RU2714457C1 - Method of treating dystrophic spinal and joint diseases - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to electrotherapy, and can be used for treating pain syndrome in dystrophic diseases of spine and joints. Course of electric stimulation procedures is conducted by applying electrodes on a projection of paraarticular muscle-nerve segments of joints. Ozone-containing cream-gel with peroxide number of active forms of oxygen of up to 750 megO₂/kg is applied on current-conducting ozone-resistant surface of electrodes of low-frequency electropulse massager. Four pairs of electrodes are arranged in pairs in the region of the involved joint and simultaneously in paraarticular regions of the cervicothoracic, thoracic and lumbosacral spines. Activating low-frequency electropulse stimulation is followed by percutaneously introducing active oxygen species from ozone containing cream-gel into paraarticular muscle-nerve segments of the spine and joints. Pulse shape, frequency, intensity and duration are selected individually for each patient in the first-second sessions. Parameters are first increased to a threshold of pain sensitivity, then the parameters are reduced by 2–5 %. Electropulse exposure is performed in a varying electric stimulation mode with amplitude of pulses of 15–80 mA, at their frequency of 15–120 Hz, duration of 250–400 mcs in amount of 10–12 procedures daily.

EFFECT: method provides higher clinical effectiveness, reduced duration and cost of treatment by using electric stimulation and ozone-containing cream gel.

1 cl, 4 tbl, 1 ex

Description

A method for the treatment of dystrophic diseases of the spine and joints

The invention relates to medicine, namely to electrotherapy and can be used in orthopedics, sports and rehabilitation medicine for the treatment and / or rehabilitation of patients with degenerative diseases of the spine and joints, including pain in the case of deforming arthrosis of large joints, dorsopathies, for prevention postoperative thromboembolism in patients at high risk.

The relevance of developing effective methods of treating degenerative diseases of the spine (DZP) and joints is dictated by the high prevalence and variability of these diseases, as well as their increasing rejuvenation. Diseases of the spine and joints affect both the older generation and very young people. The most common group of diseases of the spine is a degenerative-dystrophic group of osteochondrosis, intervertebral hernia, protrusion of the disc. Vertebrogenic syndromes account for more than 65% of all diseases of the nervous system, among which the lumbar form of dorsalgia is 71-82%. Back pains occupy a leading position in terms of the number of disabilities among the working population. Modern medicine has a large arsenal of funds aimed at treating patients with degenerative-dystrophic diseases of the spine and joints. There was a pathogenetic orientation in treatment, one of the main criteria of which is the restoration of blood circulation. The leading methods are complex conservative therapy, since surgical treatment is used in a few percent of the number of patients. However, complex conservative therapy does not significantly improve the results of treatment, which requires a long, inpatient treatment for 21-35 days.

A known method of treating diseases of the spine by interstitial electrostimulation, where exposure to electric current is carried out directly on bone tissue using an electrode brought to the pathological focus (A.S. N 1103855, IPC A61B 17/00). The known method consists in the fact that the electrode is fed directly to the pathological focus, using a pulsed exponential current from the anode of the apparatus with a frequency of 50-100 Hz, a pulse duration of 0.3-0.5 ms and a force of 4-25 mA for 15-30 minutes. The procedures were carried out after 1-5 days with a course of treatment of 3-6 on one localization.

The study of the current density in the depths of the tissues using a needle electrode turned out to be 20,000 times larger than with a plate skin electrode of 100 cm2, which determines the clinical effect of the treatment.

However, the main disadvantages of the known method of interstitial electrostimulation include its invasiveness and the possibility of infection of the injection site, trauma. In addition, the effect of improving blood supply to the bone itself is indirect and depends on the strengthening of modulating effects on the cardiovascular system during electrical irritations of the reflexogenic zones of the periosteum. In addition, the procedure may be accompanied by severe pain due to irritation by the current of periosteum pain receptors.

For the prototype of the present invention, a well-known method for the treatment of dystrophic diseases of the spine and joints is selected, including conducting a course of electropulse stimulation procedures by applying electrodes to the projection of the paraarticular muscular-nervous segments of the joints (RU 2384352, IPC A61N 1/32, A61H 1/00, 33/02, 33/04, 35/00 Publish. March 20, 2010 No. 8, EA Raspopova et al. Effect of treatment complexes using kinesiotherapy in a pool with mineral water, electrical stimulation and magnetotherapy on the state of regional blood flow in patients with post-injury atopic gonarthrosis // Issues of balneology, physiotherapy and therapeutic physical culture. - 2006 - No. 5. - P. 14-16).

The known method is as follows.

Kinesiotherapy courses are conducted on a stationary bike in a pool of nitrogen-siliceous radon-containing water with a radon concentration of 0.19 kBq / l, t 36 ° C, with an exercise pace of 30-40 in 1 minute, for 15 minutes. Myostimulation of the paraarticular muscles by sinusoidal modulated currents (SMT) is performed daily from the Amplipuls-5 apparatus, type II, with a modulation frequency of 50 Hz, a modulation depth of 75-100%, with a current strength of up to the sensation of slight vibration, 10 procedures per course. The dynamics of changes in the homeostasis of the synovial environment of the joint is assessed by the severity of intraarticular friction using an arthro phonograph.

The known method allows to improve regional blood circulation in the damaged limb, which in turn leads to a decrease in the activity of the synovial inflammatory process, has a positive effect on the course of trophic and regenerative processes in the tissues of the damaged joint.

However, the known method does not contribute to improving homeostasis of the synovial environment of the joint in the form of reducing intraarticular friction. The method is time consuming using various

physiotherapeutic and exercise therapy techniques, difficult to perform for the patient. The method is time-consuming both when performing both physiotherapeutic procedures and the entire course of therapeutic effects. The need for regulated (SES) provision of rhodium-containing compounds, the lack of the possibility of rapid oxygen supply to activate aerobic-metabolic regenerative processes prevents widespread use in clinical practice.

From literature it is known that the currently widely used methods of cutaneous electrotherapy are ineffective, since the skin prevents the penetration of electric current into the body and reduces it by 100-500 times (S.S. Johnson, 1972; A.S. Presman, 1958) . The weakened current entering the body almost does not reach the bone.

The task of the invention is to provide an effective method for the treatment of patients with degenerative diseases of the spine and joints, devoid of the disadvantages of the prototype.

The technical result of the invention is to increase the effectiveness of treatment by creating conditions for stimulating the somatic part of the nervous system, which ensures regulation of voluntary movements and tissue sensitivity, enhancing the physiological motor activity of myofibrils in the field of electrical exposure, enhancing the activity of smooth muscle cntles of the middle tunic of the vessels and myogenic tone in the zone impact, reducing treatment time and cost.

The technical result is achieved by the fact that in the known method of treating pain with dystrophic diseases of the spine and joints, including conducting a course of electrical pulse stimulation procedures by applying electrodes to the projection of the paraarticular muscular-nervous segments of the joints, ozone-containing cream is applied to the conductive ozone-resistant surface of the electrodes of the low-frequency electropulse massager gel with a peroxide number of reactive oxygen species up to 750 megO2 / kg, four pairs of electrodes in pairs position in the area of the affected joint and simultaneously in the paraarticular zones of the cervico-thoracic, thoracic and lumbosacral spine, through exposure

low-frequency electric pulse stimulation percutaneously inject reactive oxygen species from the ozone containing cream gel into the paraarticular muscle and nerve segments of the spine and joints, exposure parameters: the shape of the pulses, their frequency, intensity and duration are selected individually for each patient in the first or second sessions, while first, the parameters are increased to the threshold of pain sensitivity, then the parameters are reduced by 2-5%, the electropulse effect is carried out in a changing mode of electrical stimulation with amplitude Doi pulses 15-80 mA at a frequency of 15-120 Hz with duration of 250 - 400 microseconds in an amount of 10-12 daily treatments.

In physiotherapy, electrophoresis is known and widely used in the prior art - a method of introducing drugs into tissues using a constant or pulsed electric current. The method has an advantage over the traditional use of medicinal substances, since the drug in this case directly gets to the right place without affecting the whole organism, for example, the method of treating neurological and orthopedic and traumatic pathologies (No. 2141359 (IPC A61N 1/30, A61K 35/78, published on November 20, 1999)

By electrophoresis, a medicament derived from Carica papaya melon tree latex is administered. Before drug administration, 50-100 mg of a powdered preparation with 350 PE activity is dissolved in 5-10 ml of physiological saline, 0.02-0.06 ml of dimethyl sulfoxide is added, the resulting solution is wetted with white filter paper, on top of which an electrically conductive pad with a temperature of 37 -39 ° C, and the positive electrode is also placed on the pathology area. The electrophoresis procedure is carried out for 15-20 minutes, with a current strength of 10-15 mA, while at least 3 courses of 20-30 procedures are carried out with an interval of 30-45 days. As a drug from the positive pole, caripazim or papain is used. In addition, aminophylline or potassium iodide can be added from the negative electrode. In this case, based on the disease, use various options for the location of the pads.

However, the known method is designed directly for the penetration of drugs into the zone of interest and does not allow to stimulate the neuromuscular system. Medicines, during electrophoresis, do not penetrate beyond the dermis (G.K. Butskevich, 1981; V.S. Ulashchik, 1981), which means they do not affect bone tissue.

Currently, ozone therapy is widely used. In orthopedic and traumatological practice, ozone therapy is used to treat such traumatic diseases as:

- osteochondrosis (degenerative-dystrophic lesion) of the spine. Moreover, in the treatment of DDPP (osteochondrosis), intravenous and paravertebral administration of the ozone-oxygen mixture is alternated.

- diseases of the joints (arthrosis, arthritis) With arthritis in the joint, inflammation occurs, with arthrosis - characteristic dystrophic changes with its subsequent immobilization. Treatment is carried out by introducing an ozone-oxygen mixture into the joint. The amount of mixture depends on the size of the joints (1-20 ml).

- intervertebral protrusion and hernia. Ozone therapy in this case is an alternative to the surgical method of treating this serious condition. It can be used at different stages of the development of the process, if this is not a terminal phase with mandatory surgical intervention.

Ozone therapy mainly relieves the inflammatory process, and also helps to reduce hernial protrusion. In addition, this method allows you to deal with the most common complication of intervertebral hernia - radicular syndrome, which is manifested by often shooting back pain.

The positive effect of the use of the ozone-oxygen mixture in the treatment allows to improve microcirculation in the affected area, stimulate collagen synthesis, relieve the inflammatory process, has an analgesic effect, restores protein synthesis, optimizes lipid peroxidation (LPO) in the vertebral-motor segment (PDS). Ozone therapy, acting on pathogenetic links, in diseases of the joints eliminates symptoms such as stiffness, pain, stiffness, swelling, crunching, muscle spasms and some other symptoms caused by immobilization. Due to its unique ability to prevent further destruction of articular cartilage., The ozone-oxygen mixture is also used to treat diseases of the joint structures. Therapy is based on increasing metabolism, eliminating inflammation, enhancing microcirculation and regeneration.

The following methods of introducing ozone into the body are used: intravenous administration of ozonized solutions, perinvertebrates, periarticular and intraarticular blockages, flowing aeration in closed plastic chambers, body applications with ozonized materials (oil, ointments), oral administration of ozonized cocktails, intramuscular or intravenous administration of ozonized blood .

Information on the transdermal administration of reactive oxygen species - ozonides from an ozone-containing cream gel with a high ozonide content and a peroxide number of at least 750 meg O2 / kg during electrical stimulation with a low-frequency electric pulse field, the inventors did not find in the sources of scientific, medical and patent documentation.

Thus, the invention meets the criteria of the invention of "novelty" and "inventive step".

The technical result of the proposed method is to increase the effectiveness of the treatment of degenerative diseases of the spine and joints, in particular dorsalgia and arthralgia by creating conditions for:

- stimulation of the somatic part of the nervous system (branches of motor and sensory neurons), providing regulation of voluntary movements and tissue sensitivity,

- enhancing the physiological motor activity of myofibrils in the field of electrical exposure and thereby the simultaneous stimulation of the blood pumping "pump" of arterial vessels,

- enhancing the activity of smooth muscle cells of the middle membrane of blood vessels and myogenic tone in the impact zone.

Conducting low-frequency electrical impulse stimulation of the paraarticular muscles of the spine along its entire length and the problem area of the joint with simultaneous transdermal electrophoretic exposure to active oxygen species - ozonides contained in the cream-gel along with irritation of bone osteoreception provides reflex modulation of peripheral blood circulation in the bone marrow tissue and at the same time creates blood circulation in the musculoskeletal segment of the paraarticular zone.

The initiating moment of readaptation processes in the affected joint, in addition to increased blood circulation, is intensification in the intraarticular space, cartilage and bone tissue of the joint, redox metabolic reactions due to electrophoretic delivery to these zones via the articular pathway and with the arterial blood flow of active oxygen-ozonide forms from the cream in the process of performing electropulse stimulation.

To confirm the achieved technical result, the authors conducted experimental and clinical studies. During the research, the following tasks were solved:

- evaluate the biological activity (pro- and antioxidant potential) of ozone-containing creams with different percentages of reactive oxygen species (ROS);

- to study the systemic and local responses in rats during procedures with EMC and EMC procedures plus cream gel with ROS (ozonides);

- to evaluate the effectiveness of the application of the EMC + cream - gel SAFC procedures in patients with clinical manifestations of radiculopathy with pain.

Stage 1, in-vitro - studied physical = chemical parameters and biological activity of ozone-containing cream-gels with various% ROS content

Stage 2, in vivo - on 38 rats, the local and systemic effects of EMC + cream-gel with a different percentage of ROS were studied (3%, 10%. 30%)

Stage 3, in vivo - clinical trials. Patients, a total of 43 people, divided into 2 groups. The main group treatment with EMC + cream-gel with ROS and control treatment of EMC

Stage 1. The influence of low-frequency electro-pulse effects on the physicochemical parameters and biological activity of a cream gel containing reactive oxygen species. 90 bench experiments with the influence of an electric field created in the interelectrode space by a low-frequency pulsed current on cream samples containing various amounts of active oxygen (ozonides) were performed. The electrical characteristics of the current corresponded to the standard modes used in the physiotherapeutic practice of EMC / TENS therapy. The absence of negative influence of pulsed electrical influences on the chemical structures of cream substrates has been established. At the same time, changes in the metabolic parameters of the cream are shown, indicating an increase in its biological activity. The research results are reflected in the article Peretyagin, A.S. Gordetsov, A.G. Solovieva, O.A. Grechkaneva, S.A. Zhiltsov, S.A. Sokolov, P.V. Peretyagin, N.V. Didenko “The influence of low-frequency electro-pulse effects on the physicochemical parameters and biological activity of a cream containing reactive oxygen species.” Volga Federal Medical Research Center, Nizhny Novgorod, Russia Association of Russian Ozone Therapists, Nizhny Novgorod, Russia 2017, Bioradicals and Antioxidants 2017 Volume 4, No 4 from 57-65

At the second stage, the local and systemic reactions of experimental animals were studied during EMC / TENS therapy. The use of a cream with a high content of reactive oxygen species (30%, PV-750 meg O2 / kg), during EMC / TENS therapy, was accompanied by the initial level of microcirculation, both immediately after the end of the procedure, and 60 minutes after its end.

Moreover, the use of creams with 30% content of reactive oxygen species also enhanced the role of increasing endothelial activity and the neurogenic regulation factor, compared with other series of experiments, which is crucial in maintaining pial circulation and providing nutrition for the functional element of organs (Table 2).

The resulting value of vascular tone, which supported the maximum volumetric microcirculation was noted against the background of the combined use of electromyostimulation and the foretic administration of a cream with 30% ozonide content. This testified to a greater balance of regulatory microcirculation systems, which, against the background of electromyostimulating effects, was provided by a multifactorial systemic action of reactive oxygen species, modulating the metabolic effect on blood supply and tissue metabolism.

(P.V. Peretyagin, O.A. Grechkaneva, S.P. Peretyagin “Features of microcirculation with the combined use of low-intensity electropulse stimulation and electrophoretic administration of reactive oxygen species from cream with ozonides in the experiment,” J. Bioradicals and Antioxidants 2017 vol. 4, No. 4 from 51-57 Nizhny Novgorod, Russia)

Stage 3 Clinical trials were conducted on 43 patients with a diagnosis of dorsopathy of the lumbar spine and arthropathy of the knee joints aged 62 to 73 years. The protocol for the treatment of patients in the control group (20) included painkillers, vascular, antioxidant, and vitamin therapy. From physiotherapeutic agents, the procedures EMC-TENZ were used to stimulate the paraarticular zones of the spine in the thoracic and lumbar region and the paraarticular zones of the knee joints. In the experimental group of patients (23), physiotherapeutic procedures for electric pulse low-frequency stimulation of the paraarticular zones were accompanied by the combined electrophoretic administration of reactive oxygen species (ozonides) contained in a cream with 30% ozonized olive oil (750 meg O2 / kg) performed on a low-frequency electro-pulse massager MH8002 Combo, OZOTENZ * therapy called by us.

The examination protocol included an assessment of the sensory component of pain, vertebral neurological symptoms, CT (MRI) of the lumbar spine and knee joints; study of microcirculation (laser fluorometry), central and peripheral hemodynamics (tetrapolar rheography), respiratory function (spirometry) and a number of metabolic indicators (POL and AOA, SOD, MDA, glucose, lactate, LDH, ORP, pH) in the blood by standard biochemical methods .

As a result of the treatment, a significant improvement was observed in 88.6% (19) of the patients of the main group. It usually occurred during the second or third procedure of OZOTENZ * therapy and was accompanied by a significant reduction in pain and their disappearance at the end of the course of treatment in the lower back with physical exertion, complete restoration of range of motion in the lumbosacral spine. The improvement, characterized by the restoration of active movements and minor back pain during physical exertion, was diagnosed in 11.1% of patients and occurred, as a rule, after five to six procedures. Deterioration in patients of the main group and complications were not observed. In the control group, a significant improvement was noted in 75.0% of patients and improvement in 25.0% of patients. In the main group of patients with the inclusion in the conservative treatment of OZOTENZthera, a more significant increase in the volumetric microcirculation in the peripheral bed in all areas of the study was 1.6–3.3 times (P <0.05). A significant increase in myocardial productivity and efficiency, the total activity level of cardiac rhythm oscillations with a predominance of parasympathetic link modulations in its regulatory mechanisms was noted, which, combined with an increase and optimization of the work of the external respiration apparatus: DO - 172%, BH - 88%, MOD - 116% the aggregate explained the mechanisms of the systemic effects of EMC stimulation and the electrophoretic effect of cream ozonides on oxygen-dependent metabolic processes. In the study of biochemical parameters, confirmation of such a positive effect was the intensification of free-radical oxidation reactions with stimulation of antioxidant reserves, activation of energy generation processes.

Thus, the clinical application of the well-known physiotherapeutic method of EMC / TENS therapy allows, by means of low-frequency electro-pulse effects, to cause myostimulation, relaxation, electrolipolysis and lymphatic drainage in the area of neuromuscular blocks of tissues of the musculoskeletal apparatus of the joints of the spine and limbs, as well as to carry out additional biostimulating effect on the same zone and the whole organism with active forms of oxygen (ozonides) from ozone cream. The transcutaneous delivery of ROS from the cream occurs from the interelectrode space to the tissue level during OZOTENZ therapy procedures due to the mechanisms of electrophoretic contamination of the drug into the pathological focus.

Before carrying out the method, there is a stage of preparation for the method and the necessary actions and explanations.

The method is carried out on a device of an electric pulse low-frequency electric massager MN8002 Combo, having 4 pairs of ozone-resistant electrodes. The procedure is carried out in a prone position or sitting in a comfortable position. During analgesic therapy, the electrodes of one channel are set so that the pain point is located between the electrodes, or one electrode is placed directly on the pain point, and the second at a distance of at least 5-10 cm from the first. Electrodes should not touch each other. The electrodes of other channels are used for the simultaneous treatment of other pain points or, together with the electrodes of the first channel, are used to block the pain zone (on the opposite side). For pain in the spine, a paravertebral one- and two-sided arrangement of electrodes on both sides of the pain area is possible.

A distinctive feature of the pain therapy procedures for injuries of the joints of the extremities according to the proposed method is an electrode application system for simultaneous electro-pulse exposure with electrophoretic interstitial delivery of ozone-containing substrates, which includes the placement of paired electrodes on problem areas of the upper or lower extremities, as well as the application of similar electrodes on paraarticular zones (cervical -collar and thoracic - for the treatment of joints of the upper limbs and and lumbosacral spine - with the defeat of the joints of the lower limbs) of the spine.

Depending on the anatomophysiological conditions and the nature of the disease, electrodes of various shapes and sizes are used. An increase in the size (area) of the electrodes increases the amount of drug being forwarded and comfort during the procedure.

- Two electrodes are connected to each channel of the device - the anode (+, red) and the cathode (-, black).

To relieve pain, it is preferable to place a cathode on the focus.

- In the course of treatment, to prevent the effect of "addiction" -adaptation of the reflexogenic zones of the muscle-nerve segments of the paraarticular zone to an electrical stimulus, in each subsequent procedure, the anode and cathode are interchanged. Sequencing:

- prepare the device, connecting wires, elastic belts, electrodes, ozone cream. Prior to the first procedure, it is advisable to select the necessary electrodes and elastic belts;

- 5-10 minutes before the procedure, the skin in the places of installation of the electrodes should be moistened, if possible, make the compress moist with a hot towel. Cover abrasions, scratches and other damages with a piece of plastic film or seal with a plaster;

- connect the pins of the connecting wires to the electrodes;

- place the electrodes on a horizontal plane (on the table) with the working surfaces up;

- apply ozone to the electrodes - containing a cream gel with ROS, evenly distributing it over the surface. Apply the cream at the rate of approximately 0.5, 1.0, 1.4 ml to the electrodes 50 × 50, 100 × 50, 100 × 70 mm, respectively;

- install and fix the electrodes,

- connect the plugs of the connecting wires to the device;

- turn on the device, set the parameters, carry out the procedure;

- at the end of the procedure, disconnect the plugs from the device, remove the electrodes, carry belts and electrodes for washing. When washing and drying the electrodes, the wires can not be turned off. Electrical parameters of the procedure

Muscle and nerve cells in normal and pathological conditions have different excitability, therefore, the characteristics of the current pulses necessary to achieve the action potential in these cells can vary significantly.

- Characteristics of current pulses responsible for the selective effect on cells of various excitability and lability (functional mobility): Pulse shape

Short asymmetric rectangular biphasic pulses are used. Such impulses do not cause skin irritation and reduce muscle fatigue.

To increase the depth of current penetration and increase the permeability of the skin during electrophoresis of ozone-containing cream, pulses with steep leading edges of short duration (1-2 seconds) are used.

Pulse frequency

- The frequency determines which types of muscle fibers react.

Slowly reacting muscle fibers are excited at frequencies up to 15-25 Hz, fast-reacting fibers - at frequencies above 35 Hz.

- The analgesic effect begins to appear at a frequency of 10 Hz, increasing further and reaching its maximum at 60-70 Hz.

- When pulses with a frequency of 50-90 Hz, a prolonged muscle tension occurs in combination with fast muscle fatigue, so these frequencies can be used to train speed endurance and maximum strength.

Pulse duration

In the apparatus MH-8002 Combo, the pulse duration varies from 50 to 400 microseconds. The pulse duration determines the depth of current penetration. Typically, greater muscle mass requires longer pulse durations.

An increase in the duration of the pulses leads to the excitation of slowly reacting cells - damaged skeletal muscles, nerve vegetative fibers, smooth muscles. Impulse intensity

The intensity level depends on the individual subjective sensations of each patient and is determined by different circumstances - the area of application, blood circulation in the skin, skin thickness, quality of contact with the electrodes. In practice, the intensity should be sufficient to provide a therapeutic effect, but not cause pain.

The proposed method is carried out as follows. On the conductive ozone-resistant surface of the electrodes of the low-frequency electropulse massager MH 8002 Combo, an ozone-containing cream with a peroxide number of reactive oxygen species - ozonides of at least 750 meg O2 / kg is applied. Four pairs of electrodes are arranged in pairs in the area of the affected joint and simultaneously in the paraarticular zones of the cervicothoracic, thoracic and lumbosacral spine. Carry out the selection of exposure parameters. The shape of the pulses, their frequency, intensity and duration is selected individually for each patient in the first or second sessions. First, the parameters are increased to the threshold of pain sensitivity, then the parameters are reduced by 2-5%. The effectiveness of the selected parameters is evaluated upon reaching the maximum - 80-90% contamination of the ozone-containing cream applied to the electrodes. When exposed to low-frequency electro-pulse stimulation, percutaneous administration of reactive oxygen species from an ozone-containing cream to the paraarticular muscle and nerve segments of the spine and joints occurs. Electropulse exposure is carried out in a changing mode of electrical stimulation with an amplitude of pulses of 15-80 mA, with a frequency of 15-120 Hz, a duration of 250-400 μs in the amount of 10-12 procedures, daily.

Clinical example:

Patient From 58 years old, she was admitted to the clinic of the rehabilitation department with a diagnosis of dorsopathy of the lumbar spine, a hernia in the LII-LIII region with complaints of pain in the right paravertebral lumbar region (lumbalgia), irradiation of pain in the right thigh region of the right (lumbar ischialgia), aggravated by movement . The intensity of the pain level on the YOUR scale in the initial state was 6.1 points. At the initial examination, there was a decrease in radicular sensitivity and the presence of an analgesic posture, a decrease in the range of motion in the right hip joint, a decrease in the right knee reflex, muscle-tonic syndrome, and a symptom of Lassieg tension. On the R-gram signs of degenerative-dystrophic lesions of the lumbar spine, a hernia in the region LII - LIII.

The patient underwent a course of treatment, including electrical stimulation procedures using a low-frequency electro-pulse massager, model МН8002 Combo combined with the electrophoretic effect of ozone cream OZOTENZ, with an active oxygen content (ozonides) of at least 750 meg O2 / kg.

During the first and second procedures, we individually selected the parameters of electrical stimulation. The individual parameters of the procedure, in which the maximum percutaneous cream contamination was observed, 80% of the initial volume during the procedure, were:

- procedure time - 30 + 5 min;

- pulse parameters: ON = 6-8 sec, OFF = 2 sec, RAMP = 1 sec, Width = 350-400 microsecons .;

- in order to avoid "getting used to", every 5 min during the device switched to a new operating mode (in 30 minutes 6 steps - transitions were performed) - see table 4:

* - mode A was not used in this type of procedure ** - procedure intensity - see below. (Intensity of procedure:

On the MH 8002 Combo instrument, the procedure intensity is set in the range from 0 to 100 tA. In this patient, the lower threshold of sensitivity for a given current was 35 mA, at a frequency of 50 Hz. Performing the first procedure with such a current intensity was accompanied by 45-50% absorption of the drug. During the second procedure, the electrical parameters were adjusted: the current intensity was increased to 55mA., And then at the beginning of the procedure it was reduced to 50 mA, the pulse frequency was brought up to 65 Hz . Carrying out the procedures with the parameters indicated in table 4 was accompanied by the maximum absorption of the ozone cream.

A feature of conducting OZOTENZ therapy procedures in this patient was the location of conductive electrodes; 1st para-paravertebral in the lumbar region, 2nd para-articular in the projection of the greater trochanter of the right hip joint, 3rd pair - along the posterior surface of the right thigh in the projection of the biceps, semi-tendon and semi-membranous muscles, 4th pair - on the front surface of the right femur in the paraarticular zone of the knee joint. The course was performed 10 procedures. The result of the treatment course was a decrease in the intensity of pain after the second procedure by 20-25%, after the third procedure by 35%, at the end of the course the patient noted pain regression to 0.5 on the YOUR scale

To achieve significant results in the treatment of systemic diseases and injuries of the musculoskeletal system, repeated long-term course treatment with repeated courses is necessary.

Claims (1)

A method of treating pain in dystrophic diseases of the spine and joints, including conducting a course of electropulse stimulation procedures by applying electrodes to the projection of paraarticular muscle and nerve segments of the joints, characterized in that an ozone-containing cream gel with peroxide is applied to the conductive ozone-resistant surface of the electrodes of the low-frequency electropulse massager the number of reactive oxygen species up to 750 megO ₂ / kg, four pairs of electrodes are placed in pairs in the area of the affected joint Ava and at the same time in the paraarticular zones of the cervico-thoracic, thoracic and lumbosacral spine, through the influence of low-frequency electro-pulse stimulation, active forms of oxygen are introduced percutaneously from the ozone containing cream gel into the paraarticular muscle and nerve segments of the spine and joints, exposure parameters: pulse shape, their frequency, intensity and duration - they are chosen individually for each patient in the first or second sessions, while first they increase the parameters to the threshold of pain Actually, then the parameters are reduced by 2-5%, the electropulse effect is carried out in a changing mode of electrical stimulation with an amplitude of pulses of 15-80 mA, with their frequency of 15-120 Hz, duration 250-400 μs in the amount of 10-12 procedures daily.