One of the most difficult but important tasks is the treatment of lumbar radicular pain and other types of back pain. Any pain that occurs in the region of the spine or in the area of ​​the lower extremities should be eliminated as soon as possible. If the pain is permanent, a person becomes irritable and may have various psychogenic disorders that will complicate the process of healing and recovery. In order to quickly eliminate the pain, the doctors came up with a blockade.


With the help of blockade, one of the links of the arc responsible for the pain reflex is turned off. Sometimes with the help of blockade, doctors establish the true cause of the pain. To a local anesthetic, in some cases, corticosteroids are added, which allow for a longer therapeutic effect. Intra-articular injections of steroids help reduce inflammation and relieve the discomfort caused by them. Doctors use blockades in neuritis, radiculitis, sympathalgia and myositis. In addition to relief of pain, blockade can lead to regional vasodilation.

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There are several types of blockades: medicinal, novocaine and lidocaine.

Therapeutic blockade of

With the help of therapeutic blockades pain syndromes and neurological diseases are effectively treated. This method is based on the introduction of a drug in the pathological focus, which was the cause of the pain. In comparison with other methods of treatment, therapeutic blockades have not been used for a long time. The main goal of this blockade is to eliminate the cause of the pain. The pain should be stopped quickly enough, thus there should be a minimum of side effects, time and material expenses.

Therapeutic blockades have many advantages over other methods of treatment:

  • fast and good analgesic effect is achieved due to the fact that the drug acts directly on the endings and the conductors that are the spreaders of pain;
  • side effects are extremely rare, since the active substances of the drug are directly into the source of the pathology, and only then into the general bloodstream;
  • treatment blockade can be used many times;
  • achieves a good therapeutic effect;
  • therapeutic blockade reduces muscle tension, vascular spasms, edema in the focus of pain and inflammatory reaction.

Lidocaine and Novocaine blockades

The essence of this procedure is that the anesthetic drug is injected into the area of ​​the most painfulness - at the points of anatomical origin of the nerves, as well as the location of the nerve plexuses, into trigger points.

With the introduction of such a blockade, an analgesic effect occurs, which can last a short time( about half an hour), but this time is enough to activate the process of normal tone of spasms. The effect of this blockade is manifested in the fact that muscle spasm is removed on the entire muscle, the intensity of pain decreases and the volume of movement in the joint increases.

Contraindications to novocaine / lidocaine blockade:

  • marked bradycardia;
  • syndrome of sinus node weakness;
  • myasthenia gravis;
  • cardiogenic shock;
  • history of epileptiform seizures;
  • arterial hypotension;
  • kidney disease.

Modern methods of blockade in neuralgia

Paravertebral blockades are made in the immediate vicinity of the spine. Such blockages can be subcutaneous, muscular, intradermal, radicular. Sometimes such blockades block the ganglia of the borderline sympathetic trunk.

Paravertebral and funicular blockades are often carried out by doctors, and among all other blockades they take first place. This corresponds to the level of diseases of the nervous peripheral nervous system, which also occupy the first place among chronic diseases.

Paravertebral blockades are a complex procedure that should be performed by an experienced neurologist. Carrying out such a procedure requires skills and special knowledge. Before performing such manipulation, the doctor must establish a focus of pain and a damaged cord.

As a rule, paravertebral blockades are used to treat funiculitis. For such blockade, a 0.5% -1% solution of novocaine or a mixture with hydrocortisone emulsion is used. Less commonly used are other medications.

Intercostal blockade and sciatic nerve blockade

Often the cause of pain in the nape is irritation of the cervical roots. This is due to osteochondrosis or because of the irritation of the perivascular plexus of the vertebral artery by osteophytes in the area of ​​the unco verbal joint. In such cases, doctors prescribe novocain blockades, which act on the cervical roots and the stellate node. The purpose of this blockade is the introduction of the drug in the intercostal space to the location of the located nerve.

Intercostal blockades are divided into: front, parasternal, posterior and lateral. The choice of the level of blockade depends on the location of the focus of the injury or disease. When the blockade is performed, the doctor must take into account the fact that the neurovascular bundle passes along the lower edges of the ribs. In the posterior parts of the ribs( beginning from the articulation of the lump of the rib and the transverse process of the spine to the initial part of the costal groove), the nerves and joints are located closer to the middle of the intercostal space. From the seventh to the tenth intercostal nerves are between the artery at the bottom and the vein at the top.

Intercostal blockade is performed when the patient lies on the side that is healthy. First, the doctor performs a fine needle intradermal infiltration, and then through this zone introduces a thicker needle, which strains perpendicularly to the lower edge of the rib, and then, after slightly pulling the needle back, inserts it from below upward in an oblique direction under the lower edge of the rib.

Blockade of the sciatic nerve is carried out when the patient lies on his stomach. Initially, the doctor conducts a horizontal line of iodine solution through the top of a large trochanter and a vertical line along the outer edge of the ischial tuber. The place where these lines intersect is located under the sciatic nerve. At this point the doctor introduces the needle and produces it by layer-by-layer infiltration of the tissues, while gradually moving the needle towards this sciatic nerve. When introduced into this place novocaine, there is a perineural blockade. With this method, the intra-neural injection of anesthetics and a needle should be avoided. If the nerve is injured, cicatricial changes can result, leading to persistent pain. Therefore, this method is recommended only in extreme cases. When blockade of the sciatic nerve, doctors use a mixture of hydrocortisone and novocaine.

Epidural blockade of

Epidural blockade is a blockade of the roots of the spinal nerves. This blockade is carried out by introducing a solution of novocaine. With this method, Novocaine blockade is practically carried out to the radicular nerves of Najott, which pass in the epidural fiber between the inner edge of the intervertebral foramen and the main line of the dura mater.

This procedure should be performed by an experienced physician to avoid side effects. Before the procedure, it is determined whether the patient has an allergic reaction to the drug used.