Cervical Traction – StatPearls – NCBI Bookshelf

Continuing Education Activity

Cervical traction is a non-invasive procedure used to provide symptomatic relief for a variety of cervical pathologies. Though it can lead to temporary symptomatic relief, there is limited data on its long-term safety and therapeutic efficacy. This activity reviews the indications, contraindications, and techniques involved in performing cervical traction and highlights the role of the interprofessional team in caring for patients who utilize cervical traction.

Objectives:

• Describe the conditions that cervical traction is used for.

• Outline the contraindications to cervical traction.

• Explain how to monitor a patient undergoing cervical traction.

• Explain the importance of a well-coordinated interprofessional team in the care of patients that are considering cervical traction.

Access free multiple choice questions on this topic.

Introduction

The practice of spinal traction goes back to the fourth century BC, where Hippocrates first described it as a treatment for kyphosis. It was subsequently implemented in other spinal pathologies including cervical pain and myelopathy. In the 1600s, the Germans employed cervical traction in their medical practice, as an adjunct to open reduction of cervical dislocations, and fractures. In 1929, the Halter device was introduced for the reduction of cervical injuries; then several other devices followed to ensure more efficient traction. To date, there is no accurate description of the mechanism of relief provided by cervical traction. The theory behind its efficiency emphasizes the widening of the intervertebral foramen upon traction, with separation of the facet joint. This will relieve the sustained pressure on the nerve roots, and hence alleviate symptoms of radiculopathy. Other theories suggest that traction allows for cervical muscle relaxation, and is not involved in intervertebral separation. [1][2]

Indications

Cervical traction has been used in a variety of cervical pathologies:

• Cervical disc disease

• Cervical spine fracture

• Facet joint dislocation

• Atlantoaxial subluxation

• Occipitocervical synopsis

• Spondylosis

• Radiculopathy

• Foraminal Stenosis

• Myofascial tightness

Overall, most published studies on cervical traction for spondylosis and myelopathy are of low quality and include a small number of participants. Among the few studies with adequate statistical power, there is no evidence on the long-term benefits of cervical traction, although many articles suggest a definitive temporary relief. Likewise, intermittent traction was not able to achieve a more favorable outcome than its sustained counterpart, despite its theory of increasing blood flow to the spine parenchyma and nerve roots. However, the practice of cervical traction in fractures and facet joint dislocations is important when used along with closed reduction and fixation. In cases of facet joint dislocation, failure of traction suggests the need for surgical intervention. [3][4][5][6]

[7]Moreover, the use of cervical traction for atlantoaxial subluxation is well established in the pediatric population as a second-line treatment. Failure to improve after a trial of soft collar and pain management for two weeks necessitates cervical traction. In cases of no improvement after the third week, surgical management is required. Cervical traction is also a standard of practice in occipitocervical synopsis where symptoms are limited to pain, along with a trial of a cervical collar. If neurological deficits are suspected, surgical evaluation is warranted.

Contraindications

There are no scientific reports that accurately describe the contraindications and relative contraindications for cervical traction. Probable contraindications and/or relative contraindications to cervical or lumbar traction include the following:

• Acute torticollis

• Aortic Aneurysm

• Active peptic ulcer disease

• Diskitis

• Old age

• Osteomyelitis

• Osteoporosis

• Ligamentous instability

• Primary or metastatic tumor

• Spinal cord tumor

• Myelopathy

• Pregnancy

• Severe anxiety

• Untreated hypertension

• Vertebral-basilar artery insufficiency

• Midline herniated nucleus pulposus

• Restrictive lung disease

• Hernia

Preparation

The patient’s vital signs should be monitored before and immediately following the application of cervical traction in all high-risk patients, especially in those with high blood pressure or cardiac problems. It is important to obtain a detailed history and perform a systematic physical exam, before cervical traction, to rule out any contraindications.

Technique or Treatment

There are different ways to apply cervical traction to the cervical neck. [8][9][10][11][9]

Manual Cervical Traction

Manual traction is mainly for diagnostic purposes, with the ability to confirm a suspected diagnosis after successful relief of symptoms.

• The head and neck are held in the hands of the practitioner, and then gentle traction of a pulling force is applied.

• Intermittent periods of traction can be applied, holding each position for about 10 seconds.

It also allows the performer to apply controlled pressure on pressure points, which helps alleviate the patient’s pain. Ideally, it is done at a 20-degree angle of flexion, but the examiner must explore all angles, including the extension of the neck and chin rotation, with a thorough assessment of each position.

Mechanical Cervical Traction

Mechanical traction includes pinning, with the placement of a Halo device around the head; where anterior pins are placed 1 cm above each of the eyebrows, and two posterior pins are placed on the opposite end of the skull. The addition of pins can be essential if further stabilization is required.

• A harness attaches to the head and neck of the patient while he is laying down on his/her back.

• The harness is itself attached to a machine that applies a traction force, which can be regulated through a control panel.

Other shorter-term traction devices comprise the Gardner-Wells tongs, which constitute two pins, pointing upward (towards the vertex of the head), to be placed below the temporal ridge, bilaterally. In both cases, careful pinning is to be applied with a torque pressure of 2 lb (0.9 kg) to 4 lb (1.8 kg) in the pediatric population, and up to 8 lb (3.6 kg) in adults.

Mechanical traction requires a 0-degree angle pull for C1 and C2 pathologies, and a 20-degree angle flexion for below C2 cases. Moreover, the force applied during pull tension must not exceed 10 lb (4.5 kg) in cases of C1-C2 subluxation, but can otherwise increase up to 45 lb (20.4 kg). Some practices require a gradual increase of the pull tension, while others prefer choosing the lowest weight inciting an effective response.

Over-the-Door Traction

This is a more practical way of applying cervical traction, that is more accessible to outpatient practices.

• Over-the-door traction entails strapping a harness to the head and neck of the patient that is in a seated position.

• The harness is connected to a rope in a pulley system over a door. The force is applied using weights (a sandbar or a waterbag) attached to the other end of the rope.

Furthermore, intermittent traction is another modality where a repeated sequence of rest and traction is applied. It is believed to increase blood flow to the nerve roots and spine parenchyma. One must understand that during the rest phase, tension is not entirely released. As a general rule, intermittent traction is the method of choice for degenerative disc disease and/or joint hypomobility. On the other hand, sustained traction is most often used for neck pain of muscle or soft tissue etiology, and/or disc herniations. Cervical traction can be applied while the patient is supine or seated. The supine position is preferred, allowing for more posterior pressure loading. This will ensure cervical muscle relaxation and transmit less pressure on the temporomandibular joint (TMJ). The sitting position is favored only for patients who cannot lay supine for a prolonged period of time, as in cases of patients suffering from reflux esophagitis.

Complications

Complications are rare, providing that patients are adequately screened for conditions that are contraindicated. Postprocedural increase in peripheral nerve pain and a decrease in central pain, increase in neurological symptoms, or sudden disappearance of central pain are alarming signs of traction-induced spinal cord compromise.

Clinical Significance

Cervical traction is a simple procedure, performed by physical therapists and physicians.  It constitutes several modalities of practice depending on the pathology being treated. The established efficiency of this technique in cervical fractures, facet joint dislocations, and other orthopedic diseases makes it a useful tool for medical practitioners. However, its role in chronic cervical spondylosis is uncertain. For this purpose, the design of randomized controlled trials on adequate population samples, comparing cervical traction to sham traction, would provide the scientific community with information of great importance about the use of cervical traction in spinal cord spondylosis.

Enhancing Healthcare Team Outcomes

The application and education of the patient in regards to cervical traction may be done by EMS, physical therapists, physicians, and orthopedic nurses. While the procedure is simple, it is important that the patient be monitored by the nurse and physical therapist for complications and improvement. The nurse and therapist should coordinate reporting with the treating clinician.

Complications are rare, providing that patients are adequately screened for conditions that are contraindicated. Postprocedural increase in peripheral nerve pain and a decrease in central pain, increase in neurological symptoms, or sudden disappearance of central pain are alarming signs of traction-induced spinal cord compromise.[11] An interprofessional team approach to evaluation and education of patients requiring cervical traction will provide the best outcomes. [Level 5]

Review Questions

• Access free multiple choice questions on this topic.

• Comment on this article.

References

1.

Dadabo J, Jayabalan P. Acute management of cervical spine trauma. Handb Clin Neurol. 2018;158:353-362. [PubMed: 30482363]

2.

Eghbal K, Rakhsha A, Saffarrian A, Rahmanian A, Abdollahpour HR, Ghaffarpasand F. Surgical Management of Adult Traumatic Atlantoaxial Rotatory Subluxation with Unilateral Locked Facet; Case Report and Literature Review. Bull Emerg Trauma. 2018 Oct;6(4):367-371. [PMC free article: PMC6215068] [PubMed: 30402528]

3.

Crawford AH, Gr HC, Schumaier AP, Mangano FT. Corrigendum to Management of Cervical Instability as a Complication of Neurofibromatosis Type 1 in Children: A Historical Perspective With a 40-Year Experience [Spine Deformity 6 (2018) 719-729]. Spine Deform. 2019 Mar;7(2):376. [PubMed: 30660236]

4.

Guan J, Chen Z, Wu H, Yao Q, Zhang C, Qi T, Wang K, Duan W, Gao J, Li Y, Jian F. Is anterior release and cervical traction necessary for the treatment of irreducible atlantoaxial dislocation? A systematic review and meta-analysis. Eur Spine J. 2018 Jun;27(6):1234-1248. [PubMed: 29663144]

5.

Shah K, Gadiya A, Nene A. Autostabilization of neglected high-grade fracture-dislocation in the cervical spine. J Craniovertebr Junction Spine. 2018 Oct-Dec;9(4):274-276. [PMC free article: PMC6364368] [PubMed: 30783353]

6.

Chou R, Côté P, Randhawa K, Torres P, Yu H, Nordin M, Hurwitz EL, Haldeman S, Cedraschi C. The Global Spine Care Initiative: applying evidence-based guidelines on the non-invasive management of back and neck pain to low- and middle-income communities. Eur Spine J. 2018 Sep;27(Suppl 6):851-860. [PubMed: 29460009]

7.

Crawford AH, Schumaier AP, Mangano FT. Management of Cervical Instability as a Complication of Neurofibromatosis Type 1 in Children: A Historical Perspective With a 40-Year Experience. Spine Deform. 2018 Nov-Dec;6(6):719-729. [PubMed: 30348350]

8.

Hunter A, McGreevy J, Linden J. Pathologic C-spine fracture with low risk mechanism and normal physical exam. Am J Emerg Med. 2017 Sep;35(9):1383.e1-1383.e2. [PubMed: 28554588]

9.

Kang MS, Hwang JH, Ahn JS. An evaluation of contrast dispersal pattern on preganglionic epidural injection through trans-lateral recess approach in patients with lumbosacral radiculopathy. Eur Spine J. 2019 Nov;28(11):2535-2542. [PubMed: 30911918]

10.

Ahn H, Singh J, Nathens A, MacDonald RD, Travers A, Tallon J, Fehlings MG, Yee A. Pre-hospital care management of a potential spinal cord injured patient: a systematic review of the literature and evidence-based guidelines. J Neurotrauma. 2011 Aug;28(8):1341-61. [PMC free article: PMC3143405] [PubMed: 20175667]

11.

Moustafa IM, Diab AA. Multimodal treatment program comparing 2 different traction approaches for patients with discogenic cervical radiculopathy: a randomized controlled trial. J Chiropr Med. 2014 Sep;13(3):157-67. [PMC free article: PMC4161715] [PubMed: 25225464]

Disclosure: Karl Abi-Aad declares no relevant financial relationships with ineligible companies.

Disclosure: Armen Derian declares no relevant financial relationships with ineligible companies.

What Are The Benefits of Cervical Traction? Plus Exercises to Try

What is cervical traction?

Traction of the spine, known as cervical traction, is a popular treatment for neck pain and related injuries. Essentially, cervical traction pulls your head away from your neck to create expansion and eliminate compression. It’s considered to be an alternative treatment for neck pain, helping people avoid the need for medication or surgeries. It can be used as part of a physical therapy treatment or on your own at home.

Cervical traction devices lightly stretch the neck to reduce pressure on the spine by pulling or separating the vertebrae. It’s said to be both highly effective and fast-acting. Read on to learn more about this technique and how it can be of benefit to you.

Cervical traction devices treat different types and causes of neck pain, tension, and tightness. Cervical traction helps to relax the muscles, which can significantly relieve pain and stiffness while increasing flexibility. It’s also used to treat and flatten bulging or herniated disks. It can alleviate pain from joints, sprains, and spasms. It’s also used to treat neck injuries, pinched nerves, and cervical spondylosis.

Cervical traction devices work by stretching the spinal vertebrae and muscles to relieve pressure and pain. Force or tension is used to stretch or pull the head away from the neck. Creating space between the vertebrae relieves compression and allows the muscles to relax. This lengthens or stretches the muscles and joints around the neck.

These improvements may lead to improved mobility, range of motion, and alignment. This will allow you to go about your daily activities with greater ease.

A 2017 meta-analysis of studies analyzed the effectiveness of cervical traction in relieving neck pain. This report found that the treatment significantly reduced neck pain immediately following treatment. Pain scores were also reduced in the follow-up period. More in-depth, high-quality studies are needed to learn more about the long-term effects of this treatment.

A 2014 study found that mechanical traction was effective in treating people with pinched nerves and neck pain. Mechanical traction was more effective than exercising alone or exercising in addition to using over-door traction.

There are several ways to do cervical traction, either with a physical therapist or on your own at home. Your physical therapist can help you to decide upon the best method to suit your needs.

Your physical therapist may recommend that you buy cervical traction equipment to use at home. Certain devices may require you to have a prescription. Cervical traction devices are available online and in medical supply stores. Your physical therapist should show you how to use the device properly before you use it on your own.

It’s important that you check in with your physical therapist even if you’re doing a home treatment. They’ll make sure you’re doing the best treatment, measure your progress, and adjust your therapy as necessary.

Manual cervical traction

Manual cervical traction is done by a physical therapist. While you’re lying down, they’ll gently pull your head away from your neck. They’ll hold this position for a period of time before releasing and repeating. Your physical therapist will make adjustments to your exact positioning in order to get the best results.

Mechanical cervical traction

Mechanical cervical traction is done by a physical therapist. A harness is attached to your head and neck as you’re lying flat on your back. The harness hooks up to a machine or system of weights that apply traction force to pull your head away from your neck and spine.

Over-the-door cervical traction

An over-the-door traction device is for home use. You attach your head and neck to a harness. This is connected to a rope that’s part of a weighted pulley system that goes over a door. This can be done while sitting, leaning back, or lying down.

Generally, it’s safe to perform cervical traction, but remember that results are different for everyone. The treatment should be totally pain-free.

It’s possible that you can experience side effects such as headache, dizziness, and nausea upon adjusting your body in this manner. This may even lead to fainting. Stop if you experience any of these side effects, and discuss them with your doctor or physical therapist.

It’s possible for you to injure your tissue, neck, or spine. You should avoid cervical traction if you have:

• rheumatoid arthritis
• postsurgery hardware such as screws in your neck
• a recent fracture or injury in the neck area
• a known tumor in the neck area
• a bone infection
• issues or blockages with vertebral or carotid arteries
• osteoporosis
• cervical instability
• spinal hypermobility

It’s important that you follow any safety instructions and recommendations provided by your doctor or by the manufacturer. Make sure you’re performing the movements correctly and using the appropriate amount of weight. Don’t overexert yourself by doing cervical traction for too long. Discontinue use if you experience any pain or irritation or if your symptoms get worse.

There are several exercises that can be done using cervical traction devices. Make sure to listen to your body and go to your own edge or threshold in terms of stretching and the duration of your exercises.

To use an air neck traction device, place it around your neck and adjust the straps as necessary. Then, pump it up and wear it for about 20–30 minutes. Do this a few times throughout the day. You can wear the device while doing activities where you tend to slouch.

To use an over-the-door neck traction device, you’ll usually you’ll start with about 10–20 pounds of pulling force, which can be increased as you gain strength. Your physical therapist can recommend the right amount of weight for you to use. Pull and hold the weight for 10–20 seconds and then slowly release. Continue this for 15–30 minutes at a time. You can do this a few times throughout the day.

A Posture Pump is used while you’re lying down. Do a warm-up before using this device. Slowly turn the head side-to-side, then forward and backward, and then lean the neck from side-to-side. Do each exercise 10 times. Then, attach the portable device to your head and increase the pressure so it tightens around your forehead. Once it’s pumped, wait 10 seconds before releasing the air. Do this 15 times. Then inflate the unit and relax in a comfortable position for up to 15 minutes. Make sure you’re not pumping it too much, especially in the beginning. Once you release yourself from the pump, keep your head in line with your spine as you come into a standing position. Repeat the warm-up routine.

You may also wish to incorporate stretching into your daily routine. You can use accessories such as exercise balls or resistance bands. Yoga is another great tool to relieve neck pain, and there are plenty of cervical traction exercises your physical therapist may be able to recommend that don’t require any equipment aside from a bed or table.

Cervical traction may be a safe, wonderfully effective way for you to resolve neck pain. It may provide you with numerous improvements to your body, inspiring you to do it often. Ideally it will be effective in relieving neck pain and enhancing your overall function.

Always talk to your doctor or physical therapist before beginning any treatment. Touch base with them throughout your therapy to discuss your improvements as well as any side effects. They can also help you to set up a treatment plan that addresses exactly what you need to correct.

Neck pain – causes and treatment

Causes of neck pain

The first type of causes of neck pain is associated with disorders in the normal functioning of the spine and related systems. These primarily include osteochondrosis. This disease is characterized by deformation of the intervertebral discs and their thinning. There is an opinion that osteochondrosis is a disease of people of age. In fact, even people under the age of 25 turn to doctors with this problem. It is worth noting that this disease is constantly getting younger. One of the factors that cause the likelihood of its occurrence is a sedentary lifestyle. Stress and constant nervous tension also lead to the occurrence of osteochondrosis. But, of course, the main cause of this disease lies in heredity.

The next most common cause of neck pain is myofascial pain syndrome. The main symptom of this condition is the compaction of the muscles of the cervical region and their involuntary contractions. The syndrome is characterized by periodic muscle tension and, consequently, spasms. At the initial stage, there are short-term painful sensations in the neck area during movement or turning of the head. In the later stages, the pains become arbitrary, appearing for no apparent reason.

The cause of pain in the neck may be dysfunction of the facet joints, which are designed to connect the vertebrae. Violations in their work cause a decrease in the mobility of the spine. The main symptom is the occurrence of acute pain in the neck with a sharp turn of the head. Inflammation and pain do not go away within a few days. Pain with dysfunction of the facet joints increases with a long stay in a standing position or with a long sitting in one position. Strengthening of symptoms also occurs during bending, when doing squats or arching the spine. The facet joint works non-stop. Wearing out, it transfers the load to the vertebrae and other joints, causing their degradation and destruction.

Pain in the neck may result from the development of hernias. During their formation, the spinal nerve is pinched, which causes acute pain in the neck. Often such pains “shoot” and give to the shoulders and arms, accompanied by prolonged headaches and weakness. Often there is numbness of the limbs. A hernia can cause neck myelopathy, which in turn is also characterized by pain. This disease occurs as a result of compression of the vessels of the spinal cord and practically does not occur in young people, it is typical for patients over 50 years of age.

Of course, pain in the neck can be caused by various injuries of the cervical spine. Most often, people who have suffered as a result of an accident, athletes and housewives turn to doctors with such injuries. Spinal injuries are accompanied by headaches, weakness, tinnitus.

Neck pain can be caused by infectious diseases. These may be tuberculosis, epidural abscess. Pain that occurs involuntarily even in a static state may indicate the occurrence of metastases in the spine. Infectious diseases, as a rule, proceed with a high temperature, accompanied by weakness and drowsiness.

A less common cause of neck pain is musculo-tonic syndrome. With the development of this pathology, the patient experiences intermittent spasms of muscle groups that last for some time. As a result of the pressure of these muscles on the vessels and nerves, pulling pain appears.

For neck pain, scalene muscle syndrome is most common. Its course is marked by a violation of the blood supply to the scalene muscles of the neck. With this syndrome, patients often experience pain in the morning, any head tilt is difficult for them. In cases where the syndrome progresses, the pain becomes longer, and the attacks begin to visit the patient even at night when air is inhaled. Such pain can radiate to the shoulders and back, pull the chest.

Diagnosis and treatment

The doctor’s primary goal in determining the causes of neck pain in a patient is to exclude serious pathologies. In this case, the most complete description by a person of all complaints, including even those that at first glance may not be related to problems with the neck, is of great importance. For subsequent effective treatment, the doctor conducts a thorough external examination of the patient in order to identify violations in the structure of the spine, individual structural changes in the muscles. In this case, additional consultation of narrow specialists is often required: a surgeon, a neurologist, an oncologist. To clarify the clinical symptoms and accurately establish the diagnosis, the doctor gives directions for a general and biochemical blood test, urinalysis. As a more specific analysis, in some cases, a blood test for C-reactive protein is prescribed. Hardware research methods include CT and MRI of the cervical spine. The doctor may also prescribe ENMG – a diagnosis of the conduction of nerve fibers.

The choice of treatment methods depends entirely on the cause identified as a result of the diagnosis. For example, drug treatment is used to relieve muscle spasm. For the same purpose, massage and compresses are prescribed. Manual and traction therapy are well suited for removing muscle blocks and decompressing nerve tissues. Treatment methods with the help of orthopedic instruments: cervical collars, special pillows can alleviate the symptoms. If such methods are insufficient, the doctor will prescribe special injections to pain points. Efficiency was also proven by physiotherapy and physiotherapy exercises. Surgical intervention is performed only when the causes of pain in the neck lie in physiological disorders.

Headache and neck pain causes and treatment ➤No Pain Clinic

Symptoms

As a rule, pain in the neck is dull in nature. Sometimes the pain gets worse when you move your neck. Neck pain may be accompanied by numbness, tingling, sometimes the pain may be acute, there may be a violation of swallowing, swollen lymph nodes, dizziness. May be associated with headache in the face, pain in the shoulder, numbness or tingling in the shoulder (paresthesia of the upper limb). These associated symptoms often result from root compression. For example, compression of a root with sensory fibers supplying the occipital region can lead to neck pain radiating to the occiput. Depending on the disease, in some cases, neck pain may be accompanied by pain in the upper back or in the lower back, for example, in Bechterew’s disease, when the inflammatory process covers the entire spine.

Diagnosis

During the examination, the doctor must assess the presence of painful points in the neck, the range of motion in the neck, the presence of muscle spasm, the condition of the muscles of the neck, shoulders, the presence of muscle weakness, tension of muscle groups in the upper body. In some cases, instrumental studies are needed, such as X-rays, computed tomography (CT), magnetic resonance imaging (MRI), or ENMG (diagnosis of nerve conduction). These research methods help to verify the diagnosis.

Treatment

In most cases, neck pain is treated conservatively. Medical treatment. NSAIDs (Voltaren, ibuprofen, naproxen) can be quite effective in relieving mild to moderate neck pain. In the presence of muscle spasm, muscle relaxants and sometimes even antidepressants may be recommended. But taking these drugs can be accompanied by drowsiness. The use of cold compresses can reduce pain and relieve muscle spasm.

Massage can be helpful in relieving muscle spasm and improving blood flow to the muscles.

Manual therapy allows you to remove muscle blocks, mobilize motor segments and eliminate subluxations of the facet joints. Traction therapy is also used to decompress the nerve roots.

Orthopedic products (cervical collar) are useful when there is severe pain (for example, whiplash or radiculopathy). Wearing a neck collar regularly is not recommended as it can lead to weakening of the neck muscles. In addition, with pain in the neck, a good effect is the use of orthopedic pillows, which provide the neck with a physiological position during sleep.

Acupuncture. Impact on biologically active points allows you to restore normal conduction through nerve fibers and reduce pain.

Local anesthetic trigger point injections of can be quite effective, especially when myofascial pain occurs.

Which preparations are used for injection?

The basis of any drug blockade is a local anesthetic that eliminates pain.
K
other groups of drugs can be added to it:

• non-steroidal anti-inflammatory drugs (NSAIDs) – reduce inflammation,
  relieve swelling, anesthetize;
• Glucocorticoids are anti-inflammatory hormones that also have
  decongestant and antiallergic action;
• slow-acting symptom-modifying drugs (SYSADOA), we have
  known as chondroprotectors – slow down degenerative processes in
  cartilage,
  improve her recovery.
• products based on hyaluronic acid, vitamins, etc. – auxiliary
  drugs that replenish the deficiency of joint fluid, improve metabolism and
  regeneration inside
  joint.

Thus, any blockade is a complex effect on the affected area.

What are the advantages of therapeutic blockades?

• High-quality and fast analgesic effect. The drug works
  directed towards the source of pain.
• Low risk of side effects. The drug enters the bloodstream only after
  finding the source of the pain syndrome.
• Good therapeutic effect.
• Ability to relieve vascular and muscle spasm, inflammation in the focus.
• You can inject multiple times – with each outbreak of pain.
• Restoration of tissue trophism and removal of edema.

Will there be any restrictions after the injection?

It is not recommended to immediately exert yourself heavily physically, which
often happens because people get rid of pain. If you are not careful about the plan
physical activity, the symptoms will return and be more severe.

What side effects should be expected after injections?

Therapeutic blockades are distinguished by an extremely low percentage of complications – 0.5%. It may
be a reaction to drugs, symptoms of intoxication (vomiting, dizziness,
palpitations), vascular damage at injection sites. To prevent
complications, additional drugs are administered, and after the procedure, the patient
it is recommended to lie down for 1-2 hours.

Blockades of the spine may cause bleeding, infection of the puncture,
damage to the internal membranes, soft tissues. The latter is usually associated with
doctor’s inexperience.
Anaphylactic shock may also develop.