nnpNeurology, Neuropsychiatry, PsychosomaticsНеврология, нейропсихиатрия, психосоматика2074-27112310-1342"IMA-Press", LLC10.14412/2074-2711-2020-4-137-142nnp-1418Research ArticleREVIEWSОБЗОРЫTolperisone in the treatment of acute and chronic nonspecific back painТолперизон в лечении острой и хронической неспецифической боли в спинеГоловачеваВ. А.GolovachevaV. A.

Вероника Александровна Головачева

Кафедра нервных болезней и нейрохирургии Института клинической медицины

119021, Москва, ул. Россолимо, 11, стр. 1

Veronika Aleksandrovna Golovacheva

Department of Nervous System Diseases and Neurosurgery, Institute of Clinical Medicine

11, Rossolimo St., Build. 1, Moscow 119021

xoxo.veronicka@gmail.comГоловачеваА. А.GolovachevaA. A.

Кафедра нервных болезней и нейрохирургии Института клинической медицины

119021, Москва, ул. Россолимо, 11, стр. 1

Department of Nervous System Diseases and Neurosurgery, Institute of Clinical Medicine

11, Rossolimo St., Build. 1, Moscow 119021

ЗиновьеваО. Е.ZinovyevaO. E.

Кафедра нервных болезней и нейрохирургии Института клинической медицины

119021, Москва, ул. Россолимо, 11, стр. 1

Department of Nervous System Diseases and Neurosurgery, Institute of Clinical Medicine

11, Rossolimo St., Build. 1, Moscow 119021

ГолубевВ. Л.GolubevV. L.

Кафедра нервных болезней Института профессионального образования

111123, Москва, шоссе Энтузиастов, 86

Department of Nervous System Diseases, Institute of Professional Education

86, Shosse Entuziastov, Moscow 1111223

ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет)РоссияI.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of RussiaRussian Federation202027082020124137142Copyright © Golovacheva V.A., Golovacheva A.A., Zinovyeva O.E., Golubev V.L., 20202020Головачева В.А., Головачева А.А., Зиновьева О.Е., Голубев В.Л.Golovacheva V.A., Golovacheva A.A., Zinovyeva O.E., Golubev V.L.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://nnp.ima-press.net/nnp/article/view/1418

Nonspecific back pain (NBP) is one of the most common reasons to see a neurologist or therapist. Acute (<4 weeks' duration), subacute (4 to 12 weeks), and chronic (>12 weeks) NBPs are recognized. The diagnosis of NBP is based on anamnestic data, somatic, neurological, and neurologic-and-orthopedic examination findings and on the exclusion of the specific causes of back pain, discogenic radiculopathy, and vertebral canal stenosis. Nonsteroidal anti-inflammatory drugs (NSAIDs) and muscle relaxants are used in the pharmacotherapy of acute, subacute, and chronic NBP. Tolperisone is widely used as a muscle relaxant in Russia and in the countries of Europe and Asia. Clinical trials have shown the efficacy and good tolerance of tolperisone used alone and in combination with NSAIDs for NBP. The review presents clinical recommendations from different countries on the use of muscle relaxants in the treatment of acute and chronic NBP. It is concluded that a large-scale qualitative randomized trial should be conducted to investigate the efficacy of muscle relaxants, tolperisone in particular, in the treatment of acute, subacute, and chronic NBP.

Неспецифическая боль в спине (НБС) – одна из самых частых причин обращения к неврологу или терапевту. Различают острую (<4 нед), подострую (от 4 до 12 нед) и хроническую (>12 нед) НБС. Диагноз НБС устанавливается на основании анамнестических данных, результатов соматического, неврологического и нейроортопедического осмотра, исключения специфических причин боли в спине, дискогенной радикулопатии и стеноза позвоночного канала. При острой, подострой и хронической НБС в качестве фармакотерапии применяют нестероидные противовоспалительные препараты (НПВП) и миорелаксанты. В России, странах Европы и Азии в качестве миорелаксанта широко используется толперизон. Результаты клинических исследований показали эффективность и хорошую переносимость толперизона в виде монотерапии и в комбинации с НПВП при НБС. В обзоре представлены клинические рекомендации разных стран по использованию миорелаксантов при острой и хронической НБС. Сделан вывод о необходимости проведения большого качественного рандомизированного исследования по изучению эффективности миорелаксантов, в частности толперизона, в лечении острой, подострой и хронической НБС.

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The authors declare that there are no conflicts of interest present.