Treatment of patients with comorbid pain syndromes: an effective and safe approach

   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.

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