, tendinitis and bursitis occur simultaneously;
Arthritis is an inflammation of the joint, in which the edges of the bones are affected and the cartilage tissue suffers. Arthritis can be infectious, autoimmune or allergic. It accompanies such pathologies as tuberculosis, brucellosis, viral hepatitis, and can be a complication of acute respiratory infections, traumatic injuries;
in the shoulder joint, pain from injury occurs when ligaments are torn and sprained, capsule injuries, intra-articular bone fractures, pathology of cartilage tissue, nerves and blood vessels;
arthrosis - a disease in which the intra-articular cartilage tissue is destroyed, as a result of which a complication such as arthritis appears, and the joint may become non-functional;
capsulitis - suppurative processes in the joint capsule. Usually this is a chronic process, it leads to a significant limitation of the range of motion and constant pain in the joint;
calcification - otherwise called "collision syndrome", occurs when calcium salts appear inside the tendon and attach to the joints. When the shoulder is abducted, pain occurs, for example, if you put your hand behind your head;
humeroscapular arthritis is a pathology of the tissues surrounding the shoulder joint.

The causes of pain provoked by pathologies of other organs are diseases of the spine, liver diseases, as well as damage to the heart and lungs.

Contraindications

Like any procedure, Sokolovsky's supraclavicular and axillary blockades in the shoulder joint have contraindications. Refusals are made in the following cases:

if the patient is febrile;
in the presence of hemorrhagic syndrome;
with infectious lesions of tissues in the shoulder area;
if the patient suffers from severe cardiovascular insufficiency;
with severe pathologies of the kidneys or liver;
if the patient is allergic to drugs that will be used for therapeutic blockade;
if there is a high risk of exacerbation of chronic diseases, such as diabetes or stomach ulcers.

IMPORTANT! Blockades are not carried out in case of severe diseases of the central nervous system - in this case, drug blockades are replaced by other methods of anesthesia.

Preparations

Doctors use several groups of drugs as medicines for blockades of the shoulder joint - these are local anesthetics, glucocorticoids, B vitamins, antihistamines and vasodilators.

Local anesthetics

Novocaine is used as local anesthetics. It is characterized by the least toxicity and a pronounced strength of action. Many doctors prefer this particular anesthetic for relieving muscle pain in the shoulder. The main disadvantage of novocaine is frequent allergic reactions, vascular pathologies and weak potency compared to other drugs and duration of action.

Lidocaine is a longer acting anesthetic. It accumulates and is converted mainly in the liver and excreted in the urine. Lidocaine compares favorably with its positive properties. It is stable in solution, other medications can be added to it, has low toxicity, but high potency and good permeability through cell membranes.

From lidocaine comes a pronounced deep anesthesia. This drug practically does not provoke allergic reactions. It is now the most commonly used anesthetic.

Blockades should be done exclusively by a medical professional

Trimecaine is another popular drug that is close in its characteristics to lidocaine, but it is slightly inferior in terms of strength of action. Although, just like Lidocaine, it has low toxicity and practically does not provoke negative allergic reactions in patients.

Prilocaine is one of those anesthetics that is practically non-toxic and has the same duration of pain relief as lidocaine. However, trimecaine penetrates into the nervous tissue much worse, mainly accumulates and acts in the muscle tissue. Prilocaine has unique properties that make it suitable for use in pregnant women and children.

Mepivacaine - in terms of strength of action, this analgesic drug is not inferior to lidocaine, but has much greater toxicity. It does not dilate blood vessels and provides a long-lasting effect even more than lidocaine. However, with an overdose of this drug and the careless administration of a slightly larger dose, severe toxic reactions occur. Therefore, doctors when working with mepivacaine need to carefully select the dosage for each patient.

Glucocorticoids

Glucocorticoids are the most beneficial group of drugs that are administered to block pain in the shoulder joint. They have a powerful anti-inflammatory, immunosuppressive, anti-allergic effect. In degenerative-dystrophic processes in the shoulder joint, glucocorticoids play an important role in suppressing inflammation, which provokes pain.

The introduction directly into the focus of inflammation in the shoulder joint allows you to effectively suppress all pathological processes. In order to achieve the desired effect, it is necessary to take a small amount of the drug, which almost completely realizes itself in the focus of inflammation. Medicines are absorbed minimally, a small amount is enough to act even with chronic pain.

REFERENCE! It is safe to use steroid hormones in small doses, especially when applied topically to the shoulder joint. However, glucocorticoids are carefully administered to patients with gastric ulcers, diabetes mellitus, purulent processes, hypertension, and also in older people, since they can provoke unwanted reactions.

Among the common drugs used hydrocortisone acetate from 5 to 125 mg per blockade. The solution is mixed with a local anesthetic in order to avoid necrosis. Dexamethasone and Diprospan are the most active glucocorticoids, the effectiveness of which exceeds the characteristics of the drug Hydrocortisone by 25-30 times. They have little effect on electrolyte metabolism, so they do not provoke necrosis of soft tissues and nerves. For one blockade, 1 to 4 mg of Dexamethasone is sufficient.

Kenalog, or triamcinolone acetonide, - this glucocorticoid is absorbed rather slowly and acts in tissues for a long time. It is mainly used in chronic arthrosis and for the treatment of arthritis in order to create a depot of glucocorticoids in the shoulder joint. Re-introduction of the drug is possible in a week.

vitamins

B vitamins - these drugs are also actively used to block pain in the shoulder joint. Vitamins have the following positive characteristics:

they enhance the therapeutic efficacy of therapeutic drug blockades;
have ganglioblocking action;
enhance the potential of local anesthetics;
take part in the synthesis of amino acids;
improve lipid and carbohydrate metabolism;
activate tissue trophism;
have an analgesic effect, for example, with periarthritis;
improve biochemical processes in the nervous system.

As preparations, vitamins B1, B6 and B12 are used, respectively, thiamine, pyridoxine and cyanocobalamin. 1 ml of vitamin is sufficient for administration. Vitamins are used with caution in patients prone to angina pectoris, blood clots and allergies.

Antihistamines and vasodilators

Antihistamines are not self-administered. They are used along with anesthetics. Thanks to antihistamines, the central and peripheral effects of pain are reduced. Drugs are an excellent tool for the prevention of allergic and toxic responses of the body to the introduction of a particular drug.

Diphenhydramine is often included in the composition of drug blockades.

Also, antihistamines improve the therapeutic effect of drug administration of the drug. In a single dosage, Diphenhydramine, Diprazine or Suprastin can be added to anesthetics. Also, along with antihistamines, vasodilators are also used. They enhance the therapeutic effect of the blockade and promote the flow of the drug into the blood.

The following are used as vasodilators:

Papaverine, which in itself is a myotropic antispasmodic;
No-shpu, which reduces the contractility of smooth muscles.

For therapeutic blockades, you can use Lidocaine, Dexamethasone and one of the B vitamins, as well as No-shpa medicine. All drugs are mixed, the patient's own blood (about 5 ml) is taken in the recommended amount. Mixed drugs and for a certain time. This injection is given in the upper arm.

Advantages

Shoulder blockade has clear advantages. First, it is a fairly effective treatment. After the blockade, patients get rid of pain for a long time, and injections help even with pain that is not relieved by conventional anesthetics.

Secondly, for use, doctors can take several drugs, i.e. prepare your own combinations. It can be, for example, Diprospan and Lidocaine. Such an injection helps to quickly relieve the patient of the pain of arthrosis. The effect lasts for several weeks, and for the course it is recommended to do 3 to 5 blockades.

When chipping the shoulder with Novocain, the blockade of the brachial plexus relieves discomfort for a shorter period, however, this allows the doctor to conduct the necessary studies, for example, to pump out fluid from the shoulder joint. If you make a blockade, all this time the patient will not feel pain.

REFERENCE! After administration, the active substance acts directly at the site of injury. Usually the effect occurs within 10-15 minutes, if the execution technique is carried out correctly. In patients, swelling of tissues decreases and inflammation is removed, the pain of the shoulder joint that bothered them disappears, and mobility improves. On average, the effect of the blockade lasts about 3 weeks.

Complications

In some cases, medical axillary blockade of the joint can provoke complications. In fairness, it should be said that the risk of such complications is quite small. According to statistics, they occur in one percent of all patients who have experienced this procedure.

In most cases, negative complications appear for several reasons:

this is an incorrect administration of the drug, for example, interscalene blockade entails damage to the phrenic nerve;
non-compliance with the rules recommended by the doctor by the patients themselves.

It is necessary to administer drugs as accurately as possible so that there are no complications.

Complications after blockade of the shoulder joint appear in several forms. Allergic form - a complication occurs in a rash of varying degrees, which can occur both in the area of \u200b\u200bthe shoulder joint itself, and throughout the body. This is an individual reaction of the body to the administered drugs. It is much worse if anaphylactic shock develops, which can be fatal for the patient.

Usually, before making a blockade with an axillary access, doctors ask the patient about the presence of an allergy to various drugs and enter the data on the card. If the card contains allergy marks, then this drug will not be used, and pain relief is carried out in other ways. If there are no data, then after the procedure for the first blockade, the patient is left in a medical institution for some time to observe his reaction.

Toxic complications may arise from an incorrect injection given by the staff, or an incorrect prescription of the drug. An increase or decrease in blood pressure can also be attributed to the individual reactions of the body to the blockade. Usually the pressure is controlled by tablets.

Inflammation associated with infection in some cases is the result of a medical error when non-sterile needles were used. They also rarely occur due to non-compliance with the rules of hygiene by patients who could infect the infection after visiting a medical institution.

The joint is punctured with a needle of sufficient length and diameter. The skin at the point of needle insertion is displaced to the side (see Fig. 1). Perform anesthesia of the skin, subcutaneous tissue; the advancement of the needle into the tissue must be preceded by an anesthetic solution. When the needle passes through the joint capsule, the surgeon's hand experiences resistance, after which the needle freely penetrates into the cavity. The reverse stroke of the piston can produce synovial fluid, blood, pus, exudate. Medicines can be injected into the joint. When the needle is removed, the skin shifted at the beginning of the manipulation is released, and the needle passage channel is closed. After treatment with iodine solution, an aseptic dressing is applied to the puncture site.

INDICATIONS: evacuation of pathological contents, administration of anesthetics and medicines.

SHOULDER BLOCK

The blockade is performed in front, behind and from the lateral side (Fig. 43).

During puncture from the front, the patient is laid on his back, the arm is bent at the elbow joint, brought and rotated outwards so that the elbow joint is in the frontal plane. At the same time, on the anterior surface of the shoulder joint, the small tubercle of the humerus and the coracoid process of the scapula are easily determined, between which a place is chosen for puncture of the shoulder joint. The needle is directed exactly from front to back. For puncture from behind, the patient is laid on the stomach, the posterior edge of the apex of the acromial process and the edge of the deltoid muscle lying under it are groped. Here, a shallow fossa is defined, bounded by the edge of the mentioned muscle and the supraspinatus muscle running almost horizontally. The needle is inserted into the bottom of the fossa, advancing in the direction of the coracoid process. Puncture of the shoulder joint from the lateral side is performed in the position of the patient sitting or lying on a healthy side. The arm is placed along the body. The needle is inserted midway between the end of the acromial process and the greater tubercle of the humerus.

The most complete answers to questions on the topic: "how long does the blockade of the shoulder joint last?".

Joint problems are constantly accompanied by pain. It can manifest itself both in a static position and when moving. In this case, it is painful for a person to move, he tries to take a comfortable position, in which there are no unpleasant sensations, but the pain does not go away by itself. The task of specialists is to identify the problem and eliminate it with the help of special treatment methods. However, in addition to this, the removal of the pain syndrome is also required, one of the methods to achieve this goal is the blockade.

Blockades are widely used in medicine to eliminate pain. One of the drugs used for such procedures is Diprospan, a glucocorticoid with a strong anesthetic effect. Reviews of specialists and patients about this tool are mostly positive. It really helps to get rid of discomfort. However, this drug can not be used in every case, this requires appropriate indications and the complete absence of contraindications. Today we’ll talk about how the blockade of the shoulder joint is done with the introduction of Diprospan, when it can be used and when it can’t.

What is a blockade

Blockade is one of the modern methods of eliminating the pain syndrome that occurs in the affected joint. This method of treatment is widely used by specialists in combination with other activities such as massage, acupuncture, manual therapy, surgery, etc. It is important to know that blockades are used not only to combat the symptoms of the disease, but also to treat the disorder.

The essence of the blockade is quite simple. A special medication is injected into the affected area, which immediately begins to act. Events of this kind have been known to medicine since the beginning of the last century, but now they are used most widely. The reason for this was a breakthrough in pharmacology and an abundance of all kinds of drugs, which allows you to choose the best option in each case.

Blockades have a number of advantages compared to other methods of treatment. Let's analyze them in more detail:

Efficiency. The drug immediately begins to act on the affected focus, reducing or completely eliminating soreness for a certain time.
Reducing the drug load on the body. With the blockade, only one drug is used, which is injected into the affected area. In this case, the minimum doses of the drug enter the bloodstream. The minimum of side effects is also associated with this: the lower the concentration of the drug in the blood, the lower the risk.
Blockades have a positive therapeutic effect. They allow you to eliminate spasms of blood vessels and muscles, inflammation, swelling.
This method of treatment is indicated for repeated use. As soon as the patient feels a deterioration in the condition, the drug can be re-introduced to him.

Drug blockades are used for lesions of various parts of the spine and joints. The list of disorders of the musculoskeletal system, in which this method is used, is quite extensive. Typical diseases include:

neuropathy;
tunnel syndrome;
pain in the neck and back;
pain in the shoulder, knee, ankle joint;
pain in the intervertebral hernia;
osteochondrosis;
osteoarthritis;
rheumatic affection of the joints, etc.

For blockades, a wide variety of medicines are used. Diprospan is considered one of the most effective and we will talk about it in more detail later.
See also: Symptoms and treatment of capsulitis of the shoulder joint

What is Diprospan

Diprospan is a hormonal drug belonging to the glucocorticoid group. It is characterized by an anti-inflammatory effect, and also reduces the sensitivity of the body to irritants that can cause discomfort. Diprospan is sold as a suspension and is bottled in 1 ml ampoules. We draw your attention to the fact that it is impossible to administer the drug intravenously in any case. A possible effect in this case may be cardiac arrest.

Diprospan is widely used in the fight against lesions of the musculoskeletal system, as well as autoimmune diseases. The drug can be used in the symptomatic treatment of the following types of disorders:

anaphylactic shock;
suffocation in bronchial asthma;
acute allergic syndrome, etc.

However, Diprospan is not indicated for all violations. For example, it is not used to anesthetize the trigeminal nerve. Specialists prefer other glucocorticoids to him. The use of the drug is permissible only with the permission of a doctor, self-medication with Diprospan is unacceptable. The effect of Diprospan provides betamethasone. This substance allows you to speed up the process of penetration of the drug into the cells, so that the desired effect occurs approximately 15-20 minutes after the administration of the drug.

Indications, contraindications, complications

Diprospan blockades are shown in a number of cases. For example, they are widely used to combat diseases that fall under the category of non-infectious inflammatory arthritis, such as:

rheumatoid arthritis;
reactive arthritis;
ankylosing spondylitis;
Reiter's disease, etc.

Diprospan is also prescribed in the presence of exudates, when non-steroidal agents are not able to provide a sufficient anesthetic effect. The drug is used for pain relief in postoperative and post-traumatic arthritis, bursitis, periarthritis, and other lesions.

However, in some cases Diprospan cannot be used. This drug is not without contraindications, therefore, before its appointment, a thorough diagnosis of the body should be carried out. The drug cannot be used for blockades in the presence of the following health problems:

diabetes with complications;
nephritis;
glaucoma;
stomach ulcer;
tuberculosis;
duodenal ulcer;
cholelithiasis.

Also, before the appointment, it is necessary to determine whether the patient has an individual intolerance to the drug. In addition, the drug cannot be combined with vaccines, so during the vaccination period it should be used very carefully and not earlier than a week after the injection. During treatment, it is necessary to completely exclude alcoholic beverages.

If the drug is used correctly, the risk of complications is minimal, although side effects can still occur in everyone. Among the typical problems that it is time to bring the use of Diprospan include:

loss of appetite;
stool disorder;
feeling of nausea.

In some cases, it is possible to increase the volume of bone tissue, the occurrence of puffiness and an increase in body weight.

Blockade technique

If there are no contraindications to the use of the drug, the specialist must determine the dosage for a particular patient.

Before administration, the drug must be diluted. For this, novocaine or lidocaine can be used, the appropriate option is also determined individually. In addition, local anesthesia is also used. The injection site must be disinfected. Only after completing the preparatory procedures can a blockade be carried out. It is not recommended to administer the drug on your own, only a professional should do this.

Diprospan blockade begins its action in about 15 minutes. The following effects are noted:

stiffness in the movement of the joint disappears;
discomfort disappears;
edema disappears;
tissue hyperemia disappears.

With the help of Diprospan, it is possible to achieve a long-term effect. Pain returns only after 72 hours.

The blockade with Diprospan must be carried out by a specialist. Only a professional can determine the indications, contraindications and dosage of the drug for a particular case. Avoid self-medication!

Treatment options for shoulder pain

my mom did it. Well, it’s unpleasant and even painful, but it helped her a lot .... but she did several times

European scientists conducted studies of punctures of the hip joint, during which it was found that the exact hit in the joint cavity "blindly" by experienced surgeons occurs in 50% of cases, under ultrasound control - in 80%, under the control of an image intensifier tube (electronic-optical converter) - at 100%. Therefore, the blockade of the hip joint should be done only under the control of the image intensifier.

Firstly, there is a limit on the number of procedures performed. At the same time, they can be carried out on one large one (blockade of the knee joint) or from 3 to 5 small and medium ones. In the latter case, various combinations are possible, usually performed on one medium and several small ones.

No need to be nervous - this will lead to fear of the procedure, and muscle tension will make it difficult for the doctor to work. It is best to take herbal sedatives in the evening.

Why does the shoulder joint hurt?

Only those joints that are most significant for life are blocked (for example, blockade of the knee joint).

This drug is a glucocorticoid - an artificially created analogue of the adrenal hormone. They are the most powerful anti-inflammatory agents in modern medicine. Their mechanism of action in the joints is to prevent the penetration of cells of the immune system through the synovial membrane. Since they do not get inside, cytokines are not released - special proteins responsible for the development of inflammation.
Without showing the necessary effectiveness from the 2nd or 3rd injections in the same area of the knee.
Medical blockade of the knee composition is often used in the treatment of a disease such as arthrosis. Specialists who widely use this method of treatment consider it indispensable in a number of cases and argue that the introduction of drugs directly into the area of the diseased joint or periarticular tissues reliably stops the disease, allows you to get rid of severe pain and thereby preserve the ability of patients to work. The action of the injection occurs immediately.
Blockades with local anesthetics can prevent the development of such complications as pain contracture, when the patient limits the range of motion in the shoulder joint due to pain. This eventually leads to atrophy of certain muscle groups, which, even after the elimination of pain, does not allow you to move the upper limb in full.
aceclofenac,
It's important to remember! Establishing the true cause of pain in the shoulder joint is very important, since only in this case it is possible to choose a really correct and effective treatment, to prescribe appropriate preventive measures.
The shoulder joint is a unique articulation in the human body, because only it has such a large range of motion in all 3 planes. This gives us the ability to move our arms over such a large range. But, unfortunately, sometimes a person loses this ability, which is associated with diseases of the shoulder joint. In such cases, the pain in the shoulder is the most worrying, which can be either barely noticeable or unbearable.
Therapeutic blockade of the spine is one of the few methods of treatment that avoids surgery. In our clinic, this technology is successfully used to treat a herniated disc.
Secondly, glucocorticoids should not be injected into the supporting joints (hip, knee, ankle) more than 3 times a year.
To prevent complications, the health worker carries out the complete sterility of the technique. Only disposable instruments (syringes and needles) are used. Diprospan specially comes in a dosed form for 1 injection, so as not to leave the ampoule open. Therefore, clean instruments and drug solutions from different ampoules are used to block different joints.

More articles: Treatment of leg joints with folk remedies

They are divided into 2 main groups. With absolute - blockade with diprospan is prohibited, since the occurrence of complications is inevitable.

Approaches to the treatment of pain in the shoulder

Diprospan has a number of advantages that allow it to be used in chronic inflammatory joint diseases:

Blockade of the hip joint in many clinics is carried out under the supervision of an image intensifier tube - an electron-optical converter, the control of which ensures the exact entry of the needle into the cavity of the hip joint. Hyaluronic acid is injected into the joint cavity, which gives an excellent effect in the treatment of the early stage of arthrosis of the hip joint. If the puncture is performed by a surgeon without the use of an image intensifier tube and ultrasound, then a direct hit into the cavity of the hip joint will be provided only by 50-60%.
Blockade of the knee joint is carried out with the following drugs:
Also read:
nimesulide,

The treatment of joint pain consists of several components:

With pain in the shoulder joint, its function suffers, which often even leads to the loss of the patient's ability to work and the need to change their profession. Therefore, you need to do everything to get rid of it, and the sooner the better.

Medical therapy

Most often, paravertebral blockades are used by doctors. The very name of this procedure reveals its main meaning: the anesthetic is injected into the muscles that are located near the spine (

Thirdly, the intervals between blockades must be long - at least 3 months.

All glucocorticoids come in the form of either a concentrate or a dry powder. The ampoule or vial is a single dose, that is, for a single injection. Before the procedure itself, they are diluted with various solutions from 1 ml for small and up to 5 ml for large joints.
Infection in the joint, surrounding tissues or general (throughout the body).
Contains two main components that dissolve quickly or slowly. Therefore, it has both fast (after 3 hours) and long-term elimination of inflammation and pain up to two months.
The blockade has established itself as a wonderful pain reliever in the treatment of the hip joint.
hydrocortisone acetate. It is prescribed if the symptoms of the disease are not very pronounced. The drug is very well retained in the joint cavity, the duration of exposure is up to one week.
How to treat shoulder chondrosis?
Ketoprofen, etc.
etiotropic therapy, which is aimed at eliminating the cause of pain;

In this article, we will look at why the shoulder joint hurts, as well as how you can get rid of the pain syndrome.

Currently, intra-articular injection of diprospan is performed in every 3 patients with rheumatoid arthritis. Efforts are being made to set up special treatment rooms in polyclinics to perform this procedure. It has already been proven that the use of local blockades allows for up to 10 days to reduce the treatment time for inflammatory diseases of the joints.

The amount of medication administered depends on the size of the joint.

Increased bleeding associated with diseases or taking anticoagulant medications.

Does not form a deposit on the joint capsule, therefore, there is a low risk of developing allergies.

The complexity of this technique lies in the fact that the location of the hip joint is not very convenient due to its hiding under the skin, a layer of muscles and subcutaneous tissue. Elimination of pain, spasms of muscles and vessels of the hip joint occurs after repeated blockade, swelling goes away, blood flow and metabolism in tissues are restored.
Diprospan. The instant ester of betamethasone dipropionate instantly reduces pain and has a prolonged therapeutic effect, which begins after 2-3 hours. Treatment with diprospan is not accompanied by pain and various complications, therefore, it does not require additional anesthetics. This is a powerful drug that effectively removes the inflammatory process. Safe blockade with diprospan can also be used in severe diseases such as systemic lupus. The dose is selected individually, strictly for each patient. In addition, diprospan is also blockade for lesions of the shoulder, elbow and hip joints.

The effect of the blockade lasts up to 1 month, after which the procedure can be repeated. At this time, other treatment methods are used that are aimed at eliminating the cause of the disease.
All these drugs differ in the strength of the anti-inflammatory and analgesic effect, as well as the risk of side effects. The most effective drugs are from the first generation (diclofenac, indomethacin, ibuprofen), but they also have more side effects. Next-generation drugs (selective and highly selective COX-2 inhibitors), which include nimesulide, meloxicam, xefocam, have less anti-inflammatory efficacy, but their administration is much safer for the patient.

Pathogenetic treatment that disrupts the mechanism for the development of pathological symptoms;

The shoulder joint has a very complex structure, therefore it is prone to various diseases.

- near, near;

Diseases seriously limit a person's ability to work and can lead to disability. If 1-2 joints are affected, one blockade is enough to restore normal life without pain. If blockade of the knee joint (large) is performed, then one dose is used.

Pain and other symptoms are not caused by inflammation (such as nerve damage).

Unlike other glucocorticoids, diprospan does not cause malnutrition and depletion of surrounding tissues.

Other conservative methods

Diseases of the shoulder joint, which are caused by inflammation of the surrounding tissues (ligaments, capsules, tendons, muscles), require qualified treatment. In the initial stages of the disease, not every patient seeks help, so diseases of the shoulder joint quickly begin to progress and require a serious approach.

Kenalog-40. It is a suspension of triamcinolone acetonide. The effect of the drug does not occur immediately, but after a day, but lasts up to 30 days. The drug can cause negative effects: atrophy of skin and fatty tissues, necrosis of muscles and tendons.

Security mode

In some cases, locally irritating drugs based on capsaicin (red pepper extract), bee or snake venom, which are applied to the diseased joint in the form of ointments, will help relieve pain. Such drugs can be used only if the pain is not caused by inflammation, but by a degenerative-dystrophic process. Such medicinal formulations cause vasodilation in the area of application and improve the nutrition of joint structures and periarticular tissues, which leads to a decrease in pain.

Physiotherapy methods

Diclofenac - a potent representative of NSAIDs, allows you to quickly and effectively get rid of joint pain

symptomatic measures that eliminate the main signs of the disease (pain, swelling, etc.);

Therapeutic exercise and massage

There are many reasons why shoulder pain develops. These are inflammatory lesions of the components of the joint, and degenerative-dystrophic disorders, and various kinds of injuries. The following are the most common causes of shoulder pain:

Alternative Treatments

What is a therapeutic blockade of the spine or joint - knee, shoulder, hip and others?

Only half is inserted into the middle (elbow) joints.

Late stages of arthrosis, accompanied by a violation of the shape of the joint and mobility in it.

The use of blockade of the knee joint for the treatment of arthrosis

With the same result, it can be introduced both into the cavity and into the periarticular space.

More articles: Capsules for arthrosis of the joints

Shoulder injuries are caused by a torn muscle or rotator cuff. Blockade of the shoulder joint can be carried out with hormonal drugs or diprospan. Pain reduction occurs when an injection is injected into the suprascapular region. Treatment with diprospan is carried out only 2 times, with a gap of 20-25 days. Improvement comes after the first procedure. Timely blockade of the shoulder is an ambulance for pain, shock and severe inconvenience.

Drugs used for blockade

Of the anesthetics, safe drugs are used - lidocaine, trimecaine or novocaine. A vitamin complex of group B and homeopathic preparations are also prescribed.

Drug treatment is necessarily supplemented by the use of other conservative methods, which are the basis for the treatment and prevention of further relapses of the pain syndrome.
First-generation drugs are used mainly for acute pain syndrome, when it is necessary to quickly relieve a person of suffering, and the duration of their use should not exceed 14 days. Second and third generation drugs are suitable for long-term use when the pain is chronic and the patient needs almost daily pain relief.
Rehabilitation therapy, which is used to restore all impaired functions of the shoulder and the amplitude of its movements, as well as to prevent recurrence of the disease.
Tendinitis is an inflammation of the tendons of the muscles that attach to the shoulder area. It can be both infectious in nature and develop as a result of physical overload, for example, work associated with increased activity in the shoulder joint (some sports, etc.).

- spine). Most often, anesthetics are administered, which relieve muscle spasm, which eliminates pain. But most often these blockades are relatively short-term and do not have a very long-lasting effect. This is due to the fact that only superficial muscles are exposed to therapeutic effects. The anesthetic is not injected into the deeper muscle layers, since there is a high probability of damage to the nerves or spinal cord.

This is a procedure associated with the elimination of pain syndrome - the introduction of various drugs into the joint cavity or into soft tissues near the joint, most often painkillers, which allow you to break the circular mechanism of pain syndrome formation.

In small ones - already a quarter of the diluted diprospan.

Lack of stability in the joint (old ligament injuries, dislocations).
To eliminate a small inflammation, one injection is sufficient.
In diseases of the elbow joint, severe pain is localized in the general area of the elbow, but there may be no damage to the joint itself. Inflammation covers the tendons, swelling appears. Disorders of the elbow joint are caused by professional sports activities or heavy physical exertion in construction and agricultural work. The development of arthrosis of the elbow joint can be affected by a previous injury, but to a greater extent this is a violation of its functionality. Any vigorous activity in which the muscles of the forearm are constantly involved leads to the occurrence of epicondylitis of the elbow joint - a disease accompanied by degenerative-dystrophic processes of muscles and tendons. Sometimes the symptoms of elbow joint disease are associated with a decrease in the elasticity of collagen fibers, they become brittle, thin and easily destroyed.
The introduction of the drug directly into the bag of the joint contributes to the rapid relief of pain

Special elastic bandages for the shoulder help protect the joint from damage

NSAIDs exist in all dosage forms: solutions for intramuscular and intravenous injections, capsules and tablets for oral administration, ointment, gel, cream, patch for external use. Thus, the pathological focus can be affected simultaneously from several sides, which only increases the effectiveness of the analgesic effect.
It is necessary to treat pain in the shoulder joint only taking into account the 4 above principles. In this case, all pain sensations pass quickly and no longer bother the person.
Bursitis is an inflammation of the shoulder bag. It occurs for the same reasons as tendonitis. Very often these pathologies are combined.

Blockade of the joints of the pelvis and shoulder

In order for the anesthetic to reach deeper muscles, our clinic uses an exclusive technique - intraosseous blockade of the vertebrae.

We use the knee block procedure to treat certain types of knee injuries. It is most commonly used in clinical practice. This predisposes a typical knee lesion in arthritis and arthrosis. Limitation of mobility and the risk for a person to become disabled leads to the priority procedure on this joint.

Death (necrosis) of the bone adjacent to the joint or intra-articular fracture.

Repeated blockade of the joint is not contraindicated.

The use of blockade in diseases of the elbow joint

Conservative treatment of injuries of the elbow joint is not always used, more often with urgent and immediate assistance to obtain a positive result. Such a fast-acting treatment is very effective, instantly relieves pain and neuralgic manifestations of a damaged elbow joint.

Blockade of the knee can be carried out in two ways: by inserting a needle from the outer surface or from the inside. In a very severe case, the blockade is carried out on both sides.

Ensuring immobilization of the shoulder joint and limiting unwanted movements is achieved by providing bed rest, applying special elastic bandages to the joint, and using orthopedic products (bandages, orthoses). If rigid fixation is necessary, for example, after an injury, surgery, the doctor can even apply a plaster cast for the required time. Important! Despite the fact that drugs from the NSAID group are OTC drugs, it is strictly forbidden to prescribe them and select doses on your own, because they have serious contraindications and side effects. It is necessary to use such medicines only on the advice of a doctor.

All methods that are used for this can be divided into 2 large groups: conservative and surgical. In most cases, you can get rid of the pain syndrome with the help of conservative methods, medicinal and non-drug, but sometimes only surgery will help correct the situation.

Arthritis is an inflammation of the joint, which can be infectious, allergic, autoimmune. An example is rheumatoid, psoriatic, rheumatic, septic purulent arthritis, shoulder damage in systemic connective tissue diseases, brucellosis, tuberculosis, reactive arthritis, complications of acute respiratory infections, viral hepatitis, etc.

Blockade with diprospan of the knee and shoulder joints

This is one of the best blockades performed by single doctors. More often neurosurgeons who have a certain technique and understanding of the anatomy of the spine. A special drug mixture is injected directly into the vertebra itself, and this leads to the fact that the drug spreads throughout the vertebra, exits with the bloodstream, anesthetizes and relaxes deep-lying muscles. A very good analgesic effect is achieved, which cannot be achieved with a simple blockade. With bone blockade, even those muscles that are closer to the abdominal cavity are anesthetized. And most importantly, in capable hands, this is an absolutely safe procedure.

The knee joint is very complex - in addition to the cartilaginous surfaces and the capsule inherent in all joints, there are also menisci and internal cruciate ligaments.

They begin with the emotional and medical preparation of the patient. The doctor explains all the possible "painful" moments of the intervention. Particularly disturbing can be an injection of a sedative or local anesthesia (chopping) with novocaine. It is necessary to take a prone position and relax the leg.

With relative contraindications, the procedure is not performed, since there is a high probability of a lack of therapeutic effect. But it can be performed if the doctor or patient desires this, and also after assessing the possible risk.

What is diprospan?

The relatively low cost of the drug and the duration of the therapeutic effect are beneficial for people with chronic arthritis and arthrosis.

Main advantages

The blockade of the elbow joint relieves the pain syndrome, while maintaining the full working capacity of the sick patient.

All drugs used for blockade can be taken only after a complete examination according to the recommendations of a specialist who prescribes individual treatment to the patient. Self-treatment in this matter will only bring negative consequences. A knee blockade can be prescribed to a patient who has been diagnosed with the following diseases:
Appointed after the subsidence of acute pain syndrome. The treatment program depends on the underlying pathology. UHF, magnetotherapy, shock wave therapy, laser treatment, electrophoresis, phonophoresis, post-isometric relaxation, etc. are prescribed. An important condition for successful treatment is that you need to do the procedures regularly and take the full course recommended by the doctor, even if the pain has already subsided.
In cases where symptoms cannot be overcome with NSAIDs, resort to the use of glucocorticoid anti-inflammatory drugs. Such medications are usually not prescribed systemically for joint pain, if it is not caused by a rheumatological disease, but is used locally as injections into the joint area or into its cavity.
Almost without exception, patients with shoulder pain are prescribed drugs from the group of non-steroidal anti-inflammatory drugs and analgesics. In most cases, they allow you to quickly and effectively defeat the pain syndrome. These medicines immediately have 2 points of application: symptomatic (eliminate pain, swelling, redness) and pathogenetic, as they reduce inflammation (the main mechanism for the development of pain).
Traumatic injuries, which are quite common. All components can be injured in the shoulder: intra-articular and extra-articular ligaments with the development of ruptures and sprains, capsule, bones (intra-articular fractures), cartilage tissue that complements the articular cavity, muscles that envelop the shoulder, blood vessels and nerve fibers.
When treating the shoulder joint in our clinic, we

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During therapeutic blockade, we inject into the joint cavity either painkillers or a hyaluronic acid preparation, which create additional lubrication of the articular surfaces and improve gliding during joint movements. Also, the cartilaginous surfaces are covered with a thin protective film, which for some time saves the cartilage from the effects of adverse factors (overload, excessive friction in the joint, etc.)

Indications for blockade

Next, the skin is treated with antiseptics, after which the doctor, already wearing sterile gloves, chooses a puncture site. There are four standard points around the patella, usually the upper-outer one is chosen.

These include a general severe condition, but not necessarily as a result of an infection. It is possible after heart attacks or strokes, serious injuries. Severe chronic insufficiency of the work of any internal organ also greatly limits the capabilities of a person. The last is the low effectiveness (or lack of it) of at least 2 articular blocks performed earlier.
To maintain the effectiveness of the method by 90-95%, as in the scientific literature, it is necessary to take into account the type and nature of the disease. A mandatory component is the presence of acute and active inflammation:
The decision to prescribe this procedure is made by a specialist doctor. Blockade is often carried out by diprospan in a triangle formed by conditionally drawn lines from the olecranon, between the lateral epicondyle and the proximal radius. The needle is inserted perpendicularly into this triangle of the elbow joint.

synovitis occurring within the framework of arthrosis;

Physiotherapy treatments play an important role in the treatment of shoulder pain
Since these medicines have a very powerful anti-inflammatory and analgesic effect, 1 injection is enough. In severe cases, 2-3 injections may be needed. After that, in 80-90% of patients, the pain syndrome quickly disappears.
In modern medicine, there are a large number of representatives from this group of drugs:

Contraindications

Arthrosis is a degenerative-dystrophic disease that gradually destroys intra-articular cartilage tissue and causes secondary changes in the joint, which can lead to loss of its function.

do not use
This procedure can be carried out in two ways:
To begin with, they take an empty sterile syringe and carefully puncture (puncture) into the articular cavity. This is done to remove excess fluid from there, after which the needle is removed and discarded. Then, taking a syringe with diprospan, similarly pierce soft tissues, enter the cavity and slowly inject the drug.
Blockades are performed only in a hospital or clinic. It is necessary to have a special treatment room in them, equipped with equipment and medicines. A mandatory requirement is strict adherence to cleanliness and sterility by both the medical staff and the patient.
Inside the joint, especially with effusion into the cavity (most often it is rheumatoid or psoriatic arthritis).
If the blockade is carried out from the inside of the elbow joint, then there is a possibility of a complication - nerve damage. Treatment of the ulnar nerve will require additional time and medication.

non-infectious arthritis;

It is an integral part of the overall healing process. Exercise therapy allows you to strengthen the muscles of the shoulder girdle, increase the degree of mobility in the shoulder, resume all the necessary range of motion of the upper limb. The exercise program should be compiled by a specialist who should control the correctness and effectiveness of the exercises. For each pathology, various exercises are selected.

Preparation for the procedure

The most commonly used drugs, which are based on such an active substance as betamethasone:

diclofenac,
Capsulitis is an inflammation of the joint capsule, which is prone to chronic course and pathological changes in the joint membrane, which leads to a significant limitation of the range of motion in the shoulder and constant pain.
Hormonal agents, using only painkillers and physiotherapy.
An injection for joint blockade is carried out on the outside of the knee joint just above the patella;
Indications for this type of manipulation are inflammation of various ligaments, in a large number braiding the shoulder. They start with standard procedures - first they give the patient a comfortable position (lying or sitting with back and arm support). The skin is treated with alcohol and iodine solution three times, after which the doctor puts on sterile gloves and chooses a puncture site.

At home, you need to take a shower and put on clean linen.

Execution technique

Synovial membrane of the joint (synovitis with gout, arthrosis, trauma).

Dosage of the drug

As a result of the measures taken, the blockade of the cartilage tissue leads to the formation of a film that has a protective effect on the cartilage from various mechanical frictions and overloads.

Serous arthritis that manifested itself after an injury or surgery;

Massage allows you to achieve an improvement in local blood circulation in the tissues of the joint, an increase in the elasticity of the muscle frame of the shoulder.
diprospan,
ibuprofen,

Blockade of the knee joint

Ligament calcification (collision syndrome) when calcium salts are deposited inside the tendons that attach to the joint. This causes pain in a certain position of the hand, for example, when it is abducted and placed behind the head.

A common injury to the shoulder joint is a rupture of the rotator cuff, a series of muscles attached to the tubercle of the humerus that we use to rotate. When the rotator cuff is torn, the pain is constant (both during movement and at rest) and is aggravated by rotation of the arm. Often in these cases, doctors prescribe injections of hormonal drugs. And although this gives a fairly good initial effect, it can lead to the destruction of connective tissue and only aggravate the situation in the future.

The injection is carried out from the outside or inside from the own ligament of the patella to the ligament that connects the kneecap and the tibia.

There are two puncture points: external and anterior. Since the biceps tendon is most often injured, the anterior puncture is the method of choice. Pressing the muscles with his fingers, the doctor enters the joint cavity with a “control” needle and removes excess fluid. Then a new puncture is made and periarticular tissues, or a diprospan solution is injected inside.

Shoulder block

If there is hair on the body, then it is advisable to shave it off on the skin around the joint.

In periarticular tissues with damage to the bags (bursitis), ligaments (enthesitis), tendons (tendinitis) or other soft tissues.

After the blockade

6 Forecast

Ganglia and tendovaginitis, bursitis and periarthritis.

Often people resort to non-traditional methods of treatment, among which the most popular folk remedies, apitherapy, hirudotherapy, osteopathy, acupuncture. It must be emphasized that there are many folk recipes to eliminate pain in the shoulder joint. But before using one of them, it is advisable to consult a doctor about its appropriateness and the presence of contraindications in a particular patient.

Flosteron.
indomethacin,
Shoulder-shoulder periarthritis is an inflammation of the tissues that surround the shoulder joint.

Forecast

Katyunya Dmitruk

The effectiveness of the procedure is quite high - often it can completely eliminate pain. In advanced stages of knee joint disease, blockade can significantly reduce pain or be a good addition to complex treatment.

Blockade of the spine, knee, shoulder and hip joints - blockade with a hernia of the spine.

It is not recommended to go home immediately, as active movements will lead to the absorption of the drug and a decrease in the therapeutic effect. It is necessary to create rest of the limb for at least 3 hours. Special means of immobilization are not required for this, just lie down.

You must bring a clean change of clothes (for example, a nightgown and pants) and shoes.

Blockade of the knee joint

With mild inflammation, it can only be used if it is impossible to treat in other ways, for example, with a stomach ulcer or allergies. There are three more criteria that should always be checked, even with clear indications:

In medicine, “blockade of a joint” means injections of anti-inflammatory or painkillers into its cavity or surrounding tissues (intra-articular or peri-articular injection). This method, developed about 50 years ago, is now widely used by doctors who treat diseases of the musculoskeletal system. It allows you to inject the drug directly into the lesion, allowing you to increase the effectiveness of treatment and eliminate the side effects of some medications.

Blockade should not be used for:

Surgical treatment is prescribed in the case when the entire arsenal of conservative methods does not bring the desired result, the disease progresses or it cannot be cured without surgery.

In especially severe cases, the use of corticosteroids is combined with local anesthetics. Such joint blockades relieve even high-intensity pain. As an anesthetic, novocaine or lidocaine is most often used.
meloxicam,

Causes that are associated with the pathology of the internal organs and other parts of the musculoskeletal system (diseases of the cervical spine, when the nerve fibers that go towards the shoulder are compressed, pathology of the liver, damage to the heart, lungs).

Blockade of the hip joint

Must be done 3 days in a row. Make several injections, in the area (under the skin) that hurts. At first it hurts a little, then all the pain goes away.

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In our clinic, such therapeutic blockades of the hip joint are carried out under the control of an electron-optical converter (EOP). Only in this case it is possible to guarantee 100% hit of the needle exactly in the joint cavity.

Over the next week, despite the improvement in the condition, you should not change your activity and protect the joint from overstrain. Short (no more than 30 minutes) walks in the fresh air will be useful.

Blockade with a hernia of the spine

With long hair on your head, you will need a scarf or a disposable cap to tidy it up.

It is necessary to exclude the infection as the cause of inflammation (the introduction of hormones will only aggravate the process). Hormone preparations (glucocorticoids) are most often used. With this route of administration, they enter directly into the intra-articular fluid and the surrounding synovial membrane. This provides an immediate anti-inflammatory effect for a long time. Side effects of taking hormones due to their absence in the blood are practically absent. Deforming osteoarthritis, since the injection is required only by the periarticular method; Pain in the shoulder joint is the main symptom of its defeat, and is almost always present. To get rid of pain once and for all, it is necessary, first of all, to establish the cause. It is important not to forget about prevention, which will prevent repeated episodes of the disease. Blockade of the shoulder joint allows you to quickly relieve a person of pain

xefocam,

Impingement syndrome of the shoulder joint.

Shoulder block

Lady with a dog In this procedure, the most effective is the introduction of hyaluronic acid preparations. A particularly good effect is achieved in the early stages of arthrosis of the hip joint. The hip joint is simpler than the knee joint, but it is well covered by muscles, which makes access to it quite difficult. Therefore, the manipulation performed on the hip joint requires special technical equipment and knowledge of anatomy. Many patients, especially with a weak effect of the drug, try to require frequent blockades. But there are certain requirements for the use of hormones:

During the procedure, it is better not to talk.

Who did the blockade of the shoulder joint? Does it hurt a lot? Does it help? Tell me, I'm afraid.

The number of affected joints should be limited.

Currently, many funds have been created, of which diprospan is most widely used.

arthritis of a chronic form;

Medication blockades (including blockades of the knee joint) are an effective method of treatment in which drugs (painkillers and anti-inflammatory drugs) are injected directly into the focus of the disease. This type of treatment is not new. It has been used for many years in neurology, orthopedics, traumatology and rheumatology, but still has not lost its relevance. The use of the blockade allows you to quickly relieve the patient of pain (even in cases where conventional analgesics do not help), and in patients suffering from diseases of the musculoskeletal system, slow down the development of inflammatory and degenerative processes in the joint and ligaments, improve the patient's condition.

The terminology of joint blockade refers to injections of both painkillers and anti-inflammatory medicines. This technique, which was developed over fifty years ago, is currently actively used by doctors involved in the treatment of various diseases that are associated with the joints, as well as the motor and supporting apparatus.

The procedure is based on the principle that allows you to inject drugs directly into the lesion itself, thereby ensuring the effectiveness of the treatment process. Also, thanks to the method of exposure, the blockade helps to eliminate many side effects that can occur with the usual use of medications.

Major diseases In what cases are injections effective?

The procedure can be applied in a number of diseases, among which are the following:

Intercostal neuralgia;
Any kind and localization of osteochondrosis;
protrusion;
Arthritis;
contractures;
Bursitis;
tunnel syndrome;
Arthrosis.

When is blockade undesirable?

But at the same time, therapeutic blockades are contraindicated in diseases such as:

Deforming osteoarthritis;
chronic arthritis;
In situations where there is no effect after injections with Diprospan or with other types of drugs.

Contraindications

There are also several contraindications that relate to the patient's condition:

Lack of consciousness in a person;
The patient's tendency to profuse bleeding;
Pathology of the blood;
General serious condition;
Sensitivity to drugs;
Contraindications to drugs;
Epilepsy;
Hemophilia;
Pregnancy and lactation.

Varieties and descriptions of blockades Paraarticular

Para-articular blockade is understood as one of the most effective methods among innovative types of therapy for various syndromes and diseases of the joints. This technique is based on the introduction of drugs around the affected joint both intradermally and subcutaneously. This blockade belongs to a large group of local healing blockades.

Pros:

The effect of getting rid of pain begins almost immediately;
Minimal or no side effects;
It is possible to apply this technique repeatedly;
therapeutic effects.

The main goal of the blockade- Eliminate the source of pain and its main cause of occurrence. Also important is the fight against the localization of pain. The main parameters of exposure in this case are speed and the absence of side effects. It is also important to avoid time and material costs.

The decision on the appointment and the need for paraarticular blockade is made only by the doctor, and he does this on the basis of pain and the clinical picture.

Periarticular block

Also, such a blockade is called periarticular, because the mixture is injected into the region of periarticular tissues, such as tendons, ligaments or muscle structures. The drugs administered with this type of blockade are micronized, so they all have a prolonged action. The analgesic effect lasts for a long time.

Besides, periarticular blocks are safe and painless, which makes it possible not to use additional anesthetics. The dose is prescribed individually by a medical professional.

Indications:

Ankylosing spondylitis and Reiter's disease;
Shoulder-shoulder periarthrosis;
Lupus erythematosus;
Arthritis;
Osteoarthritis extending to the shoulder joints.

The procedure is prescribed and carried out by an orthopedic traumatologist, as well as a chiropractor or neurologist.

Intra-articular block

This is a type of minimally invasive non-surgical procedure in which the drug is injected directly into the joint. It is used specifically for the treatment of facet or arthrosis pain, as well as for spondyloarthrosis. The procedure takes place under the close supervision of modern technology - ultrasonic or X-ray sensors.

Indications:

Pain in the back. They can be either solitary or complicated by spreading to the legs or to the buttocks;
Pain in the cervical region. They can be both single and complicated by the spread of pain in the shoulder joint, shoulder, as well as in the occipital or suprascapular region.

Features of the blockade technique in various joints Shoulder block

The person lies on his back, and the arm is bent at the elbow. In this case, the elbow joint should be in the frontal plane, and there should be a small tubercle on the front surface of the entire shoulder joint. It is a tubercle between the humerus and the coracoid process of the scapula. There is a blockade between them.

Blockade of the elbow joint

The blockade is performed after the person bends the elbow to a right angle. The place where the needle will be inserted is just between the lower edge of the epicondyle and the olecranon.

Blockade of the wrist joint

The blockade is performed necessarily from the dorsal-radial surface on the lines that connect the styloid processes of the radius and ulna. The brush is located in the pronation position.

Blockade of the hip joint

It is carried out both from the outside and from the front side of the surface. The person is in a supine position with a straight thigh. During the puncture, the localization of the needle insertion site is just below the inguinal ligament. The needle is inserted from front to back, up to its stop in the bone.

Blockade of the knee joint

Injections into the knee joint can be done both from the outside and the inside, or only from the outside. Doctors prefer the second option more, as it is easier to perform and safer for the patient (less likely to cause any complications). But sometimes it is necessary to quickly eliminate severe pain (for example, when the meniscus of the knee joint is torn) or there is some other difficult situation, then injections are made on both sides.

In cases where the meniscus is not torn, but infringed, the following manipulation is performed:
the patient lies on his back with a small cushion under the injured knee. Novocaine is injected into the patella area, after which the leg is bent, unbent, and rotational movements are performed. If such actions do not cause difficulties and pain, then the injury has been successfully eliminated, otherwise, the question of what to do next is decided individually.

If, despite the pain and severe swelling of the joint, a person does not go to the doctor to eliminate the pinched meniscus, then gradually, due to ever-increasing intra-articular pressure and improper load distribution, arthrosis develops.

Let's take a closer look at how the blockade of the knee joint is performed for arthrosis:
the person lies on his back, and a roller is placed under the knee. The needle is inserted from the outside, in a place between the middle and upper third of the edge of the patella, and then smoothly moves parallel to the bottom of the knee.

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Ankle block

The blockade is performed only on the anterior surface. The foot is given a slight plantar flexion during conduction. The needle should pass between the talus and tibia.

Essential medicines

The groups of drugs required for blockade can be divided into the following:

Glucocorticoids. These drugs are distinguished by such striking actions as anti-shock, anti-inflammatory, anti-allergic, analgesic. The disadvantage is the fact that with frequent use, osteoporosis may develop at the injection site. The brightest representatives of this group include Dexamethasone, Kenalog and Hydrocortisone acetate.
B group vitamins. Representatives of this group are necessary for the synthesis of amino acids, as well as for lipid metabolism and to enhance the effect of drug therapeutic blockade. Representatives are vitamins such as B1, B6 and B12. These are Thiamine Chloride, Pyridoxine and Cyanocobalamin.
Antihistamines. They can significantly reduce both peripheral and central effects of pain. They play the role of prophylactic agents against allergies and toxic poisoning. Representatives are drugs such as Diphenhydramine, Diprazine and Suprastin.
Vasodilator drugs. The main role of these drugs is to enhance the therapeutic effect during the therapeutic blockade. Prominent representatives are Papaverine, No-Shpa and medicinal solutions.
Anesthetic drugs. They differ in anti-inflammatory and analgesic effect, can cause allergies. Used for blocking. The most popular representatives of this group of drugs are Lidocaine and Novocaine.

The main drugs that are used to carry out the blockade include:

- Novocaine. A local anesthetic that is the standard for blockade procedures. Absorbed by nervous tissue. When using the drug, such reactions of the body as cold, heat, and then pain and tactile are activated. They are activated sequentially;
- Trimecain. Amide-type drug. Exceeds Novocaine in duration of action by 3 times;
- Decain. Much stronger than Novocaine and Trimecaine, but has a strong degree of toxicity;

Lidocaine. A stable drug from the side of chemistry. Useful properties do not disappear under the influence of any acids. 2 times stronger than Novocaine, but also 4 times more toxic;
Sovkain. Can be added to Novocain to potentiate active action. Much stronger and more toxic than Novocain;
Editocaine. This drug has a significant impact force and a quick onset of work in the body. Sensory activity is much less pronounced than motor activity.

Complications and side effects

Possible Complications

The probability of development and manifestation of complications that may occur during the therapeutic blockade is very small and amounts to approximately 0.5 percent of the total cases. The risk of consequences may depend mainly on the general and detailed condition of the patient, as well as on such points as the quality of the procedure and the variety of its implementation.

Side effects:

Toxic. This kind of complications can occur due to the fact that the drugs enter the lumen of the vessels, as well as with the wrong choice of the drug, its dosage and / or concentration. This problem also develops with a lack of skills of a medical worker.
Allergic. Allergies to the medications used can manifest both in delayed types and as anaphylactic shock. In the first case, allergy is characterized by skin manifestations. As for anaphylactic shock, then with it the human condition rapidly begins to deteriorate. He may develop respiratory failure, as well as cardiac arrest;
Vegetovascular. This type of complications is characterized by serious pressure drops. It should be noted that the central nervous system does not suffer much in this case. In addition, there are no changes in the work of the heart and the entire respiratory system as a whole;
Puncture some cavities. This applies to the spinal cavity, as well as the pleural and abdominal cavities. This complication of blockade is very rare.
Inflammatory. May develop during infection. The most severe consequences include meningitis, as well as osteomyelitis and periostitis;
Traumatic. They appear when nerves or blood vessels are damaged. Also, such complications include the occurrence of bruising;
local reactions. These complications can arise in the course of an incorrectly or incompetently selected drug. They also occur in the process of poor-quality injection of the drug into the area of conduction. The consequences are manifested both in the form of edema, increased pain, and in the form of non-specific inflammation processes.

Before and after blockade Before the blockade

Blockades, regardless of the complexity of the implementation, are performed in specialized medical organizations. In other words, only in the conditions of a specialized medical institution. Before carrying out, it is necessary to make sure and check the availability of the necessary cabinet, which has all the necessary medications, as well as specialized equipment for the blockade.

Patient preparation

Before the blockade, the patient must perform such actions as:

Taking a shower and putting on clean linen;
Shaving the hair at the site of the drug blockade;
Take spare clothes with you for the procedure: pants and a shirt, and be sure to change shoes;
If the patient has long hair, it is necessary to collect them under a scarf or cap. This is necessary not only so that they do not interfere, but also to better maintain the sterility of the office;
During this procedure, it is forbidden to talk.

Also, you should not be nervous before the procedure and during it, because due to fear, the human muscles will be very tense, which will make the doctor's work much more difficult. Therefore, it is recommended to take some sedatives before the procedure. Preferably of vegetable origin.

After the blockade

You should not immediately go about your business or home after the blockade. The fact is that any active movements can cause the absorption of the drug into the blood, which will lead to a significant decrease in the therapeutic effect. It is recommended to create complete rest of the affected limb for at least 3-4 hours. Immobilization does not require any special immobilization means, a person just needs to lie down.

Over the next 7-10 days, it is also not recommended to increase activity., even if the person's condition has improved significantly. Also, despite significant improvements, it is necessary to protect the joint from possible overstrain. As a preventive measure, it will be useful to perform short (up to 30 minutes) walks along the street.

Prevention

Many patients, especially when using drugs with a weak effect, try to require doctors to perform therapeutic blockades more often, however, there are some important parameters, according to which blockades should not be performed as often as patients want.

Requirements:

First moment: there are some specific restrictions aimed at the number of blockades carried out per person. For one performance, it can be carried out as one large blockade (for example, of the knee joint), or up to 5 medium or small blocks. As for carrying out several medical procedures at the same time, there may be various combinations;
Second point: it is forbidden to inject funds into the supporting joints more than 3 times in one year. These joints include the ankle, hip, and knee joints;
Third moment: the minimum time interval between blockades is 3 months.

Conclusion

Therapeutic blockade is one of the most effective methods that allows you to get rid of most pathologies, diseases and pain. It should also be noted that the blockade gives a minimum number of complications or side effects. For this reason, it is widely used in practical medicine.

Therapeutic drug blockades can be considered as methods of pathogenetic or symptomatic therapy. The direct supply of drugs to the irritation zone ensures the elimination of painful sensations in a short time, favors the early restoration of the functions of damaged joints and recovery.

To obtain a positive result from the procedure, it is necessary to determine the causes and conditions for the development of pathology, clinical assessment of symptoms and a competent choice of medicines in the ratio of effectiveness / safety.

One of the priority areas for the treatment of diseases of the musculoskeletal system is muscle blockade., in order to prevent the destruction of articular structures, eliminate tissue inflammation, and stop pain.

The principle of exposure is quite simple, and is based on the introduction of a medicinal solution directly into the pathological focus. Due to the direct supply of the drug, an effective treatment process is ensured, the development of a rapid pharmacodynamic response.

Since the active components are initially localized in the affected area (and not in the bloodstream), the drug load is reduced, the risk of side effects is reduced, and the remission period is reduced. A positive aspect of therapeutic blockades is the duration of action, the possibility of repeated administration in the acute stage.

The main advantages of the procedure include the ability to influence different aspects of the pathological process.

The versatility of the mechanism of action of drug blockades is expressed in the following aspects:

in the rapid cessation of the inflammatory process and associated pain syndrome;
in reducing muscle spasm;
in the elimination of edema;
in the normalization of metabolic processes;
in the restoration of tissue structures and joint mobility;
in inhibition of synthesis and growth of microbial communities;
in the normalization of the reflex mechanisms of nervous activity responsible for the internal activity of the body, its relationship with the outside world.

Reference! In addition to therapeutic blockades, there are diagnostic and symptomatic ones. The former are used to determine the essence of the disease, the mechanisms of its development, they facilitate the search for pathogenetic factors, symptomatic ones are designed to prevent complications.

The classification of blockades is based on the level of interruption of nerve impulses:

Periarticular block- injection of the drug mixture into the periarticular space of the structures of the musculoskeletal system (muscles, ligaments, tendons). This type of injection is painless and safe, with a prolonged analgesic effect.
Paraarticular blockade- the introduction of an injection suspension intradermally or subcutaneously around the affected joint. The main advantages are a quick analgesic effect, no adverse reactions, suitable for long-term treatment.
Intra-articular block- the drug is injected directly into the articular junction. It refers to the methods of a minimally invasive surgical procedure, helps to stop the symptoms of the facet syndrome of the spine, arthrotic pain.

Carrying out therapeutic procedures is associated with possible complications and side effects of drugs, therefore, the appointment of a drug blockade is personal, and depends on the stage of progression of the pathology, the clinical condition of the patient.

Indications

The most common injections are in the shoulder joint help with such pathologies and conditions as:

syndrome;
and different genesis;
stretching of the ligamentous apparatus;
open and closed limb injuries;
joint contractures;
postoperative pain.

Reference! In vertebrology and neurology, blockade of the ankle joint is popular in case of damage to the cartilage and neighboring anatomical structures. The risk of injury, the development of pathological changes in the bone structures, capsule, synovial membrane is associated with constant movement of the joint and load.

Carrying out medical manipulations is possible as an independent procedure or in combination with other medical, physiotherapeutic methods.

It should be noted that the effectiveness of treatment depends on how accurately the technique of blockade of the elbow joint was observed and the drug was correctly determined.

Contraindications

The absolute limitation for performing medical manipulations is:

It is advisable to limit the intra-articular administration of drugs when determining neuropsychiatric diseases or disorders, a negative attitude or a categorical refusal of the patient to conduct blockades.

What medicines are used

Currently, the range of drugs used for blockade in case of pain in the shoulder is quite wide, which provides great opportunities for individual selection of a medication.

The key issue in choosing the optimal drug is the prognosis of efficacy, which is based on its pharmacological features and benefits, and the identification of factors that can affect therapeutic results.

Medicines differ in the rate of absorption, the duration of the therapeutic effect, the level of toxicity, and the mechanism of action.

The basic drugs for the treatment of damaged brachial plexus are called several pharmacological groups:

anesthetics;
glucocorticosteroids;
vasodilators;
antihistamines;
B vitamins.

Most Prescribed Class for Treatment of Shoulder Pain Syndrome- anesthetics of local forms that prevent the generation of pain impulses, their transmission along nerve fibers.

Under their influence, various types of sensitivity are turned off, the severity of pain decreases, and the mobility of the affected joint is restored.

The standard anesthetic activity is:

"Novocaine";
"Dikain";
"Trimekain";
"Lidocaine";
Ropivacaine.

Close attention is paid to the potential effect of glucocorticoids on the course of destructive processes in the musculoskeletal system. They have a complex action against inflammation, pain, allergies. Additionally, they have anti-shock, desensitizing, immunosuppressive and antitoxic abilities.

The complex therapeutic efficacy determines their popularity as the drugs of choice for prophylactic blockade. The introduction of steroid hormones in small doses does not pose a health hazard.

Important! This pharmaceutical group should be used with caution in severe periarticular osteoporosis, pathological bleeding, instability of the shoulder joint, in pregnant and lactating women, the elderly, and young children.

The classic example of hormone therapy is blockade using drugs such as Kenalog, Hydrocortisone, Dexamethasone.

For therapeutic muscle blockade, it is possible to use antihistamines (for example, Suprastin, Diprazin, Dimedrol), which are often combined with anesthetics.

The therapeutic effect is to prevent hypersensitivity reactions, and if the allergy has already begun - to block the production of histamine.

B vitamins are used to enhance the therapeutic effect.:

"Thiamin chloride";
"Pyridoxine";
"Cyanocobalamin".

They compensate for the lack of vitamin B, which is a participant in metabolic processes, normalizes and maintains the activity of the central nervous system at the physiological level, improves tissue trophism, and stops pain.

How does blockade occur?

The procedure is performed in a medical institution.(operating, dressing or treatment rooms) in compliance with the rules of asepsis and antisepsis. In emergency cases (with bone fractures), it is allowed to carry out therapeutic blockades at the prehospital stage.

Important! Before starting therapeutic manipulations, it is necessary to conduct an intradermal test to determine the sensitivity of the body to the composition of the injection solution.

How to make an injection:

After the completion of the therapeutic blockade, the injection site is covered with a sterile napkin, an aseptic dressing or a bactericidal plaster is applied.

In order to prevent complications from therapeutic blockade, it is necessary to ensure the rest of the shoulder joint for 3-4 hours. Over the next 7-10 days, dynamic and static loads on the sore arm are contraindicated.

Possible Complications

Complications and side effects are the manifestation of toxic and allergic reactions, mechanical damage to tissues and blood vessels, infectious complications. A technical complication associated with the detachment of the catheter, a fracture of the puncture needle is allowed.

In practice, the most common overdose of anesthetics, which causes the appearance of toxic reactions. A typical clinical picture is characterized by signs of CNS excitation, rapid breathing, loss of consciousness, depression of the cardiovascular system.

Important! The frequency of occurrence of toxic reactions is affected by the general condition of the patient, a history of diseases that increase the toxicity of anesthetics: beriberi, drug addiction and alcoholism, diabetes mellitus, alimentary exhaustion.

With increased sensitivity to the components of the injection solution, there is a risk of developing allergies - anaphylactic shock, urticaria, edema, respiratory failure, in the worst case, cardiac arrest may occur.

If the rules of asepsis and antisepsis are not observed, there is a possibility of the formation of infectious complications. The infection provokes an inflammatory response that has a wide range of manifestations, dominated by fever, intoxication, and a violation of general well-being. The most severe consequences of the infectious and inflammatory process are meningitis, osteomyelitis, periostitis.

Mechanical damage to blood vessels, nerve trunks is associated with low qualification of the doctor: ignorance of topographic anatomy, non-compliance with the technique of joint blockade. As a result - the outpouring of blood from damaged vessels into soft tissues (bruising), the appearance of swelling, increased pain.

Conclusion

The feasibility of performing therapeutic drug blockades in case of damage to the shoulder joint is based on a clinically proven multifactorial effect on pain and inflammation.

The procedure is effective in the treatment of a wide range of diseases and pain disorders of the proximal segment of the arm, it is well tolerated and has a high safety profile.

Both painkillers and anti-inflammatory drugs. This technique, which was developed over fifty years ago, is currently actively used by doctors involved in the treatment of various diseases that are associated with the joints, as well as the motor and supporting apparatus.

Major diseases

In what cases are injections effective?

The procedure can be applied in a number of diseases, among which are the following:

Any kind and localization of osteochondrosis;
protrusion;
Arthritis;
contractures;
Bursitis;
tunnel syndrome;
Arthrosis.

When is blockade undesirable?

But at the same time, therapeutic blockades are contraindicated in diseases such as:

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Irina Martynova. Graduated from the Voronezh State Medical University. N.N. Burdenko. Clinical intern and neurologist of BUZ VO \"Moscow Polyclinic\".

Deforming osteoarthritis;
chronic arthritis;
In situations where there is no effect after injections with Diprospan or with other types of drugs.

Contraindications

There are also several contraindications that relate to the patient's condition:

Lack of consciousness in a person;
The patient's tendency to profuse bleeding;
Pathology of the blood;
General serious condition;
Sensitivity to drugs;
Contraindications to drugs;
Epilepsy;
Hemophilia;
Pregnancy and lactation.

Varieties and descriptions of blockades

Paraarticular

Pros:

The effect of getting rid of pain begins almost immediately;
Minimal or no side effects;
It is possible to apply this technique repeatedly;
therapeutic effects.

Expert opinion

Filimoshin Oleg Alexandrovich

Doctor - neurologist, city polyclinic of Orenburg. Education: Orenburg State Medical Academy, Orenburg.

The decision on the appointment and the need for paraarticular blockade is made only by the doctor, and he does this on the basis of pain and the clinical picture.

Besides, periarticular blocks are safe and painless, which makes it possible not to use additional anesthetics. The dose is prescribed individually by a medical professional.

Indications:

Ankylosing spondylitis and Reiter's disease;
Shoulder-shoulder periarthrosis;
Lupus erythematosus;
Arthritis;
Osteoarthritis extending to the shoulder joints.

The procedure is prescribed and carried out by an orthopedic traumatologist, as well as a chiropractor or neurologist.

Indications:

Pain in the back. They can be either solitary or complicated by spreading to the legs or to the buttocks;
Pain sensations. They can be both single and complicated by the spread of pain in the shoulder joint, shoulder, as well as in the occipital or suprascapular region.

Features of the blockade technique in various joints

Shoulder block

The blockade is performed after the person bends the elbow to a right angle. The place where the needle will be inserted is just between the lower edge of the epicondyle and the olecranon.

Blockade of the wrist joint

The blockade is performed necessarily from the dorsal-radial surface on the lines that connect the styloid processes of the radius and ulna. The brush is located in the pronation position.

Blockade of the hip joint

Blockade of the knee joint

Expert opinion

Mitrukhanov Eduard Petrovich

Doctor - neurologist, city polyclinic, Moscow. Education: Russian State Medical University, Russian Medical Academy of Postgraduate Education, Ministry of Health of the Russian Federation, Volgograd State Medical University, Volgograd.

If, despite the pain and severe swelling of the joint, a person does not go to the doctor to eliminate the pinched meniscus, then gradually, due to ever-increasing intra-articular pressure and improper load distribution, arthrosis develops.

Ankle block

The blockade is performed only on the anterior surface. The foot is given a slight plantar flexion during conduction. The needle should pass between the talus and tibia.

Essential medicines

The groups of drugs required for blockade can be divided into the following:

Glucocorticoids. These drugs are distinguished by such striking actions as anti-shock, anti-inflammatory, anti-allergic, analgesic. The disadvantage is the fact that with frequent use, osteoporosis may develop at the injection site. The brightest representatives of this group include Kenalog and Hydrocortisone acetate.
B group vitamins. Representatives of this group are necessary for the synthesis of amino acids, as well as for lipid metabolism and to enhance the effect of drug therapeutic blockade. Representatives are vitamins such as B1, B6 and. These are Thiamine Chloride, Pyridoxine and Cyanocobalamin.
Antihistamines. They can significantly reduce both peripheral and central effects of pain. They play the role of prophylactic agents against allergies and toxic poisoning. Representatives are drugs such as Diphenhydramine, Diprazine and Suprastin.
. The main role of these drugs is to enhance the therapeutic effect during the therapeutic blockade. Prominent representatives are Papaverine, No-Shpa and medicinal solutions.
Anesthetic drugs. They differ in anti-inflammatory and analgesic effect, can cause allergies. Used for blocking. The most popular representatives of this group of drugs are and.

The main drugs that are used to carry out the blockade include:

- Novocaine. A local anesthetic that is the standard for blockade procedures. Absorbed by nervous tissue. When using the drug, such reactions of the body as cold, heat, and then pain and tactile are activated. They are activated sequentially;
- Trimecain. Amide-type drug. Exceeds Novocaine in duration of action by 3 times;
- Decain. Much stronger than Novocaine and Trimecaine, but has a strong degree of toxicity;

Lidocaine. A stable drug from the side of chemistry. Useful properties do not disappear under the influence of any acids. 2 times stronger than Novocaine, but also 4 times more toxic;
Sovkain. Can be added to Novocain to potentiate active action. Much stronger and more toxic than Novocain;
Editocaine. This drug has a significant impact force and a quick onset of work in the body. Sensory activity is much less pronounced than motor activity.

Complications and side effects

Possible Complications

Side effects:

Toxic. This kind of complications can occur due to the fact that the drugs enter the lumen of the vessels, as well as with the wrong choice of the drug, its dosage and / or concentration. This problem also develops with a lack of skills of a medical worker.
Allergic. Allergies to the medications used can manifest both in delayed types and as anaphylactic shock. In the first case, allergy is characterized by skin manifestations. As for anaphylactic shock, then with it the human condition rapidly begins to deteriorate. He may develop respiratory failure, as well as cardiac arrest;
Vegetovascular. This type of complications is characterized by serious pressure drops. It should be noted that the central nervous system does not suffer much in this case. In addition, there are no changes in the work of the heart and the entire respiratory system as a whole;
Puncture some cavities. This applies to the spinal cavity, as well as the pleural and abdominal cavities. This complication of blockade is very rare.
Inflammatory. May develop during infection. The most severe consequences include meningitis, as well as osteomyelitis and periostitis;
Traumatic. They appear when nerves or blood vessels are damaged. Also, such complications include the occurrence of bruising;
local reactions. These complications can arise in the course of an incorrectly or incompetently selected drug. They also occur in the process of poor-quality injection of the drug into the area of conduction. The consequences are manifested both in the form of edema, increased pain, and in the form of non-specific inflammation processes.

Before and after blockade

Before the blockade

Patient preparation

Before the blockade, the patient must perform such actions as:

Taking a shower and putting on clean linen;
Shaving the hair at the site of the drug blockade;
Take spare clothes with you to the procedure: pants and a shirt, and be sure to change shoes;
If the patient has long hair, it is necessary to collect them under a scarf or cap. This is necessary not only so that they do not interfere, but also to better maintain the sterility of the office;
During this procedure, it is forbidden to talk.

Also, you should not be nervous before the procedure and during it, because due to fear, the human muscles will be very tense, which will make the doctor's work much more difficult. Therefore, it is recommended to take some sedatives before the procedure. Preferably of vegetable origin.

After the blockade

Prevention

Requirements:

First moment: there are some specific restrictions aimed at the number of blockades carried out per person. For one performance, it can be carried out as one large blockade (for example, of the knee joint), or up to 5 medium or small blocks. As for carrying out several medical procedures at the same time, there may be various combinations;
Second point: it is forbidden to inject funds into the supporting joints more than 3 times in one year. These joints include the ankle, hip, and knee joints;
Third moment: the minimum time interval between blockades is 3 months.