Preview

Neurology, Neuropsychiatry, Psychosomatics

Advanced search

Chronic lower back pain: diagnosis and current principles of therapy

https://doi.org/10.14412/2074-2711-2019-4-147-152

Full Text:

Abstract

Chronic nonspecific lower back pain (LBP) is one of the most common causes of adult disability. The chronic course of back pain is often supported by the patient's unhealthy lifestyle and the use of ineffective treatments. The combination of cognitive behavioral therapy, therapeutic exercises, gradually increased physical activity, and rational pharmacotherapy are effective in most cases of chronic non-specific LBP. In this disease, nonsteroidal anti-inflammatory drugs (NSAIDs) are the first-choice drugs that should be prescribed in a short cycle. The choice of NSAIDs is determined by the presence of concurrent diseases in the patient and by the risk of developing adverse events. The paper discusses the efficacy and safety of meloxicam in non-specific NSAIDs.

About the Authors

V. A. Golovacheva
Department of Nervous System Diseases and Neurosurgery, I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation
11, Rossolimo St., Build. 1, Moscow 119021


A. I. Isaikin
Department of Nervous System Diseases and Neurosurgery, I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation
11, Rossolimo St., Build. 1, Moscow 119021


References

1. Vos T, Flaxman AD, Naghavi M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 disease and injuries 1990-2010: a systematic analysis for Global Burden of Disease Study 2010. Lancet. 2012 Dec 15;380(9859):2163-96. doi: 10.1016/S0140-6736(12)61729-2.

2. Airaksinen O, Brox JI, Cedraschi C, et al. Chapter 4. European guidelines for the management of chronic nonspecific low back pain. Eur Spine J. 2006 Mar;15 Suppl 2:S192-300.

3. Parfenov VA, Yakhno NN, Kukushkin ML, et al. Acute nonspecific (musculoskeletal) low back pain Guidelines of the Russian Society for the Study of Pain (RSSP). Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2018;10(2):4-11. (InRuss.) doi: 10.14412/2074-2711-2018-2-4-11

4. Henschke N, Maher CG, Refshauge KM, et al. Prognosis in patients with recent onset low back pain in Australian primary care: inception cohort study. BMJ. 2008 Jul 7;337:a171. doi: 10.1136/bmj.a171.

5. Wenig CM, Schmidt CO, Kohlmann T, et al. Cost of back pain in Germany. Eur J Pain. 2009 Mar;13(3):280-6. doi: 10.1016/j.ejpain.2008.04.005. Epub 2008 Jun 3.

6. Parfenov VA. Low back pain: causes, diagnosis, and treatment. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2009;1(1):19-22. (In Russ.) doi: 10.14412/2074-2711-2009-17

7. Parfenov VA. Diagnosis and treatment of back pain. Russkii meditsinskii zhurnal. 2004;(2):506. (In Russ.)

8. Parfenov VA, Isaikin AI. Bol' v nizhnei chasti spiny: mify i real'nost' [Low back pain: myths and reality]. Moscow: IMA-PRESS; 2016. 104 p.

9. Parfenov VA, Yakhno NN, Kukushkin ML, et al. Chronic nonspecific (musculoskeletal) low back pain. Guidelines of the Russian Society for the Study of Pain (RSSP). Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2019;11(2S):7-16. (In Russ.) doi: 10.14412/2074-2711-2019-2S-7-16

10. Oliveira CB, Maher CG, Pinto RZ, et al. Clinical practice guidelines for the management of non-specific low back pain in primary care: an updated overview. Eur Spine J. 2018 Nov;27(11): 2791-2803. doi: 10.1007/s00586-018-5673-2. Epub 2018 Jul 3.

11. Parfenov VA, Isaikin AI. Boli v poyasnichnoi oblasti [Low back pain]. Moscow: MEDpress-inform; 2018. 196 p.

12. Kalimeeva EYu, Parfenov VA. Optimization of the management of patients with nonspecific chronic low back pain. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2017;9(2):25-9. (In Russ.) doi: 10.14412/2074-2711-2017-2-25-29

13. Qaseem A, Wilt TJ, McLean RM, Forciea MA. Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 2017 Apr 4;166(7):514-530. doi: 10.7326/M16-2367. Epub 2017 Feb 14.

14. Van Middelkoop M, Rubinstein SM, Verhagen AP, et al. Exercise therapy for chronic nonspecific low-back pain. Best Pract Res Clin Rheumatol. 2010 Apr;24(2):193-204. doi: 10.1016/j.berh.2010.01.002.

15. Yamato T, Maher CG, Saragiotto BT, et al. Pilates for low back pain. Cochrane Database Syst Rev. 2015 Jul 2;(7):CD010265. doi: 10.1002/14651858.CD010265.pub2.

16. Low Back Pain and Sciatica in Over 16s: Assessment and Management. London: National Institute for Health and Care Excellence (UK); 2016 Nov. www.nice.org.uk/guidance/ng59

17. O'Connor SR, Tully MA, Ryan B, et al. Walking exercise for chronic musculoskeletal pain: systematic review and meta-analysis. Arch Phys Med Rehabil. 2015 Apr;96(4):724-734.e3. doi: 10.1016/j.apmr.2014.12.003. Epub 2014 Dec 19.

18. Machado LA, Maher CG, Herbert RD, et al. The effectiveness of the McKenzie method in addition to first-line care for acute low back pain: a randomized controlled trial. BMC Med. 2010 Jan 26;8:10. doi: 10.1186/1741-7015-8-10.

19. Sveinsdottir V, Eriksen HR, Reme SE. Assessing the role of cognitive behavioral therapy in the management of chronic nonspecific back pain. J Pain Res. 2012;5:371-80. doi: 10.2147/JPR.S25330. Epub 2012 Oct 11.

20. Beck JS, editor. Cognitive behavior therapy: basics and beyond. 2nd ed. New York: The Guilford Press; 2011. 394 p.

21. Kuritzky L, Samraj GP. Nonsteroidal antiinflammatory drugs in the treatment of low back pain. J Pain Res. 2012;5:579-90. doi: 10.2147/JPR.S6775. Epub 2012 Nov 28.

22. Kuijpers T, van Middelkoop M, Rubinstein SM, et al. A systematic review on the effectiveness of pharmacological interventions for chronic nonspecific low-back pain. Eur Spine J. 2011 Jan;20(1): 40-50. doi: 10.1007/s00586-010-1541-4. Epub 2010 Jul 31.

23. Parfenov VA. Back pain and their treatment with midocalm. Russkii meditsinskii zhurnal. 2009;(4):267-71. (In Russ.)

24. Parfenov VA. Muscle spasm in back pain. Pathogenesis, diagnosis and treatment. Russkii meditsinskii zhurnal. 2003;(10):590-3. (In Russ.)

25. Podchufarova EV, Yakhno NN. Bol' v spine [Back pain]. Moscow: GEOTAR-Media; 2010. 368 p.

26. Kassis A. Antidepressants to Treat Nonspecific Low Back Pain. Am Fam Physician. 2008 Jul 1; 78(1):51-2.

27. Henschke N, Kuijpers T, Rubinstein SM, et al. Injection therapy and denervation procedures for chronic low-back pain: a systematic review. Eur Spine J. 2010 Sep;19(9):1425-49. doi: 10.1007/s00586-010-1411-0. Epub 2010 Apr 29.

28. Xu S, Rouzer CA, Marnett LJ. Oxicams, a class of nonsteroidal anti-inflammatory drugs and beyond. IUBMB Life. 2014 Dec;66(12):803-11. doi: 10.1002/iub.1334. Epub 2014 Dec 23.

29. Garcia Rodriguez LA, Barreales Tolosa L. Risk of upper gastrointestinal complications among users of traditional NSAIDs and COXIBs in the general population. Gastroenterology. 2007 Feb; 132(2):498-506. Epub 2006 Dec 3.

30. Arfe A, Scotti L, Varas-Lorenzo C. Non-steroidal anti-inflammatory drugs and risk of heart failure in four European countries: nested case-control study. BMJ. 2016 Sep 28;354:i4857. doi: 10.1136/bmj.i4857.

31. McGettigan P, Henry D. Cardiovascular risk with non-steroidal anti-inflammatory drugs: systematic review of population-based controlled observational studies. PLoS Med. 2011 Sep;8(9): e1001098. doi: 10.1371/journal.pmed.1001098. Epub 2011 Sep 27.

32. Dreiser RL, Le Parc JM, Velicitat P, et al. Oral meloxicam is effective in acute sciatica: two randomised, double-blind trials versus placebo or diclofenac. Inflamm Res. 2001 Mar;50 Suppl 1:S17-23.

33. Colberg K, Hettich M, Sigmund R, et al. The efficacy and tolerability of an 8-day administration of intravenous and oral meloxicam: a comparison with intramuscular and oral diclofenac in patients with acute lumbago. German Meloxicam Ampoule Study Group. Curr Med Res Opin. 1996; 13(7):363-77.

34. Goei The HS, Lund B, Distel MR, et al. A double-blind, randomized trial to compare meloxicam 15 mg with diclofenac100 mg in the treatment of osteoarthritis of the knee. Osteoarthritis Cartilage. 1997 Jul;5(4):283-8.

35. Gerasimova ON, Parfenov VA, Kalimeeva EYu. Treatment of patients with acute and subacute dorsalgia. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2018;10(3):36–41. (In Russ.) doi: 10.14412/2074-2711-2018-3-36-41


For citation:


Golovacheva V.A., Isaikin A.I. Chronic lower back pain: diagnosis and current principles of therapy. Neurology, Neuropsychiatry, Psychosomatics. 2019;11(4):147-152. (In Russ.) https://doi.org/10.14412/2074-2711-2019-4-147-152

Views: 161


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2074-2711 (Print)
ISSN 2310-1342 (Online)