nnpNeurology, Neuropsychiatry, PsychosomaticsНеврология, нейропсихиатрия, психосоматика2074-27112310-1342"IMA-Press", LLC10.14412/2074-2711-2026-2-74-78nnp-2818Research ArticleCLINICAL OBSERVATIONSКЛИНИЧЕСКИЕ НАБЛЮДЕНИЯTreatment of patients with comorbid pain syndromes: an effective and safe approachЛечение пациента с коморбидными болевыми синдромами: эффективный и безопасный подходhttps://orcid.org/0000-0002-2752-4109ГоловачеваВ. А.GolovachevaV. A.

Вероника Александровна Головачева

Институт клинической медицины им. Н.В. Склифосовского; кафедра нервных болезней 

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

Veronika Alexandrovna Golovacheva

N.V. Sklifosovsky Institute of Clinical Medicine; Department of Nervous Diseases

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

xoxo.veronicka@gmail.comhttps://orcid.org/0000-0002-2845-7323ГоловачеваА. А.GolovachevaA. A.

Институт клинической медицины им. Н.В. Склифосовского; кафедра нервных болезней 

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

N.V. Sklifosovsky Institute of Clinical Medicine; Department of Nervous Diseases

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

ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет)РоссияI.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)Russian Federation2026240420261827478Copyright © Golovacheva V.A., Golovacheva A.A., 20262026Головачева В.А., Головачева А.А.Golovacheva V.A., Golovacheva A.A.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/2818

   Patients with comorbid pain syndromes are frequently encountered in neurological practice. The management of patients with chronic musculoskeletal pain in the neck and back, and primary headaches, requires a comprehensive approach based on a combination of non-pharmacological methods and optimized pharmacotherapy. A clinical case is described of the effective management of a female patient suffering from chronic non-specific cervicobrachialgia, episodic tension-type headache involving the pericranial muscles, episodic migraine without aura, and increased anxiety. A comprehensive approach was used in the patient's management, which included optimal pharmacotherapy and a combination of non-pharmacological methods. Pharmacotherapy consisted of a stepwise course of Dexalgin (dexketoprofen). Non-pharmacological therapy included in-depth educational discussions with the patient about the condition, individual kinesiotherapy, and training in ergonomics. After 3 months of treatment, the patient's neck pain had subsided, tension-type headaches were no longer present, and the frequency of migraine attacks had significantly decreased. The improvements achieved were maintained throughout the one-year follow-up period. The optimization of the management of patients with comorbid pain syndromes is discussed.

   Пациенты с коморбидными болевыми синдромами часто встречаются в неврологической практике. Ведение пациента с хронической скелетно-мышечной болью в шее и спине, первичной головной болью требует комплексного подхода, который основан на сочетании нелекарственных методов и оптимизации лекарственной терапии. Описан клинический случай эффективного ведения пациентки, страдающей хронической неспецифической цервикобрахиалгией, эпизодической головной болью напряжения (ГБН) с вовлечением перикраниальных мышц, эпизодической мигренью без ауры и повышенной тревогой. При ведении пациентки применялся комплексный подход, который включал оптимальную лекарственную терапию и комбинацию нелекарственных методов. Лекарственная терапия состояла из ступенчатого курса приема препарата Дексалгин (декскетопрофен). Нелекарственная терапия включала расширенные образовательные беседы с пациенткой о заболевании, индивидуальную кинезиотерапию и обучение эргономике. Через 3 мес лечения у пациентки регрессировала боль в шее, не отмечалась ГБН, значимо снизилась частота приступов мигрени. Достигнутые улучшения сохранились в течение года наблюдения. Обсуждается оптимизация ведения пациентов с коморбидными болевыми синдромами.

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