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Neurology, Neuropsychiatry, Psychosomatics

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Some topical problems in the diagnosis and treatment of back pain

https://doi.org/10.14412/2074-2711-2010-112

Abstract

Back pain is a topical problem for both a general practitioner and a neurologist because of not only the high rate of this syndrome, but also its differential diagnosis problems. As any clinical syndrome, back pain should be differentiated from very many other diseases. This is primarily determined by the tactics of the management and treatment of a patient with neck-and-chest or low back pain. Today the diagnosis of spinal osteochondrosis may be rather common as that of exclusion. A meticulous neurological examination is of importance when diagnosing back pain. A premium is also placed upon X-ray and neuroimaging studies. When back pain is treated, it is necessary to take into account the intensity of pain syndrome, its proneness to chronicity, the individual personality traits, and concomitant visceral involvement and to use both drug and non-drug treatments, among which remedial exercises and psychotherapy are considered most effective.

About the Authors

B. M. Doronin
Novosibirsk State Medical University
Russian Federation


O. B. Doronina
Novosibirsk State Medical University
Russian Federation


References

1. <div><p>Справочник по формулированию клинического диагноза болезней нервной системы. Под ред. В.Н. Штока, О.С. Левина. М.: ООО МИА, 2006;520 с.</p><p>Данилов А.Б., Давыдов О.С. Нейропатическая боль. М.: Боргес, 2007;192 с.</p><p>Rubin D.I. Epidemiology and risk factors for spine pain. Neurol Clin 2007;25(2):353-71.</p><p>Подчуфарова Е.В., Яхно Н.Н. Боль в спине. М.: ГЭОТАР-Медиа, 2010;368 с.</p><p>Dionne C.E., Von Korff M., Deyo R.A. et al. Formal education and back pain: a review. J Epidemiol Com Health 2001;55:455-68.</p><p>Breivik Н., Collett B., Ventafridda V. et al. Survey of chronic pain in Europe: Prevalence, impact on daily life, and treatment. Eur J Pain 2006;10:287-333.</p><p>Leino P., Magni G. Depressive and distress symptoms as predictors of low back pain, neckshoulder pain, and other musculoskeletal morbidity: a 10-year follow-up of metal industry employees. Pain 1993;53:89-94.</p><p>Linton S.J. A review of psychological risk factors in back and neck pain. Spine 2000;25:1148-56.</p><p>Main C.J., Nicholas M.K., Watson P.J. Back pain. Pain 2008 an updated review. IASP Press, 2008;395-407.</p><p>Treede R.D., Jensen T.S., Campbell J.N. et al. Neuropathic pain: redefinition and a grading system for clinical and research purposes. Neurology 2008;70(18):1630-5.</p><p>Freynhagen R., Baron R., Gockel U. et al. PainDetect: a new screening questionnaire to detect neuropathic components in patients with back pain. Curr Med Res Opin 2006;22:1911-20.</p><p>Kaki A., El-Yaski A., Youseif E. Identifying neuropathic pain among patients with chronic low back pain: use of the Leeds Assessment of Neuropathic Symptoms and signs pain scale. Reg Anesth Pain Med 2005;30(5):422-8.</p><p>Яхно Н.Н., Кукушкин М.Л., Давыдов О.С. и др. Результаты Российского эпидемиологического исследования распространенности невропатической боли, ее причин и характеристик в популяции больных, обратившихся к врачу-неврологу. Боль 2008;3:24-32.</p><p>Freynhagen R., Rolke R., Baron R. Pseudoradicular and radicular low-back pain - a disease continuum rather than different entities? Answers from quantitative sensory testing. Pain 2008;135(1-2):65-74.</p><p>Есин Р.Г., Файзуллин Р.И., Рогожин А.А. и др. Клиническая миология. Казань: Фэн, 2003;272 с.</p><p>Coste J., Delecoeuillerie G., Cohen de Lara A. et al. Clinical course and prognostic factors in acute low back pain: an inception cohort study in primary care practice. BMJ 1994;308:577-80.</p><p>Kinkade S. Evaluation and treatment of acute low back pain. American Family Physician 2007;75(8):1181-8.</p><p>Павленко С.С. Боли в нижней части спины. Новосибирск: Сибмедиздат НГМУ, 2007;172 с.</p><p>Эрдес Ш.Ф. и др. Неспецифическая боль в нижней части спины. Клинические рекомендации для участковых терапевтов и врачей общей практики. М.: КомплектСервис, 2008;70 с.</p><p>Shen F.H., Samartzis D., Andersson G.B. Nonsurgical management of acute and chronic low back pain. J Am Acad Orthop Surg 2006;8:477-87.</p><p>Haldeman S., Dagenais S. What have we learned about the evidence-informed management of chronic low back pain? The Spine J 2008;8:266-77.</p><p>Подчуфарова Е.В., Яхно Н.Н. Боли в спине и конечностях. В кн.: Болезни нервной системы: Рук-во для врачей. Под ред. Н.Н. Яхно. М., 2005;2:306-31.</p><p>Bogduk N., McGuirk B. Medical management of acute at chronic low back pain. Amsterdam: Elsevier, 2002.</p><p>Burton A.K., Balague F., Cardon G. et al., for the COST B13 Working Group on European Guidelines for Prevention in Low Back Pain. How to prevent low back pain. Best Pract Res Clin Rheumatol 2005;19:541-55.</p><p>Russo R.B. Diagnosis of low back pain: role of imaging studies. Clin Occup Environ Med 2006;5:571-89.</p><p>Carragee E.J. Clinical practice. Persistent low back pain. N Engl J Med 2005;352:1891-8.</p><p>Chou R., Huffman L.H. Nonpharmacologic therapies for acute and chronic low back pain: a review of the evidence for an American Pain Society/American College of Physicians clinical practice guideline. Ann Intern Med 2007;147:492-504.</p><p>Shen F.H., Samartzis D., Andersson G.B. Nonsurgical management of acute and chronic low back pai. J Am Acad Orthop Surg 2006;8:477-87.</p><p>Dugan S.A. The role of exercise in the prevention and management of acute low back pain. Clin Occup Environ Med 2006;5:615-32.</p><p>Hayden J.A., van Tulder M.W., Malmivaara A. et al. Exercise therapy for treatment of nonspecific low back pain. Cochrane Database Syst Rev 2005;3:CD000335.</p><p>Van Tulder M.W., Touray T., Furlan A.D. et al. Muscle relaxants for non-specific low back pain. Cochrane Database Syst Rev 2003;2:CD004252.</p><p>Ласло Х., Мелинда М., Жолт С. и др. Лечение острой поясничной боли Мидокалмом. Результаты международного мульти-центрового рандомизированного двойного слепого плацебоконтролируемого клинического исследования. РМЖ 2003;5:246-9.</p><p>Dulin J., Kovacs L., Ramm S. et al. Evaluation of sedative effects of single and repeated doses of 50 mg and 150 mg tolperisone hydrochloride. Results of a prospective, randomized, double-blind, placebo-controlled trial. Pharmacopsychiat 1998;31:137-42.</p><p>Pratzel H.G., Alken R.-G., Ramm S. Efficacy and tolerance of repeated doses of tolperisone hydrochloride in the treatment of painful reflex muscle spasm: results of a prospective placebo-controlled double-blind trial. Pain 1996;67:417-25.</p><p>Гурак С.В., Парфенов В.А., Борисов К.Н. Мидокалм в комплексной терапии острой поясничной боли. Боль 2006;3:27-30.</p></div><br />


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ISSN 2074-2711 (Print)
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